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DBT: Master Mindfulness & Validation (Part 2) · RECOVERable: Mental Health and Addiction Experts Answer Your Questions

0:13
SPEAKER_01: There is always going to be pain in life when we don't accept pain that turns it into suffering.
0:20
SPEAKER_00: Dr.
0:20
SPEAKER_00: Kiki Faling is a licensed psychologist, author, speaker, and expert in dialectical behavior therapy.
0:27
SPEAKER_01: Crisis survival skills give us something else to do.
0:30
SPEAKER_01: Often impulsive behaviors make things worse.
0:33
SPEAKER_02: Is there one of these skills that you think is most urgently needed by the average person navigating life at this particular time?
0:42
SPEAKER_01: Yeah, I would say that.
0:48
unknown: Dr.
0:48
SPEAKER_02: Kiki Feeling, welcome back.
0:50
SPEAKER_02: Thank you.
0:50
SPEAKER_02: Happy to be back.
0:51
SPEAKER_02: Thank you.
0:51
SPEAKER_02: And thanks for continuing this discussion because today we get to get into the skills, and that's what I'm really excited about.
0:56
SPEAKER_02: Me too.
0:57
SPEAKER_02: Before we do that, though, for anybody who wasn't watching or listening last week, when we introduced DBT, could you tell us again basically what it is and what it helps with?
1:07
SPEAKER_01: Yes.
1:08
SPEAKER_01: So DBT is dialectical behavior therapy.
1:11
SPEAKER_01: And it's a therapy that was designed to help people with borderline personality disorder deal with the intense emotional difficulties and impulsive behaviors that often come along with BPD.
1:22
SPEAKER_01: But it was designed to help emotion regulation difficulties in general.
1:26
SPEAKER_01: And so over the past few decades, more research has been done showing it to be helpful for PTSD, substance use disorders, eating disorders, anxiety, depression, basically all sorts of difficulties with emotions.
1:39
SPEAKER_01: And it just helps people better learn to handle the ups and downs of emotions that can happen in today's stressful world.
1:47
SPEAKER_02: And we hear phrase like emotional regulation or emotion regulation.
1:51
SPEAKER_02: And it sounds a little clinical, but it's what we're all doing every single day.
1:56
SPEAKER_01: Yeah.
1:56
SPEAKER_01: So emotion regulation, I would say, is just learning how to understand your emotions and then learning how to cope with them and work with them rather than ignore them or work against them.
2:08
SPEAKER_02: Yeah.
2:08
SPEAKER_02: Make them worse.
2:09
SPEAKER_02: Yes, exactly.
2:10
SPEAKER_02: We are going to jump into the four core skills of DBT.
2:14
SPEAKER_02: And I shared last week that in all my years of therapy, I have never been exposed to them.
2:20
SPEAKER_02: I'm going to be asking questions from the internet, the most asked questions that people have trying to research this online have asked.
2:27
SPEAKER_02: And I'm going to ask a whole bunch of mine because I'm really curious about these skills and how I could and anybody else watching or listening could use them in their own lives.
2:34
SPEAKER_02: Great.
2:35
SPEAKER_02: List them for me.
2:36
SPEAKER_02: What are the core skills of DBT?
2:38
SPEAKER_01: Yeah.
2:39
SPEAKER_01: So first I will say comprehensive DBT, like the full DBT therapy, is a combination of individual therapy, weekly skills group, and phone coaching, which we talked about last episode.
2:50
SPEAKER_01: So within that weekly skills group, over the course of a DBT skills group, you learn skills from four different modules.
2:57
SPEAKER_01: And those four modules are mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.
3:03
SPEAKER_01: And so we can walk through all four of those modules.
3:06
SPEAKER_02: I would love to.
3:07
SPEAKER_02: Great.
3:08
SPEAKER_02: Let's start with mindfulness if we can.
3:10
SPEAKER_01: Yeah.
3:10
SPEAKER_01: So mindfulness in DBT is being present, being present in this moment exactly as it is, without adding on judgments or evaluations on top of it.
3:23
SPEAKER_01: So really it's paying attention.
3:25
SPEAKER_01: It's being here, noticing what's coming into my uh my brain through my senses.
3:31
SPEAKER_01: What am I seeing, hearing, smelling, tasting, touching?
3:34
SPEAKER_01: And then what am I thinking?
3:36
SPEAKER_01: What am I feeling in my body?
3:37
SPEAKER_01: What emotions am I feeling?
3:38
SPEAKER_01: Just paying attention so that then I can better understand myself, better understand my emotions, and better understand like my inner wisdom.
3:49
SPEAKER_01: That's something we talk about in DBT a lot.
3:51
SPEAKER_01: How can I get in touch with my deepest intuition?
3:54
SPEAKER_01: That's a mindfulness skill too.
3:55
SPEAKER_01: And being present helps with that.
3:57
SPEAKER_02: The way you're describing it sounds so different than many of us hear the word where we think it's zen and sitting cross-legged on a cushion, you know, emptying our minds.
4:08
SPEAKER_02: It doesn't sound like you're emptying your mind at all when you're talking about this.
4:11
SPEAKER_01: No, no, no, no.
4:13
SPEAKER_01: Mindfulness, especially in DBT, is way more than meditation.
4:17
SPEAKER_01: It's much more accessible for a lot of people because we're not just going to ask you to sit on a mat and watch a breath.
4:24
SPEAKER_01: We may ask you to do that and you may choose to do that because it's helpful, but it's way, way bigger and way more uh creative and flexible than that.
4:32
SPEAKER_02: Give me an example.
4:34
SPEAKER_02: So maybe even right now, sitting here under lights with cameras rolling, if you're being mindful, what are you currently experiencing?
4:42
SPEAKER_01: Yeah.
4:42
SPEAKER_01: So right now, if I practice one of actually, I I guess I'd be practicing two of the DBT mindfulness skills called the what skills.
4:51
SPEAKER_01: So the first what skill is observe.
4:54
SPEAKER_01: Can I notice what's in my present moment awareness?
4:58
SPEAKER_01: And then the second what skill is describe.
5:00
SPEAKER_01: Can I put words to my experience?
5:03
SPEAKER_01: So right now, I observe the feeling of pressure on the bottom of my toes against the floor.
5:10
SPEAKER_01: I feel the pressure on the back of my legs against the seat.
5:13
SPEAKER_01: I feel a slight patter of my heart in my chest because podcasts are anxiety provoking.
5:20
SPEAKER_01: And then I'm putting words on that experience.
5:22
SPEAKER_01: Like even that idea that podcasts are anxiety provoking, that's a thought I'm having in response to the beating in of my heart that I feel.
5:30
SPEAKER_01: So that's an example of just like literally right now.
5:33
SPEAKER_01: Can I practice?
5:34
SPEAKER_01: And yeah, I did.
5:35
SPEAKER_02: What are other mindfulness practices that you teach?
5:39
SPEAKER_01: So another mindfulness what skill is participate.
5:42
SPEAKER_01: This is throwing yourself into the present moment.
5:45
SPEAKER_01: So this is just like what we would say one mindfully being here and doing what you're doing.
5:51
SPEAKER_01: So right now, I can't imagine I could be thinking about what I'm doing next because I feel very involved with you.
5:58
SPEAKER_01: But if I'm sitting in a classroom, like I'm if I'm in class, maybe it's harder to pay attention.
6:03
SPEAKER_01: And if I am thinking about, oh my God, what am I eating for dinner tonight?
6:06
SPEAKER_01: And oh, I have to go to that doctor tomorrow.
6:09
SPEAKER_01: Am I ready for that?
6:10
SPEAKER_01: That's not being present, listening in class.
6:13
SPEAKER_01: So participate is another mindfulness skill of getting experience and practice, throwing yourself into what you're doing and only doing that.
6:22
SPEAKER_02: Which sounds lovely if the moment's lovely.
6:26
SPEAKER_02: And it sounds pretty awful if the moment seems awful.
6:30
SPEAKER_02: But maybe that's a judgment I'm putting on it.
6:32
SPEAKER_01: Oh, I love that you caught that.
6:34
SPEAKER_01: I was thinking awful might be a judgment, but we can 100% validate and behaviorally describe, which is that mindfulness describe skill, of it's painful or is it boring, or does it feel unpleasant in my body, or is it making me anxious in my head?
6:53
SPEAKER_01: So um, can we describe what makes it awful?
6:56
SPEAKER_01: And like, yes, it's often uncomfortable for people who are not used to practicing it.
7:01
SPEAKER_01: Yes.
7:02
SPEAKER_02: So if I'm in this moment and I'm saying, I'm feeling anxious and I'm feeling pressure, and there are cameras everywhere and lights everywhere, and I want to do a good job, and I can make that feel kind of frenetic in my body if I if I follow those thoughts.
7:17
SPEAKER_02: Being mindful of that wouldn't change what I'm feeling.
7:21
SPEAKER_01: You can even say, Oh, I notice I'm having thoughts that I want to do well, or I notice I'm telling a story that I'm not doing well.
7:32
SPEAKER_01: Like it's kind of adding that additional describe on of rather than, oh, I'm not doing well, saying, Oh, I'm having the thought I'm not doing well.
7:40
SPEAKER_01: And so um it might just just be a noticing of can I see where I'm adding on usually with my thoughts and adding on stories, like I said, and come back to what is here now.
7:51
SPEAKER_01: There are bright lights.
7:53
SPEAKER_01: I do care about how this conversation goes.
7:57
SPEAKER_01: Like I notice I want this to go well.
7:59
SPEAKER_01: But what does that mean?
8:00
SPEAKER_01: And so right now, I probably wouldn't dive into understanding that because I just want to be here with you having this conversation.
8:06
SPEAKER_01: But if this is a problem for me, if I'm often noticing I'm having judgments about myself in podcasts, later I might think like, okay, what does it mean to do well, quote unquote, and try to unpack that for myself in a behaviorally described type of way?
8:20
SPEAKER_01: I want to feel happy at the end of it because and I'll feel happy, I think, if I'm present and I'm listening and I ask questions that I learn something from.
8:30
SPEAKER_02: To say I'm having a thought of anxious or or whatever the next word is going to be, is that a skill to separate a little bit from it?
8:41
SPEAKER_01: I think it's to see that it is already separate.
8:45
SPEAKER_01: It's not to make it separate, it's to see it for what it is.
8:48
SPEAKER_01: That a thought is adding on to what is happening in this moment.
8:52
SPEAKER_01: A thought is happening in this moment, but it's more than the bright lights and our conversation.
8:58
SPEAKER_02: Interesting.
8:58
SPEAKER_02: Okay, so what is distress tolerance in DBT?
9:02
SPEAKER_01: Distress tolerance is the module from DBT that teaches us how to cope during the most difficult parts of life.
9:09
SPEAKER_01: So when we're facing intense pain, distress tolerance skills are often going to come in to help us like tolerate that distress.
9:16
SPEAKER_01: So there's two different sets of distress tolerance skills.
9:19
SPEAKER_01: One of them is called reality acceptance.
9:21
SPEAKER_01: And these are skills for yeah, I see your face.
9:24
SPEAKER_01: It's a lot, it's very difficult.
9:26
SPEAKER_01: One of the things that makes it hard can be just even understanding what it means to accept reality.
9:31
SPEAKER_01: So maybe to make it a little bit more concrete, like the main skill in reality acceptance is a skill called radical acceptance.
9:38
SPEAKER_01: Radical in the sense of like with your full body, mind, and soul, can you acknowledge reality for what it is?
9:45
SPEAKER_01: So a concrete skill to practice acceptance with your body, for example, is to practice another reality acceptance skill called willing hands, where you literally, for folks watching, they can see me right now.
9:58
SPEAKER_01: I'm placing my hands open on the table, palms up.
10:02
SPEAKER_01: And just this physical expression of like openness can help some people.
10:08
SPEAKER_01: So often, non-acceptance is feels like very tense and frustrated and frustrated, yeah, very closed.
10:16
SPEAKER_01: And so the idea is with my body, can I open instead?
10:20
SPEAKER_01: And that can just be one of the concrete steps.
10:23
SPEAKER_01: It's not going to be enough alone, to be clear, but it's one of the skills that can help with, okay, can I be here now in this moment exactly as it is, even when I hate it?
10:31
SPEAKER_02: And that is a key point, even though I hate it, sort of like forgiving isn't forgetting its rememory and letting go.
10:36
SPEAKER_02: Acceptance does not mean I like it.
10:38
SPEAKER_02: Right.
10:39
SPEAKER_02: We're in no way surrendering to like, yeah, this is just the way it is.
10:42
SPEAKER_02: No.
10:43
SPEAKER_01: Right.
10:44
SPEAKER_01: Acceptance does not mean approval.
10:46
SPEAKER_01: That's a really big thing.
10:47
SPEAKER_01: And acceptance does not mean giving up.
10:49
SPEAKER_01: Those are the two things that come up often in when I teach this to clients.
10:53
SPEAKER_01: The way I we normally put it is like, there is always going to be pain in life when we don't accept pain, that turns it into suffering because I'm ruminating and worrying and judging and denying and suppressing and causing all of this turmoil and misery on top of pain.
11:13
SPEAKER_01: Meanwhile, pain plus acceptance is pain.
11:17
SPEAKER_01: Still not easy sometimes, maybe ever, but much more tolerable than suffering.
11:25
SPEAKER_02: So pain without acceptance is suffering.
11:28
SPEAKER_02: Pain with acceptance is pain.
11:31
SPEAKER_02: Yeah.
11:32
SPEAKER_02: But maybe a little less, maybe a little shifted.
11:35
SPEAKER_01: Well, it depends who you you ask.
11:37
SPEAKER_01: I think that for me personally, as I've practiced this more, it does inherently feel less.
11:42
SPEAKER_01: Like it's the exact same pain.
11:44
SPEAKER_01: But as soon as you feel capable of staying open and soft to it, and I know that might sound terrifying for people who don't have experience with this, but with practice, as you stay open to pain, it becomes less scary.
11:58
SPEAKER_01: It becomes much easier to feel.
12:01
SPEAKER_01: And that is often the goal with a lot of these skills, just being with what's here, including pain.
12:07
SPEAKER_02: I am not equating this little example I'm gonna give to life's pains because I'm not that naive.
12:13
SPEAKER_02: But the metaphor, and that's how my brain works.
12:16
SPEAKER_02: I'm thinking of when you are stuck in a traffic jam and you have to get somewhere important, and it's like there, you're not gonna get there.
12:22
SPEAKER_02: You're not gonna move.
12:23
SPEAKER_02: You can see what's ahead, you can see the emergency vehicles, whatever.
12:26
SPEAKER_02: Your little GPS is showing just red all the way to where you're trying to go.
12:30
SPEAKER_02: And you can sit there and curse and bonk and do all the things that make you feel awful inside, or you can say, I'm not gonna make it.
12:40
SPEAKER_02: Either way, you are literally in the same place.
12:43
SPEAKER_02: But one way you are all wound up to.
12:46
SPEAKER_02: Yeah.
12:47
SPEAKER_02: So I again, I'm not trying to equate life's pains with being stuck in a traffic jam, but that's what was coming to mind.
12:53
SPEAKER_02: Is it that same kind of thing, just choosing to like not like, oh well, because we don't do that with real life pains.
13:00
SPEAKER_02: Yeah.
13:01
SPEAKER_02: But it's like, I am grieving because I lost someone or something.
13:05
SPEAKER_02: There's no way out of that.
13:06
SPEAKER_02: There's you know, other than through, but I can make it worse.
13:10
SPEAKER_01: Yes.
13:10
SPEAKER_01: You just brought up two of the most common examples I give when teaching this traffic jam and death of a loved one.
13:18
SPEAKER_01: Oh, they're both things that are the way they are and are super painful, but in very different ways, obviously.
13:26
SPEAKER_01: Yes.
13:27
SPEAKER_01: And there is nothing to do about them.
13:30
SPEAKER_01: No matter how much we fight or ignore or deny or sue, we're in the traffic jam or we've lost this person.
13:39
SPEAKER_01: And so all of a sudden, acceptance allows us to be there and to be okay, even though there is pain or difficulty.
13:48
SPEAKER_01: And obviously, these are two are very different.
13:50
SPEAKER_01: Yes.
13:50
SPEAKER_01: Grief is going to be very, very painful no matter how much you accept it.
13:54
SPEAKER_01: Yes.
13:55
SPEAKER_01: Traffic jam may actually be okay.
13:57
SPEAKER_01: If you accept it and turn on your favorite podcast, all of a sudden it's a very different conversation that you're having with yourself, I guess.
14:03
SPEAKER_01: Of uh it just makes it so much more bearable.
14:06
SPEAKER_01: And okay, here I am, right?
14:08
SPEAKER_01: In traffic.
14:09
SPEAKER_01: Once again, here I am.
14:10
SPEAKER_01: My flight's delayed.
14:11
SPEAKER_01: It's raining and I didn't want it to be, right?
14:13
SPEAKER_01: No matter how much we fight or don't want to be in traffic or want our flight to be delayed or want it to be raining for whatever reason, it is.
14:19
SPEAKER_01: So how can we dance in the rain?
14:21
SPEAKER_01: How can we listen to music and have fun while we're in traffic, et cetera?
14:25
SPEAKER_01: And then with grief, because it's much more serious, right?
14:28
SPEAKER_01: We're not gonna have fun necessarily.
14:31
SPEAKER_01: But maybe then we get to, for fully acknowledging what's real, we get to fully connect with our loved ones who are still here and talk about that person to be there for one another, to connect, to support one another.
14:44
SPEAKER_01: And then we grow in intimacy, not only with the people who we still have, but even like with that person who's past, because we're remembering them and fully appreciating the life that they had rather than pretending like it didn't happen or stomping our feet about the truth and getting distracted from the beauty that was there.
15:01
SPEAKER_01: We're not able to enjoy that anymore, that memory, if we're like tense and denying.
15:07
SPEAKER_01: And yeah, it doesn't mean we're not despondent, but there's a there's a different feeling.
15:11
SPEAKER_01: But then the second category of skills can often help even more with that like intense pain.
15:17
SPEAKER_01: Right now, I am upset.
15:18
SPEAKER_01: These skills are called the crisis survival skills.
15:21
SPEAKER_01: So when life throws something super stressful at us and we feel intense emotions or we have urges to use substances or urges to engage in other impulsive behaviors, crisis survival skills give us something else to do.
15:36
SPEAKER_01: Often impulsive behaviors make things worse.
15:39
SPEAKER_01: Maybe they make us feel better in the short term, but then they cause us long-term problems.
15:43
SPEAKER_01: So these skills are meant to give us options for feeling better now, or at least not making things worse for ourselves without adding on to like more problems in the long term.
15:54
SPEAKER_01: They're coping sales, really.
15:56
SPEAKER_02: I'm thinking of I used to be a listener at a hotline, a crisis hotline, and when a caller would call.
16:03
SPEAKER_02: And by the end of the call, the goal was to have them in a different place, certainly a safer one.
16:07
SPEAKER_02: And we would ask what the plan was to get through the night safely.
16:12
SPEAKER_02: And I was very surprised how often it was uh I'm gonna take a bath, I'm gonna watch cat videos.
16:19
SPEAKER_02: I I would never have thought cat videos could be a suicide prevention.
16:22
SPEAKER_02: Huge, but it's a distraction that pleases you, you know, that in some way is feeding you.
16:29
SPEAKER_02: And you're not thinking about whatever horrible thing you were thinking about.
16:33
SPEAKER_02: Right.
16:34
SPEAKER_02: And is distraction one of those skills?
16:36
SPEAKER_01: Yeah, it actually is.
16:37
SPEAKER_01: So there's a full acronym in DBT WISEMID accepts A C C E P T S all stands for different types of things you can do to help yourself distract from difficult, painful moments.
16:49
SPEAKER_01: So the first one, A, for example, is activities.
16:52
SPEAKER_01: So these are very stereotypical distraction with like hobbies like reading a book or watching cat videos that people can do to get their mind off of something and maybe even feel some pleasure, although that's not the goal.
17:04
SPEAKER_01: The goal with all distress tolerance skills is to just get through this moment again, without acting impulsively in ways that would make things worse.
17:13
SPEAKER_01: Uh, one of my other favorites is the S for sensations.
17:17
SPEAKER_01: So the last one of accepts.
17:18
SPEAKER_01: Uh, this is often what folks call like grounding skills.
17:22
SPEAKER_01: So often, as we're talking about, emotions are so fueled by these like racing thoughts or spiraling worry and rumination.
17:29
SPEAKER_01: And a lot of times it can be so helpful just to come out of your head and into your body by using physical sensations.
17:36
SPEAKER_01: So even something like um splashing cold water on your face or eating something sour to like, or stomping your feet on the ground, just doing anything that gets you into your body out of your head uh can be an incredibly useful distraction uh technique.
17:53
SPEAKER_02: It doesn't sound like something that easy should be able to help in what you're calling like really painful moments.
18:02
SPEAKER_01: So again, this is where we throw, we offer to you lots and lots of skills to choose from.
18:09
SPEAKER_01: I would say sensations, yeah, is not often going to be the one that's going to get you through a moment completely, but it can come in and interrupt that thought cycle and like give you that second pause so that you can then choose to do another coping skill that like the activities, like the pleasant activities that might be a little bit more pleasant and maintaining and easier to do across the difficult moment.
18:33
SPEAKER_02: And this will be a very personalized thing.
18:36
SPEAKER_02: There are things that are going to work for me that don't work for you and somebody watching or listening.
18:40
SPEAKER_02: You have brought along one of your personalized distress tolerant kits.
18:45
SPEAKER_02: Yeah.
18:45
SPEAKER_02: It has some things in it that you use.
18:47
SPEAKER_02: And I want to know what's in that cute bag.
18:49
SPEAKER_02: I also want to know how and when you would use the things that you choose to share with us.
18:54
SPEAKER_01: Yeah, absolutely.
18:55
SPEAKER_01: So to be clear, this bag, this is called a distress tolerance kit, and it's full of tools that I use to cope with difficult situations.
19:04
SPEAKER_01: All of these things, these tools that I'm gonna introduce, are part of that like second category of distress tolerance skills.
19:11
SPEAKER_01: And these skills are called crisis survival skills.
19:13
SPEAKER_01: So, like when life is really hard, like maybe in the traffic jam and maybe after the death of a loved one, when that pain of grief or anything else is really strong, how can we just make it easier for ourselves to live in that moment?
19:28
SPEAKER_01: How can we cope with the pain without acting on impulsive urges that make it worse for us in the long term, like using drugs or self-destructive urges or just dissociation, all sorts of things?
19:40
SPEAKER_01: So distress tolerant uh crisis survival skills are uh an option for what we do when life is hard and we can't make change.
19:49
SPEAKER_01: So in this bag, I have lots of different toys and tools and things like that.
19:54
SPEAKER_01: The first thing I pull out is a little stuffed animal.
19:57
SPEAKER_01: Um uh so this one, it's a chickadee for those not watching.
20:01
SPEAKER_01: I'm birder and I love birds, and this was a gift from my partner.
20:05
SPEAKER_01: This is kind of a way to self-soothe.
20:08
SPEAKER_01: Like he's very soft and he makes me happy thinking about my partner and thinking about birding.
20:13
SPEAKER_01: So, for example, this just might be a way to distract and self-soothe, which are two different uh coping skills from DBT that can help you not necessarily feel better about something that's upsetting you, but can help you get through that difficult moment.
20:29
SPEAKER_01: Uh, something else I have in here is I have um actually some coping cards.
20:35
SPEAKER_01: Uh, the one I have is a card that is called coping statements for shame or self-criticism.
20:42
SPEAKER_01: So this is an example of when I use this kit the most.
20:45
SPEAKER_01: Like shame and self-criticism is a thing that I personally struggle with still the most.
20:50
SPEAKER_01: So when I'm feeling self-critical or going down uh like a rabbit hole over rejection sensitivity, like feeling like, oh, that was silly, or this person thinks I'm stupid, or all of these thoughts, right?
21:04
SPEAKER_01: I shouldn't have said that.
21:06
SPEAKER_01: Um, these coping statements act like another skill that we call self-encouragement, which is a part of a bigger acronym of improve the moment, which is a whole bunch of other skills for crisis survival.
21:20
SPEAKER_01: But uh, so for example, on this card is emotions always make sense, they always have triggers.
21:25
SPEAKER_01: Uh, taking time for self-care does not make me lazy.
21:28
SPEAKER_01: It's okay to be a work in progress, perfection is not possible.
21:33
SPEAKER_01: So, not all of these are always needed all the time, but it's a way to practice self-encouragement.
21:38
SPEAKER_02: And if you read those words, one of them would resonate with you in the circumstance.
21:43
SPEAKER_02: You actually feel different and better as a result of it, or it just shifts your mind a little.
21:47
SPEAKER_02: How does it work?
21:48
SPEAKER_01: Great question.
21:49
SPEAKER_01: Uh, probably depends on the moment.
21:51
SPEAKER_01: Sometimes that reminder of perfection is not possible.
21:54
SPEAKER_01: I'm like, ah, thank you.
21:56
SPEAKER_01: Like in and other times when I'm not upset, I know that's true.
21:59
SPEAKER_01: Right.
21:59
SPEAKER_01: And having that knowledge and that memory comes into this moment when I'm upset and I read that.
22:05
SPEAKER_01: And so I might it might not make me feel better right now because in my emotion mind, I don't believe it.
22:11
SPEAKER_01: But then there's another part of me.
22:13
SPEAKER_01: That remembers that that's true and it makes it like it loosens it again just a little bit.
22:18
SPEAKER_01: It's almost like radical radical acceptance, just like minute changes.
22:22
SPEAKER_01: And then all of the skills together, you just keep making small changes to get further and further away from the pain or away from the impulsive urge.
22:31
unknown: Okay.
22:31
SPEAKER_01: So other skills I have, I'm just gonna throw it out.
22:34
SPEAKER_01: So I have a lacrosse ball.
22:36
SPEAKER_01: I love pressure.
22:36
SPEAKER_01: This is for massaging.
22:38
SPEAKER_01: You can also throw it around, but that's not really my jam.
22:40
SPEAKER_01: Um, but I massage my back with it.
22:42
SPEAKER_01: The pressure feeling is a sensation that distracts me for sure from my thoughts.
22:46
SPEAKER_01: I don't know if you've ever massaged with a lacrosse ball.
22:48
SPEAKER_02: No.
22:49
SPEAKER_01: Okay.
22:49
SPEAKER_01: We maybe we can do it after the podcast.
22:51
SPEAKER_01: It's um very distracting in a way that I find pleasurable, but it's just it's very hard to think when you're massaging yourself with a lacrosse ball.
22:58
SPEAKER_01: So that's really helpful for self-criticism thoughts.
23:00
SPEAKER_01: Okay.
23:01
SPEAKER_01: Also in here, I have like a journal, I have ginger chews, I have fidget toys, I have um, yeah.
23:07
SPEAKER_01: Do you want to feel this?
23:09
SPEAKER_01: This is my favorite.
23:10
SPEAKER_01: It's like little magnets that feel like kinetic sand.
23:12
SPEAKER_01: If you've heard of that, I have.
23:14
SPEAKER_02: It's a good one.
23:15
SPEAKER_01: Yeah.
23:15
SPEAKER_01: And then I have a bracelet that was given to me that says embrace uncertainty.
23:20
SPEAKER_01: So it's almost like I'm another self-encouragement mantra that helps me sometimes.
23:24
SPEAKER_01: I was actually wearing this bracelet when I was in the hospital um a few months ago with my father, who had recently had a health event, and we were waiting for test results to come back.
23:35
SPEAKER_01: And it was just miserable.
23:36
SPEAKER_01: Like it could go that way, it could go that way, 10,000 things could happen.
23:39
SPEAKER_01: And I noticed my brain trying to think about all of the ways this could go, and then realizing that that worry was taking me away from being with my dad right then in that moment.
23:50
SPEAKER_01: So this bracelet was really helpful of like reminding of be here now and use this coping skill of like self-accept, um, self-encouragement and participate and connect with my dad rather than being stuck in worries and adding on suffering.
24:03
SPEAKER_02: Adding on suffering because there was an acceptance.
24:05
SPEAKER_02: Got it.
24:06
SPEAKER_02: So I in no way mean to challenge what works for you.
24:09
SPEAKER_02: Oh no, with this question.
24:11
SPEAKER_02: I do think there will be somebody watching saying, uh-huh.
24:15
SPEAKER_02: Crisis and a stuffed bird.
24:18
SPEAKER_02: So how, so how?
24:21
SPEAKER_02: I'll just stop right there.
24:22
SPEAKER_01: I am really glad you pushed back because this kit is what I need for myself right now at this point in my life.
24:29
SPEAKER_01: What I will say is this stuff wouldn't have been enough for me a decade ago.
24:33
SPEAKER_01: Maybe this would have helped, but it would have been in addition to other more intense skills.
24:37
SPEAKER_01: Specifically, the one that really worked for me back in the day and still works when I need it, but works brilliantly for clients struggling with suicidal thoughts, suicidal urges, cravings for drugs, like the really intense, like I feel on fire feeling, right?
24:54
SPEAKER_01: Is a skill called tip your temperature.
24:57
SPEAKER_01: So this is one where you get a bowl or a sink and you fill it with water and fill it with ice water specifically, and then you put your face in the in the bowl.
25:08
SPEAKER_01: You dunk your face in this bowl of water.
25:10
SPEAKER_01: Okay.
25:10
SPEAKER_01: Very intense, very strange.
25:12
SPEAKER_01: A lot of people are like, there's no way I'm doing that.
25:15
SPEAKER_01: But then once you do it the first time, it really, really works.
25:19
SPEAKER_01: It activates something called the mammalian dive reflex and slows your heart rate down.
25:24
SPEAKER_01: So beyond being like a grounding physical sensation, it actually resets your nervous system and helps you kind of bring that intense level of agitation down just a little bit to help you then access and use other coping skills and decide what you want to do.
25:40
SPEAKER_01: And tip your temperature is just one of four nervous system regulation skills from DBT.
25:45
SPEAKER_01: So, yeah, there are other things that we have available to you when you're talking about the stuff that, like, yeah, the stuffed bird is not going to cut it.
25:52
SPEAKER_02: Tell me, again, I no disrespect to your stuffed bird.
25:55
SPEAKER_02: Tell me some of the other three.
25:57
SPEAKER_02: So some other things that might help when you really are in of the nervous system regulation skills.
26:02
SPEAKER_01: Okay.
26:02
SPEAKER_01: So to be clear, I do think the cold water skill, tip your temperature, is the most helpful one.
26:08
SPEAKER_01: But the other four things.
26:09
SPEAKER_02: And is it a quick dip, or do you kind of hang out here?
26:11
SPEAKER_02: You hang out there.
26:12
SPEAKER_01: Yeah, you stick your face in the water and you stay there.
26:16
SPEAKER_01: You're supposed to stay there for 30 seconds, according to the manual.
26:19
SPEAKER_01: That's a long time to hold your breath, especially when you're panicking.
26:21
SPEAKER_01: Yeah.
26:22
SPEAKER_01: So you might do it short for the first time, but then you can keep doing it.
26:26
SPEAKER_01: But like just to be clear, this skill is so effective.
26:30
SPEAKER_01: Like it lowers your heart rate.
26:32
SPEAKER_01: And I mentioned this because not only emphasizing that it works, but like if you have heart problems or other medical issues, you actually should ask your doctor before using this skill.
26:43
SPEAKER_01: And so I share that not only for safety concern, but to say, like, try this if you if you struggle, because it's very, very effective.
26:51
SPEAKER_02: Thanks.
26:51
SPEAKER_02: Give me one more of them.
26:52
SPEAKER_01: Yeah.
26:53
SPEAKER_01: So the other tip skills are so the second one is eye, intense exercise.
26:57
SPEAKER_01: So so often when we are upset, when we're feeling stressed, when we're feeling emotions intensely, our body is filled with stress hormones that just make us feel agitated, make us feel like fighting or fleeing, that fight or flight response.
27:13
SPEAKER_01: And so often in modern life, there isn't a bear or saber-toothed tiger or whatever the predator would be chasing us.
27:21
SPEAKER_01: And so there, we don't have like that runaway feeling, or uh, we can't run away and use up that energy.
27:29
SPEAKER_01: So intense exercise is letting us do what our body wants to do when it's upset and move.
27:34
SPEAKER_01: So it might be go on a run, might be dance, it might be do jumping jacks for a few minutes, just something.
27:40
SPEAKER_01: Uh, it might even just be stretch, depending on who you are, but letting your body kind of metabolize that energy and use the emotion.
27:48
SPEAKER_01: If your body is agitated, use that agitation.
27:52
SPEAKER_01: And then after you exercise, rest afterwards.
27:55
SPEAKER_01: And so, like exercise might help us feel better, but even if it doesn't, it gives us something to do besides the impulsive behavior again to use that energy in a way that doesn't cause us more problems.
28:07
SPEAKER_02: So we are halfway through the four core skills, and I'm interested in learning about emotion regulation in DBT.
28:14
SPEAKER_02: What is emotion regulation and how does it help?
28:18
SPEAKER_01: Yeah.
28:18
SPEAKER_01: So I said a few times talking about distress tolerance that these those crisis survival skills might help you feel better, but they're not designed to do that, right?
28:26
SPEAKER_01: They're just designed to help you tolerate the moment.
28:28
SPEAKER_01: Emotion regulation skills are more designed to help you change your emotions, at least some of them are.
28:35
SPEAKER_01: So emotion regulation, as I said earlier, is a set of skills for understanding your emotions, for learning why you're having emotions, what's going on for you, how can they help you?
28:49
SPEAKER_01: And then making decisions for when you feel something.
28:52
SPEAKER_01: What do you want to do with it?
28:53
SPEAKER_01: Do you want to change it?
28:54
SPEAKER_01: Is it unhelpful for you in some way?
28:56
SPEAKER_01: Or do you want to go with your emotion and use it?
28:59
SPEAKER_01: Or do you just want to feel it?
29:00
SPEAKER_01: Because that's always an option as well.
29:02
SPEAKER_01: So emotion regulation skills, they're skills for understanding emotions, their skills for changing emotions, and their skills for reducing your overall emotional vulnerability.
29:11
SPEAKER_01: So doing things that make you more like emotionally stable and resilient.
29:15
SPEAKER_01: That's what I want to hear about.
29:16
SPEAKER_01: That last one?
29:17
SPEAKER_01: Yeah.
29:18
SPEAKER_01: So uh that is another acronym.
29:21
SPEAKER_01: I've said a few today already, but it's a set of skills called the ABC Please skills.
29:26
SPEAKER_01: So A stands for accumulating positive emotions.
29:29
SPEAKER_01: So this is both in the short term, how do you get more pleasure more frequently?
29:34
SPEAKER_01: And in the long term, how do you get more meaning in your life?
29:38
SPEAKER_01: And that's about figuring out what your values are and pursuing goals related to those values.
29:43
SPEAKER_01: So accumulating positive in the long term and short term is about how can we get more pleasant experiences, more pleasant emotions across time?
29:52
SPEAKER_01: Because the more we do that, the more like stable we will feel when the inevitable stressors come, come, come call in.
30:01
SPEAKER_01: Right.
30:02
SPEAKER_01: So the uh that's that's the A in ABC please.
30:05
SPEAKER_02: Is that easier to do and follow through with an experience when things are going kind of okay in your life?
30:12
SPEAKER_01: Totally, right?
30:14
SPEAKER_01: I think even earlier we talked about depression and how hard it can be sometimes to even get out of bed with depression.
30:24
SPEAKER_01: And so a lot of times for accumulating positives, it's about again meeting you where you're at and figuring out how you can get a little bit more pleasure, a little bit more meaning, a little bit more connection, relief, whatever it is you're looking for.
30:38
SPEAKER_01: And then the more you do that, it's almost like literally building a foundation underneath you.
30:44
SPEAKER_01: Harder and harder, quote unquote, things get easier and easier, and you can get more and more pleasure and meaning.
30:50
SPEAKER_01: It's a skill as well, for sure.
30:51
SPEAKER_01: It would take some work.
30:53
SPEAKER_01: Oh, definitely.
30:54
SPEAKER_01: Yeah.
30:54
SPEAKER_01: Yeah.
30:55
SPEAKER_01: Pleasure is it can be work for people, especially if they struggle with mental health difficulties.
31:01
SPEAKER_01: There can be a lot of things that disconnect you from what feels good, that disconnect you from your body, which is necessary for pleasure.
31:08
SPEAKER_01: And that's where mindfulness skills come in again.
31:10
SPEAKER_01: This is where DBT skills are all connected.
31:13
SPEAKER_02: I remember during a worst depression having to focus on the times during the day when I was still in bed that the sun came in.
31:21
SPEAKER_02: And at least I could feel it on my skin.
31:24
SPEAKER_02: And you know, it was this big of a good thing, but I had to count it because there wasn't much else going on that was good.
31:31
SPEAKER_02: So I understand how looking for them can be helpful and then noticing them.
31:37
SPEAKER_01: Yes, exactly.
31:38
SPEAKER_02: Accumulating, I guess you said too.
31:40
SPEAKER_01: Yeah, and that's a beautiful example because another part of this skill is like savoring, like not only noticing, but then letting yourself appreciate the positive that's there or the pleasantness that's there.
31:54
SPEAKER_01: Because it might be easy in a depressed state of mind, from my experience, to like feel the sun on your skin and then be like, oh my gosh, like that's giving me pleasure.
32:04
SPEAKER_01: Right.
32:05
SPEAKER_01: Wow, I'm so depressed.
32:06
SPEAKER_01: Everything sucks.
32:07
SPEAKER_01: If that's good for me, like, where am I now?
32:09
SPEAKER_01: Right.
32:10
SPEAKER_01: So it's seeing that thought, right?
32:12
SPEAKER_01: Right.
32:12
SPEAKER_01: Capturing that, being mindful of that, seeing how that's adding on, and then bringing your attention back to feeling the sun on your skin.
32:19
SPEAKER_01: It feels warm.
32:20
SPEAKER_01: Yeah.
32:20
SPEAKER_01: Warm is good.
32:21
SPEAKER_01: Yeah.
32:21
SPEAKER_01: And so this is this constant practice.
32:23
SPEAKER_01: And the more you practice, it's like a mindfulness muscle, the more you will be able to do that and then get the pleasure, and then the more you can do, and and so on.
32:33
SPEAKER_02: Can we talk for a second about acronyms?
32:36
SPEAKER_02: Because when I was researching this, it's like tip, dear man, improve the moment, give fast.
32:40
SPEAKER_02: I mean, it was there's a lot of them.
32:43
SPEAKER_02: There is a lot.
32:44
SPEAKER_02: And understand they're designed to make it easier to remember a bunch of individual things, but when there are a lot of them, even that's hard.
32:51
SPEAKER_01: Yeah.
32:52
SPEAKER_01: No, I mean, I'm a DBT therapist for how long now?
32:54
SPEAKER_01: How many years?
32:55
SPEAKER_01: And I still forget some of the acronyms.
32:57
SPEAKER_01: So, yes, I say that if they help you, amazing.
33:01
SPEAKER_01: And if they don't, you can let them go.
33:02
SPEAKER_01: They're just a vehicle to like learn the skills at first.
33:06
SPEAKER_01: Um, and they're very helpful for some people, but I am also not one of the brains that benefits from them.
33:11
SPEAKER_02: When I think of emotion regulation, and I and I read it says it helps us identify what an emotion is, what it's for, how to reduce its intensity and to step through them.
33:20
SPEAKER_02: And that's a lovely sentence, you know, and we can just move right on to the fourth one.
33:25
SPEAKER_02: As somebody who's not great at that, help us identify what an emotion is.
33:29
SPEAKER_02: Well, right there I'm stuck.
33:30
SPEAKER_02: And I shared with you before we started recording that I had a doctor friend who asked me once what I was feeling.
33:35
SPEAKER_02: And I said, Do you have a list that you could provide me that I didn't say that because that's how I talked to a friend, but can you give me a list of what I might be feeling?
33:43
SPEAKER_02: Because I think if I see the word, I can say, Oh, I'll be darned, it's this.
33:47
SPEAKER_02: But just sitting there with my mind being mush at the time, I didn't know how to name it.
33:54
SPEAKER_02: So let's let's talk about the difficulty of naming it, of knowing what it is, before we can begin to think about reducing its intensity.
34:01
SPEAKER_01: Absolutely.
34:02
SPEAKER_01: So, first I just want to offer some folks really like having language to describe their experiences.
34:08
SPEAKER_01: And so there is a term for having difficulty feeling and describing one's emotions.
34:12
SPEAKER_01: It's alexithymia.
34:14
SPEAKER_01: And there does seem to be some people who are actually maybe biologically predisposed to struggle with like feeling the your internal physical sensations, which are so key to understanding, feeling, and describing your emotions.
34:28
SPEAKER_01: But alexithymia can also just, it's more common in folks who've struggled with depression, who struggle with anxiety, who have PTSD, folks who struggle with mental health difficulties, basically, right?
34:38
SPEAKER_01: So a lot of people who come into DBT struggle with these exact difficulties.
34:44
SPEAKER_01: So again, it's designed to help people overcome these difficulties.
34:50
SPEAKER_01: So, on one hand, we have a skill called the model of emotions, which breaks down all of the different parts of your emotion.
34:58
SPEAKER_01: So when you're saying, like, what is an emotion?
35:00
SPEAKER_01: It is a full system experience.
35:03
SPEAKER_01: And what I mean by that is it's physical sensations, it's thoughts, it's what happened to trigger the emotion, like what happened outside of yourself.
35:13
SPEAKER_01: It's how you respond, what do you do?
35:17
SPEAKER_01: How do you um what urges do you have inside that can be different from what you actually do?
35:22
SPEAKER_01: And then how do you express it through your your facial expressions or your body language?
35:27
SPEAKER_01: Like all of these things give you information about what you're feeling.
35:32
SPEAKER_01: So in therapy, we can break it down with someone to help them understand piece by piece what's going on for them, mindfulness observing again, so that then they can go to another skill in DBT and like put words onto their experience.
35:47
SPEAKER_01: So that in the workbook for DBT, there is uh there are 10 pages.
35:51
SPEAKER_01: Each of the 10 is dedicated to one emotion.
35:55
SPEAKER_01: At the top of the page is a list of tons of words.
35:59
SPEAKER_01: So it's like happiness, and then it's joy and contentment and relief, and I don't know what else is there, but lots and lots of words.
36:07
SPEAKER_01: And so, and then below it, it's the type of thoughts that are common.
36:10
SPEAKER_01: And then below it, it's the type of behaviors that are common when you're feeling happy.
36:14
SPEAKER_01: So it offers, I often call it an emotion dictionary.
36:17
SPEAKER_01: And so it's this resource of okay, I can tell that I feel a pit in my stomach.
36:23
SPEAKER_01: Like that's all I can feel right now.
36:25
SPEAKER_01: That's all I've got.
36:26
SPEAKER_01: Let me go to the dictionary and see where does pit in my stomach show up?
36:30
SPEAKER_01: And like it'll show up in sadness, probably.
36:32
SPEAKER_01: It'll show up in shame, probably.
36:34
SPEAKER_01: And then I can read those pages to figure out what else is here for me and be like, oh, I'm feeling sad.
36:40
SPEAKER_01: That's what's going on.
36:41
SPEAKER_02: It's interesting to realize that if you're not taught that, or if you're raised in an environment in which you are not allowed to have feelings, that you don't learn it.
36:51
SPEAKER_02: No, and that you can.
36:52
SPEAKER_02: That's critically important to understand.
36:55
SPEAKER_01: Yeah.
36:55
SPEAKER_01: I I I love both of the things you said there, that it's completely understandable why you wouldn't know how to do this.
37:02
SPEAKER_01: It is a skill and it's a skill.
37:04
SPEAKER_01: So you can learn it in adulthood.
37:06
SPEAKER_01: Absolutely.
37:06
SPEAKER_02: Love that.
37:07
SPEAKER_02: So the last skill is interpersonal effectiveness, all about our relationships and how to have healthier ones, which would lead to having a healthier life.
37:16
SPEAKER_01: Yeah.
37:17
SPEAKER_01: Yeah.
37:17
SPEAKER_01: So the interpersonal effectiveness module is a set of skills, as you say, that's all designed to help us improve our relationships.
37:23
SPEAKER_01: So there are assertiveness skills, there are skills that can help us de-escalate conflict, there are skills that can help us like end relationships that aren't healthy for us.
37:33
SPEAKER_01: There's lots of skills to just figuring out how do we get more of what we want out of relationships?
37:39
SPEAKER_01: And how can we feel and balance connected to people and connected to ourselves?
37:44
SPEAKER_01: So there's a balance of self-respect and respect of others.
37:47
SPEAKER_01: And how can we walk that tightrope?
37:49
SPEAKER_02: Again, things we're not taught.
37:52
SPEAKER_02: I mean, imagine if as children we were taught not just you don't take somebody's toys or bite them, you know, but that you can say no, that you can have boundaries, that you can be assertive without being aggressive, all of those kinds of things.
38:08
SPEAKER_02: We're just supposed to kind of somehow figure it out, watching people who were maybe raised in healthier homes.
38:14
SPEAKER_01: Yeah, exactly.
38:15
SPEAKER_01: It's not a given.
38:16
SPEAKER_01: It's we don't know how to ask for things.
38:18
SPEAKER_01: We don't know how to say no.
38:19
SPEAKER_01: Uh, some of us, obviously.
38:21
SPEAKER_01: Um, we also are not taught how to repair relationships when harm is caused, like how to apologize, how to ask for an apology.
38:30
SPEAKER_01: So yeah, interpersonal effectiveness is not easy.
38:33
SPEAKER_01: It's also a skill and you can also learn it.
38:35
SPEAKER_01: And that's what these skills are all about.
38:37
SPEAKER_02: There's like real hope in knowing it because you can just sort of feel like you're not adulting real well.
38:43
SPEAKER_01: Yeah, right.
38:44
SPEAKER_01: And that's where those judgments come in, right?
38:46
SPEAKER_01: And where we can deny that we have problems.
38:50
SPEAKER_01: So that's where acceptance comes in.
38:51
SPEAKER_01: Can I recognize that, oh, my relationships aren't feeding me and nourishing me the way that I want?
38:57
SPEAKER_01: Mindfulness, what is missing?
38:59
SPEAKER_01: Like, what do I want from this person?
39:01
SPEAKER_01: And then assertiveness, how do I ask for it?
39:03
SPEAKER_01: And then when they say no, how do I cope with the pain of them saying no to the thing I asked for?
39:10
SPEAKER_01: There's all of this back and forth and this constant dialectical shifting of acceptance and change, which we talked about last time.
39:16
SPEAKER_01: Right.
39:16
SPEAKER_02: Dialectical.
39:17
SPEAKER_02: Is there one of these skills that you think is most urgently needed by the average person navigating life at this particular time?
39:26
SPEAKER_01: Yeah, I would say that this is actually one of the skills in general that I think the world would be a better place if everyone learned this skill, but and it just happens to be interpersonal effectiveness.
39:35
SPEAKER_01: It's a skill called validation.
39:37
SPEAKER_01: And so, invalidation, first, is the communication that someone's internal experiences, their emotions, their reactions don't make sense.
39:48
SPEAKER_01: So validation is saying your emotions are understandable.
39:51
SPEAKER_01: Your emotions, your opinions do make sense.
39:54
SPEAKER_01: That doesn't mean I agree with them.
39:55
SPEAKER_01: It doesn't mean I would feel the same way, but I can see your point of view.
39:59
SPEAKER_01: And so I feel like in today's world, it's so polarized, and there's so much this like talking past one another or the denying of other people's experiences that then we just stop listening completely and uh conflict just escalates.
40:14
SPEAKER_01: Validation is like honestly, it feels like a superpower sometimes on a one-on-one basis.
40:19
SPEAKER_01: When you can learn how to validate someone else, it increases intimacy, it decreases conflict, as I said, and just makes it so much easier to actually move forward, maybe in a relationship with this person or maybe not.
40:32
SPEAKER_01: But then you get to actually learn something instead of walking away upset.
40:36
SPEAKER_02: Is there one of those four four DBT skills that you think is most difficult for people to learn and use?
40:44
SPEAKER_01: I mean, everyone finds different things difficult, but often I would say that it all comes back to mindfulness.
40:50
SPEAKER_01: Mindfulness is a foundation of all of these skills.
40:53
SPEAKER_01: In order to know what you're feeling, you have to be able to feel it.
40:58
SPEAKER_01: In order to know that you want to change an emotion, you have to be able, you know, you're feeling it.
41:03
SPEAKER_01: And then in order to know whether something worked or not, you have to be paying attention to that.
41:07
SPEAKER_01: In order to ask someone for something, you have to know that you want that thing.
41:12
SPEAKER_01: Like it all starts with mindfulness.
41:14
SPEAKER_01: So it's both the like necessary first step that most people can get some handle on to practice the other skills, but it's also one of the trickiest ones to like really understand and to not get sucked into non-acceptance, to not get sucked into judgments and stories, but to actually just be here right now with what's here.
41:32
SPEAKER_02: And the goal of all of the things in DBT is to help us create a life that Dr.
41:37
SPEAKER_02: Lennihan, who who created it, described as a life worth living.
41:41
SPEAKER_01: Yeah.
41:41
SPEAKER_02: And I love that concept.
41:42
SPEAKER_02: And I'd love to end on it if we can talk a bit about that.
41:45
SPEAKER_02: That is a possibility.
41:47
SPEAKER_01: Yes.
41:48
SPEAKER_01: So for folks who struggle with depression or suicidal thoughts, this term life worth living will probably immediately feel like resonant.
41:56
SPEAKER_01: But even for so for folks who haven't struggled in those ways, what I want to say, I want to define what a life worth living is in DBT sense.
42:03
SPEAKER_01: And it's just the life that you would find most consistently joyful and meaningful.
42:10
SPEAKER_01: So you get to define it for yourself.
42:11
SPEAKER_01: There's not some this like, like Dr.
42:13
SPEAKER_01: Linahan isn't saying, like, this is what makes it worthwhile.
42:16
SPEAKER_01: Right.
42:16
SPEAKER_01: Your therapist isn't going to say that.
42:18
SPEAKER_01: You get to define for yourself what do I want from my life?
42:21
SPEAKER_01: And the entire goal of DBT, like the goal of the therapy, is helping you reach that life worth living.
42:28
SPEAKER_01: So you use all of these skills to figure out what are my passions, what are my values, what's giv what gives me pleasure, what relationships do I want, what life do I want, and then work towards it.
42:38
SPEAKER_02: And I don't think people routinely ask themselves those questions, try to come up with those answers.
42:45
SPEAKER_02: And I can see how you have chosen this as your field because it could, in fact, be life-changing.
42:50
SPEAKER_01: Yeah, it is.
42:51
SPEAKER_01: I think it's very understandable.
42:53
SPEAKER_01: I think we're often, especially in today's world, like on autopilot, we know what we are supposed to do, what our society expects from us, what our society expects from us, what our family expects from us, just what culture expects from us.
43:08
SPEAKER_01: And then we like go with it.
43:09
SPEAKER_01: And especially with technology, we're often so distracted that we don't always stop and check in with like, how is this going?
43:18
SPEAKER_01: Right.
43:18
SPEAKER_01: Am I enjoying this?
43:19
SPEAKER_01: Am I finding it fulfilling?
43:21
SPEAKER_01: Um, so yeah, that is also a skill.
43:23
SPEAKER_01: And it's scary to stop and ask yourself that question, but it's super, super powerful when you do.
43:29
SPEAKER_02: I am so grateful for all this time that you're with us for two full weeks talking about this all.
43:33
SPEAKER_02: But it's important, and a lot of us haven't been exposed to it or need to know more about it to decide if we want to dive in.
43:39
SPEAKER_01: Yeah.
43:40
SPEAKER_02: Thank you so much for your time and your expertise.
43:42
SPEAKER_01: Yeah, I love this conversation.
43:43
SPEAKER_01: Thank you for having me.