TOOLS: Understanding DBT from the Inside Out

An Introduction to Mindfulness

What is DBT?
<br/>:)BT (dialectical behavioral therapy) is a form of cognitive behavior therapy, which is a branch of psychotherapy that focuses on bringing together (obviously) behavioral therapy and cognitive therapy.

Behavioral therapy comes from classical conditioning to encourage positive behavior and eliminate negative behavior. Shocking a rat who goes down the wrong path in a maze, and rewarding them with cheese for finding the right path, or conditioned Pavlovian responses are both examples of behavioral therapies. Behavioral therapy can be useful for breaking thought patterns and encouraging good behavior, but doesn’t do a whole lot for emotional problems.

Cognitive therapy is much more internally focused, in which the therapist seeks to help the patient change problematic thoughts. Often the therapist will challenge the patient’s flawed assumptions and encourage them to change problematic thought loops. The concept is that over time, changing assumptions and the resultant changed behaviors will result in overall reduction of negative feelings.

The dialectical aspect of DBT comes from the balance of these two schools of thought, changing behaviors along with thought patterns; as well as balancing the dialect of radical acceptance paired with dynamic change. Loosely put, you’re okay just as you are, and here’s what you can do to get better. Without any acceptance of self, there is little reason to hope for someone to believe they, or their situation, are worthy of improvement. The belief that one is hopelessly bad or that their situation is impossible, can be one of the greatest inhibitors to progress, because it provides a fallback position from which to reject any kind of treatment.

Getting Started with Mindfulness
<br/>:)BT addresses this initial argument with the first module in the program, Mindfulness. It’s simply not possible to accept what one is not aware of, and this module focuses closely on living in the present moment, even when it sucks, becoming aware of one’s actions and reactions, and how they affect our lives in the present. Mindfulness brings in many concepts of Zen Buddhism, and it’s not uncommon for people who have been through a complete course of DBT to come out the other end a little Zen-flavored. The other modules, which will be addressed later, are Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance. Mindfulness is where we find our acceptance for our situations and ourselves, and serves as the foundation for these later modules.

My personal experience with DBT is also a little different than the “traditional” DBT program, which generally involves a group therapy work in addition to one on one time with a therapist or DBT practitioner. My program has consisted of DBT, combined with more traditional cognitive behavioral therapy with individual therapists, and group 12-step meetings.  I’ve been through the DBT program over the course of the last three years and at this point am no longer diagnosed with Borderline personality disorder. Actually I'm no longer diagnosed with a handful of things, including paranoid personality disorder and avoidant personality disorder.

My participation on the boards has been as the child of a person with borderline, my current therapist was the one to suggest that my mother most likely has borderline, and that my father most likely had antisocial personality disorder. I still work with a therapist to help me address that side of my past and upbringing. My therapy now is much more related to my immediate personal life and remaining balanced, rather than learning how to be human. I'll be drawing mostly on my own experience as well as professional resources and literature in conducting this workshop.

Mindfulness is probably the single most beneficial idea I’ve taken from my own therapy. So often I would find myself tangled up inside my own head, confused about what I wanted, what I was trying to achieve, trying to control how I felt and failing, and unable to see why that wasn’t working. Mindfulness applies to everyone, because the primary concern of being mindful is being you, right now, in your real life, in your real reality.

This Workshop Is about You

In this workshop we’ll go over some of the basics of Mindfulness, covering the objectives of being mindful, the three states of mind and how to be “one-mindful,” and how to practice being mindful, and why it helps. Most importantly, this workshop is all about you.

Before we get started, a few opening questions:

-   How familiar are you with Dialectical Behavior Therapy?  

-   How familiar are you with the concept of Mindfulness? No familiarity whatsoever is also totally ok!  

-   Is there anything you currently do to try to “stay in the present?” Is there anything specific you would like to improve upon?

-   What are you motivations for participating in this workshop? What do you hope to get out of it?

-   How familiar are you with Dialectical Behavior Therapy?

I don't do DBT, I think I am doing trauma therapy.  I believe it is a mixture between CBT and psychodynamic.  I find it very helpful.  I think the stages are:

1) stabilizing and managing responses

2) processing and grieving traumatic memories

3) reconnecting with the world

However I am interested in DBT and have heard it is very helpful for a variety of issues, some of which I struggle with.  But besides reading a bit here and there, I dont know much about it


-   How familiar are you with the concept of Mindfulness?

My T strongly encourages mindfulness actually and it has been very helpful.  She has taught me a few things and I have begun yoga on my own.  I find it helpful in managing anxiety and dissociation.  

-   Is there anything you currently do to try to “stay in the present?” Is there anything specific you would like to improve upon?

For extreme anxiety I do this one where I use my 3 senses and talk about it.  I see my pink toenail, I hear the fan, I feel the cool blanket... .over and over and over out loud... .

I do breathing meditation

I dissociate a lot in church so I really try to listen to the tone of the minister's voice, that helps (it also happens to be soothing)

Yoga

I would like to improve meditation and short mindfulness practices... .and knowing when I need them.  When the negative mental track comes on I do a stop sign, and am supposed to follow it with mindfulness but I don't always.

-   What are you motivations for participating in this workshop? What do you hope to get out of it?

I think it would be interesting to follow, and I am impressed with your progress DD so I would like to know some of what you have learned.  I also really know mindfulness is an amazing tool and would love to improve.

Practicing mindfulness is just that - practice. Something you keep working on moment by moment. Practice is how you become better at something.

Me personally? I need to practice it too 

Looking forward to what others have to say... .

Thank you so much for providing a framework and practical support to "do" DBT rather than just read about it.

-   How familiar are you with Dialectical Behavior Therapy? I have read Marsha L. book, looked at each of the modules, but don't practice enough when I am calm to use it when I am stressed.

-   How familiar are you with the concept of Mindfulness? Getting there. The non-judgement part is hard for me.

-   Is there anything you currently do to try to “stay in the present?” Is there anything specific you would like to improve upon? I like the pink toenail idea!  I worry about the future waaaaaaaay too much.

-   What are you motivations for participating in this workshop? What do you hope to get out of it? Learn when I am getting stressed out and being able to stop it from becoming overwhelming for me. I hope to become proficient in mindfulness so I can use it!

Bongo

How familiar are you with Dialectical Behavior Therapy?

Very. ON a personal level, my H recovered completely from BPD via DBT and I was working with a family therapist as a client who taught me DBT and used it in r/s to my H. We also saw a MC who was DBT skilled and used it in MC. Professionally, I worked as a psychiatric nurse for many years, including using DBT skills with clients who were addicts with BPD

.only

I am familiar with some of the basics you with the concept of Mindfulness?

I have been aware of it and practiced it for years. It takes practice and it takes mindfulness to remember to be mindful  

-   Is there anything you currently do to try to “stay in the present?

   I use the skill of mindfulness, also meditation and writing.

- What are you motivations for participating in this workshop? What do you hope to get out of it?

I would like Support and encourage others which always is encouraging and supportive of my own journey

-   How familiar are you with Dialectical Behavior Therapy?

I have been hearing of it here.

 

-   How familiar are you with the concept of minfullness?

My T is trying to teach it to me.  I am practicing observe, describe, participate this week.  I am finding it difficult.  I took some meditation classes in the past. 

 

-   Is there anything you currently do to try to “stay in the present?” Is there anything specific you would like to improve upon?

I don't plan a lot of things because this tends to take me away from the present.  I'm not sure this actually works well.

-   What are you motivations for participating in this workshop? What do you hope to get out of it?

Better understanding of DBT, help with mindfulness, peace.

So here's a question.  If you do succeed in being mindful, being in the moment and staying in the present, what about all those things you need to do to survive.  How do you pay the bills, plan your future, figure out what to do next? 

I think you were pretty close, yes. {Brief aside, Shobogenzo is on my to-read list. }

Next up: Actual exercises to start practicing mindfulness. I think a lot of pieces there will start to fall into place once we get in to exercises. As with most abstract kinds of ideas, a little practice can be much more helpful than talking about theory ad nauseum.

For the exercises I'm going to pull from my own notes as well as the DBT Skills Workbook, and other sources as they're pertinent.

A helpful explanation of Mindfulness... .based on the book

"Wherever you go, there you are"

By Jon Kabat-Sinner

I started a daily post that explore Mindfulness here

https://bpdfamily.com/message_board/index.php?topic=124333.msg1224784#msg1224784

Thank you for offering this Workshop. Thank you, united for now for the link to Mindfulness quotes from the "Wherever you go, there you are" book.

Answers:

1. DBT: No first hand knowlege. I had hoped my uBPDw would try but since she doesn't see that she has a problem it make be a while.

2. Mindfulness/questions: Combination of mindfulness and buddhist wisdom that got me through my own personal hell,  depression and devastation. Helps keep me grounded. No formal teaching

just reading and being open to new ideas and experiences.

3. - Motivations / Hoping to get what out of it: I got my life back, I feel I am in a more peaceful time in my life. I  feel in touch with my feelings (something hadn't a clue about before). 


I read a book on Bhuddist wisdom called "The Buddha is still Teaching" by Jack Kornfield.

I took what I need from it at the time and I will go back and read it again and again.

My philosophy:

Be good and true to myself. I look after myself now first and formost.

Cling to nothing. This is a universal truth in my life. I let go of my uBPDw. I still felt pain be I healed a lot quicker by letting go.

Be compassionate.

I am not limited by a passing experience.

I take joy in the welfare of others. 

I cherish the wellbeing of others.

Chaos is extremely good news, embrace it, it is an opportunity to grow, without is I will not reach my full potential.

Practice tolerance.

I have learnt to surrender my personal hopes and expectations.

Live in the present.

I am open to my own emotions, I sit with them, I do not always understand why a particular emotion is present but i chose to sit with it, let it wash over me and experience it, I try not to understands it. It is whatever it is and it is the right emotion for me at that time.

I understand the mind is all stories. Thinking makes it so.

The problems I see are because I choose to "think".

My emotional world (my pain, my grief, my sadness and my joy etc) are all specific and personal to me.

My emotional world (my pain, my grief, my sadness and my joy etc) are all universal as pain, grief, sadnessand joy are universal. At some time we all experience loss it is the nature of our existence, no one is immune to it.

We are spiritual Creatures living a human existence.

I let lifes events unfold naturally.

I vow never to lose sight of who I am. I chose to be happy and to live my life with a smile on my face.

I use meditation to relax, find, peace, clear my mind. I find it both relaxing and at times energising.

I realise I have in intellectual self, an emotional self, a spititual self and a physical self. If these part of me are in balance then I an doing ok. If I neglet one even for a few days then I am out of balence and not at my full potential.

Past and future times are nowhere to be found.

Past = a memory

Future = an "anticipated" illusion.

Neither the past nor the future exist in reality.

I live my life in the present moment. The here and now. I teach this to my children and they have gained huge strength from this one wisdom.

I do not know what is in my subconcious but I view it like sitting on the shores of an ocean and slowly, patiently experiencing one wave at a time. Reflecting on each indevidual wave as it washes up on the shore.

This is not to say i do not feel anger. I now realise that anger is a healthy emotion. I realise that when I feel angry it means I have suffered a hurt, an injustice,  a fear, a frustration or a fear. Violated boundaries are the main reason I feel angry now. How I choose to react to my anger is up to me. I hold on to this power. I now use anger to calmly set new set boundaries.   

I believe everything is as it is meant to be.

I listent to my heart. It is like having a spirit guide that shows me the path of my life's journey.

 

Exercises in Mindfulness

We've talked some about what mindfulness "is." Some of the key points brought up are:

• Something you keep working on moment by moment.



• non-judgement



• It takes practice and it takes mindfulness to remember to be mindful



• being in the moment and staying in the present



• Past and future times are nowhere to be found.

Put together, we get something like: Mindfulness is the continual practice of living and embracing the present moment- rather than the past or future- without judgment.


Being Un-mindful

To get a start at how being mindful can be helpful, it might be good to examine some of the detriments of being "unmindful" about some pretty neutral topics. (These examples are taken from the DBT Skills Workbook)

Have you ever done the following?

- While having a conversation, you’re already thinking about what you’re going to say next before the other person has even stopped speaking.

- While taking a shower, you’re already planning what you have to do later and then you forget if you’ve already washed your hair or some other body part.

- While driving or traveling, you don’t remember the experience or which roads you took.

• Can you think of any other examples of un-mindfulness?



• What might be the effects of these, or your own examples?



• Not surprisingly, these examples all begin with "While hit... ." do you think it is possible to be mindful of one thing while doing another? Why or why not?

Exercise: Timed Mindfulness

Don't worry, it's not a test! Just an exercise.

This is a good exercise for getting in touch with time as it exists, rather than how we perceive it. I'm sure most of us have had the experience of waiting in a meeting or a classroom staring at the clock and every second feels like an eternity. Or the opposite experience of being out and having a good time, and several hours click by in the blink of an eye. In the words of Soren Kierkegaard, "Most [people] pursue pleasure with such breathless haste that they hurry past it." This exercise may help you see if your perception of time matches time as it exists, and do less hurrying past pleasure, and more finding it where you are.

Ingredients

- A timing device. (Online Stopwatch, if you don't want to rummage through the kitchen for one.)

- You

Getting Started

Find a reasonably quiet place where you feel comfortable. At least somewhere that you can sit for a minute without being disturbed. It may be helpful to stake out a place as "yours" for meditation and quiet, as there will be a lot of that in this workshop. Everyone deserves their slice of peace and quiet in the world, and defining it is both justified, and necessary for peace of mind. It may be helpful to set up cushions, if you're sitting on the floor, and have a glass of water nearby for after you've finished your exercises. (I don't know about y'all, but thinking always seems to make me feel thirsty.) Free your space from distractions as much as possible, if you can, shut off the phone or noise-producing gadgets that most of us tend to carry around.

Practice

Seat yourself comfortably and take a few slow breaths. Start the stopwatch and close your eyes. Focus on your breaths and try to relax for whatever feels like one minute to you. When you feel like a minute has passed, open your eyes and stop the stopwatch.

Questions

Answering any questions on here is completely voluntary. If you're more comfortable writing them down in a personal log, or simply thinking about them, that is totally okay. This is all about you, and what is helpful for you. I'll share my own experiences as we go along.

• How much time passed? Was it more or less than a minute?



• If it was much less than a minute, how might that affect how you plan out your day? Does it often feel like there is not enough time for everything you want to accomplish?



• If it was much more than a minute, how might that have a different effect? Do you find that you often think you have more time than you do?



• How might being more "in tune" with the passage of time be helpful in planning your day? In enjoying happy times? In coping with stressful times?

More... .

- For more practice with this exercise, repeat it periodically as we move through additional exercises. Note how your experience with time changes.

- Try estimating five, or ten minutes. How does your estimation match up to longer periods of time?

Thank you for opening my eyes to the other side of mindfulness.

I really like the idea of being aware of the times when we are being unmindful. So much of modern day living is lived like this. We barely have time to think, to listen or to enjoy.

So much of the good stuff of life can pass us by. If we stay in the present the we have a much better chance of experiencing the richness and the textures of our existence as opposed the a shallow existence we call living.

Before we get started, a few opening questions:

-   How familiar are you with Dialectical Behavior Therapy? 

I don't know much about

-   How familiar are you with the concept of Mindfulness? No familiarity whatsoever is also totally ok!

I have studied some things related to this.  I have practiced it to some degree on my own and have gotten good at leaving out the past but I find my mind always working in the future. 

-   Is there anything you currently do to try to “stay in the present?” Is there anything specific you would like to improve upon?

Nothing in particular or not following any guidelines.  I notice when my mind is wandering adn I struggle to stay present some times.

-   What are you motivations for participating in this workshop? What do you hope to get out of it?

Two things - my BPDhusband will hopefully agree to start DBT soon and I imagine I can be more supportive if I understand it.  I am always open to improving myself.

On being "Un-mindful"

My own example of "unmindfulness" actually comes from this last Saturday (hey, I'm still a work in progress and I definitely don't qualify for Zen master status.) I was making coffee, which for me is 4 shots of espresso and some milk. I made two shots, and emptied the espresso cup, turned around... .no clue where those shots went. The glasses I use to measure them were empty, and my mug was empty, no clue what happened. Still no clue haha. Consequence is I ended up using more coffee and time than I had wanted to, and hopefully I just dumped them in the sink, and I won't find a measuring cup with coffee sitting in it a week from now... .This is also related to me not getting enough sleep, and not having the attention to be mindful.

For me, because I tend to be kind of spacey by nature, practicing mindfulness is really important, because this kind of stuff happens to me all the time when I'm not. I can be mid sentence with myself, and lose track of what I wanted to say. I tend to prefer communicating in writing for that reason, it forces midfulness and word choice in ways that are easy for me to skip past when communicating verbally. I'm not a terribly good cook for the same reason, if I can't set a timer for something and have to watch it, I tend to burn things, because I start cooking and then wander off to do something else and forget I was cooking. The smoke alarm is not actually a timer, who knew?  

I'm not sure if it's possible to be mindful of many things at once. If I'm really "in the zone" with mindfulness, I tend to experience everything going on as "one thing" part of "one moment."

---

Practice: Timed Mindfulness

Historically, this is a very hard exercise for me. Once again, I space out easily and lose track of time. The first time I attempted this exercise I think I ended up sitting for about four and a half minutes because I forgot what I was doing. I panicked because I was "doing it wrong" and tried again, and lasted about 20 seconds because I was too jittery and panicky to sit for more than that. After going back and forth that way, my therapist suggested that I try it in his office when I was calm, or at my sponsor's house when I was over there and a little more relaxed.

I've gotten better at it over time, although if I'm stressed out my perception of time tends to skew a little again. I usually have my ipod around me which has timers and clocks so that I can set alarms if I am feeling stressed or anxious and still need to be places on time. Although not to the same extent that I used to. Setting timers was also part of breaking some OCD habits for me, for things that still need done, just don't need 2 hours to do them, like washing dishes.

When I do this exercise now, I sat down for a while on Sunday for both short and longer spans. The one minute exercise ended up at about 1:10 the first time and 0:58 the second (so close! haha) Longer time periods are still more difficult, although usually I can get to within 30 seconds of the five minute period, and within a minute of the ten minute period, which is close enough for me. I tend to prefer longer periods of meditation, for 20 or 30 minutes, but I set a timer for those.

At Bay Wed 6/29

Un-mindfulness vs. mindfulness:

Being retired -- every day can be Saturday usually if you want it to be. Problem is having control over every minute of my day can becomes what they call set in your ways. Intrusion is to be avoided religiously. I don't even like bringing in the mail (unpredictable). Forget answering the phone (unpredictable and urgent).

But when the outside world intrudes with some event I must attend, or people want to come over, my un-mindfulness is a shock to my system. Check times and details compulsively and wish I'd never been born. OK, I don't like it much. When it is over I did enjoy people and have no regrets. But the following day I'm back living in moment like a vacation from intrusion. No, I don't live alone, but live parallel lives as it is called. Aside from being a captive audience on occasion, I'm not hindered.

Is it possible to confuse having this much mindfulness with something else like isolation? Does it count more when carved out of a busy day?