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Coping Ahead: Anticipating Stress & Boosting Confidence

Coping Ahead: Anticipating Stress & Boosting Confidence

Do you find yourself constantly worrying about every possible scenario that could go wrong? You’re not alone. Constant worrying, overthinking, and feeling out of control can take a big toll on your mental health and well-being. This makes it incredibly difficult to focus on daily tasks or enjoy life to its fullest. But there is a solution: Coping Ahead is an effective technique from Dialectical Behaviour Therapy (DBT) that helps you prepare for stress and manage emotions ahead of time.

Eventualities

When I was 19 years old I learned to pilot gliders (airplanes without engines, also called sailplanes). Before each flight, we would always go through our pre-flight checks, even if the aircraft had just landed from a previous flight. We would make sure all of the controls worked as expected, the instruments were reading correctly, and of other important things worth double-checking when you’re propelling yourself two thousand feet into the sky!

The very last step of every pre-flight check was to review “eventualities.”

Though it’s been many years now since I last flew, I still remember vividly what I would say out loud to myself at this step, time and time again:

“If a wing drops on the launch and I cannot recover, I will release the launch cable and land ahead. At a safe height and speed I will start to climb. In the event of a launch failure, I will release the cable and lower the nose to a recovery attitude, and gain sufficient speed before maneuvering. I will land ahead if possible. Otherwise, I will turn downwind, which today is [left or right] and complete an abbreviated circuit or find a safe landing solution. The wind today is ___ knots which means my minimum approach speed is ___ knots.”

Coping Ahead saves time and effort.

The reason for talking through these eventualities in so much detail on the ground is that you’ve already made all of your decisions in the event of an emergency. In an unlikely situation where the pressure is on and seconds count, you don’t need to waste precious time or mental effort deciding what to do. You’ve already thought it through, and simply must follow your plan.

And this skill isn’t just for pilots! In DBT, coping ahead is an emotion regulation skill that can help you rehearse strategies ahead of time to better handle stressful situations or uncomfortable emotions. By visualizing and planning out how you will cope with challenging situations in advance, you start to feel more confident in your ability to face them, boosting your self-esteem and reducing stress.

What’s the difference between Coping Ahead and overthinking?

Overthinking is a common response to stress that can be counterproductive. It is also a common feature of anxiety that involves dwelling on worst-case scenarios, often leading to a cycle of negative thoughts and emotions. It can be triggered by a wide range of every-day stressors or perceived threats.

On the other hand, rather than going in circles about problems, Coping Ahead involves thinking about solutions. It is a deliberate and proactive skill, rather than a reactive response that actually impairs your problem-solving abilities.

How do I learn to Cope Ahead?

If you want to learn how to Cope Ahead, there are some practical tips you can try.

  1. Identify potential stressors in your life, such as upcoming deadlines or social events.
  2. Plan coping strategies that work for you, such as deep breathing, positive self-talk, or seeking support from friends.
  3. Rehearse your coping strategies in your mind, visualizing yourself using them and picturing how they will help.
  4. Lastly, remember to take some time to relax and ground yourself. Well done!

If you are struggling with…

  • Overthinking
  • Low self-confidence
  • Anxiety
  • A sense of low control in your life
  • Borderline personality disorder (BPD)
  • Other conditions that cause intense emotional reactions to common life stressors

…then consider seeking support from a mental health professional. Coping Ahead is a skill that can be learned and practiced, and therapy can provide a safe and supportive environment for developing this skill. Contact our clinic to learn more about how we can help.

Why I’m Optimistic in 2023

Why I’m Optimistic in 2023

Finding Hope in a World Full of Challenges

Reflecting on the past year, it’s easy to feel discouraged. We are facing multiple ongoing crises in mental and physical health, the environment, economic inflation, political divisiveness, civil unrest, and war. Social injustice remains rampant. These concerns should not be dismissed, and I want to start by emphasizing that optimism in no way neglects their importance. Nor do encouraging statistics take away from the fact that every needless death is a tragedy.

However, it’s also important – for our own sanity – to consider the good news. I often describe to my clients how our brains are hard-wired to pay more attention to negative events or feelings than positive ones. This is a well-studied psychological phenomenon known as negativity bias. It can lead to rumination and even depression. We recall criticism better than praise. We remember negative events more strongly than positive ones, and think about bad things more frequently than good things. Counterintuitively, our brains do this for our own benefit. It is far more important for survival to know where the dangers are than to take time to appreciate the wonders of life!

We see this reflected in our news and social media: negative and alarming news grips our attention, and so it gets more airtime. We click more frequently on alarming headlines, so they get published more often. This amplifies the illusion that the world is threatening by default.

We cannot make effective change when trapped in a state of despair. To avoid such a toll, it is important to balance our negativity bias with mindful awareness of what’s going well. And it turns out there are many, many good things happening!

Discovering Optimism

One antidote to the prevailing doom-and-gloom narrative of our time can be found in Matt Ridley’s Book The Rational Optimist. He uses hard data and historical analysis to show that we have made incredible progress in recent centuries, and this trend of increased prosperity is likely to continue as we innovate and adapt to ever-changing circumstances.

Another important book is the late brilliant physician Hans Rosling’s Factfulness: Ten Reasons We’re Wrong About the World–and Why Things Are Better Than You Think. He writes:

“Every group of people I ask thinks the world is more frightening, more violent, and more hopeless—in short, more dramatic—than it really is.

Uncontrolled, our appetite for the dramatic goes too far, prevents us from seeing the world as it is, and leads us terribly astray.

Step-by-step, year-by-year, the world is improving. Not on every single measure every single year, but as a rule. Though the world faces huge challenges, we have made tremendous progress. This is the fact-based worldview.”

Such thinking is not new, either. Even back in 1830, British historian Thomas Macaulay posited:

“Hence it is that, though in every age everybody knows that up to his own time progressive improvement has been taking place, nobody seems to reckon on any improvement during the next generation. … On what principle is it that, when we see nothing but improvement behind us, we are to expect nothing but deterioration before us?”

So, what exactly is all this progress that thinkers like Ridley, Rosling, and Macauley are talking about? Here are some examples.

Good News for a Change

Poverty is declining.

Globally, the number of people living below the poverty line (defined as living on less than $2.15 USD a day, in 2017 dollars) fell from 2.01 billion people (37.8% of the population) in 1991 to 648 million people (8.44% of the population) in 2019. It is still too early to calculate precisely how the covid-19 pandemic affected this trend; preliminary estimates indicate it may have pushed 70 million people or about 9% of the population back into extreme poverty in 2020. Yet the overall trend continues as it has for past decades. In 2017 renowned economist Max Roser commented that “Newspapers could have had the headline ‘Number of people in extreme poverty fell by 137,000 since yesterday’ every day in the last 25 years.” For more insights, see his excellent research website Our World in Data.

Population growth is stabilizing.

Although the global population is still growing, the rate of growth has been slowing down since 1968 in an accurately predicted manner. The population is expected to peak somewhere around 10.4 billion people in the year 2100, and then decline. With reduced poverty comes gains in education and health, and declines in child mortality, all of which are associated with lower birth rates.

The rapid decline in child mortality deserves its own emphasis: Hans Rosling once stated that “child survival is the new green.” According to his educational website Gapminder.org, “saving poor children is an important factor in ending both poverty and population growth. The death of children is not holding back population growth. It is one of the reasons poor people still have many children.” People have less children when they do not need to worry about whether or not those children will survive to adulthood.

Medical advancement continues at an astonishing pace.

Life expectancy is rising everywhere. People around the world are living longer and healthier lives, thanks in part to advances in medicine as well as increased access to nutrition and education. From vaccines that have eradicated deadly diseases like smallpox and polio to new treatments for chronic conditions, the progress in medicine is astounding.

For example, new medical technology allows us to identify cancer and other diseases earlier, leading to better treatment outcomes. Targeted therapies are becoming more widely available, less invasive, and more effective than traditional treatments like chemotherapy. Midstage trials are providing renewed hope for the development of vaccines against various cancers.

Genetics represent another marvel of medical advancement. Knowledge about the genetic basis of diseases helps improve diagnoses and treatments. Researchers are making significant progress in developing gene therapies that can cure sickle cell disease, HIV/AIDS, and other debilitating diseases. Genetic testing is now available for certain inherited conditions, like Huntington’s disease, which can help people make more informed decisions about their health and their future.

We are also making progress towards treatments for amyotrophic lateral sclerosis (remember the ice bucket challenge in 2015?) and Alzheimer’s disease. The development of robotics has transformed surgical procedures, resulting in faster recovery times and fewer complications. Telemedicine makes healthcare more accessible and convenient. Wearable tech like smartwatches and fitness trackers can monitor vital signs and alert patients and their physicians to potential health issues.

Mental health care is advancing too!

Technology is helping mental health treatment as well. Our clinic and many others offer secure telehealth appointments, so that remote clients can get the same treatment as everyone else. We utilize cutting-edge measurement-based care platforms such as Greenspace to monitor mental health outcomes and help clients gain insight into treatment progress. Apps like How We Feel and Calm help clients develop emotional intelligence and mindfulness skills in an easy, approachable way. Neurofeedback is another relatively recent technology that provides an excellent alternative (or complement) to traditional talk therapy.

There are many more examples of medical innovation, and it may take time for some of these gains to become sufficiently accessible. But every day we are making great steps towards a healthier world.

There’s still time for the environment.

There’s no denying the reality that ecological sustainability and preservation are serious concerns. It seems likely we will overshoot 2.5°C of global warming, leading to severe weather events, expansion of deserts, food insecurity, animal species extinction, and economic harm. However, we can take solace in the fact that many initiatives are working, and progress is being made.

Many countries have reduced their greenhouse gas emissions while increasing their GDP. The world is making great strides towards clean and sustainable energy. Renewable energy sources like solar, wind, and hydro are becoming more accessible and affordable. Even though nuclear energy has suffered tragic accidents, it remains one of the safest and cleanest forms of energy when compared to death rates from air pollution created by fossil fuels. Fourth-generation nuclear reactors currently being developed will be even smaller, safer, and more efficient with far less nuclear waste produced.  Scientists are making important discoveries towards fusion power, which has the potential to radically transform the world’s energy usage.

Another real concern is deforestation, but let us remember the wise words of Mr. Rogers concerning catastrophes: look for the helpers. Organizations like Cool Earth, which I fundraised for in 2019 and continue to support, are doing excellent work in this field. And we have data to support progress: a 2018 study published in Nature (one of the top scientific journals) identified with confidence that global tree cover has increased 7.1% since 1982.

Less harm from natural disasters

Furthermore, improvements in infrastructure and emergency preparedness have significantly reduced annual deaths from natural disasters, which were 3.7 million in 1931 and only 13,008 in 2022. Although we cannot prevent events like earthquakes, we can prevent high losses of life. The numbers prove that our efforts are working.

Admittedly, the tasks ahead will not be easy. But there is strong evidence that human effort and adaptability will allow us to fight current environmental threats and build a more sustainable world.

The world is more peaceful than ever before.

Given the widespread destruction and devastation in the first half of the 20th century, it is notable that the world has not seen a major global conflict in the past 78 years. Even considering the recent Ukraine conflict, warfare today is less frequent, less lethal, and more localized. While nobody knows the future for certain, there are reasons to believe that this calm and stability will persist. The globalization of trade means that the citizens of other countries are worth more to a nation alive than dead. As quality of life improves, we have less reason to engage in the discomforts of violence and vengeance. Institutions such as the United Nations have been developed to foster diplomacy, and cooperation has become more productive than armed invasion.

Violent crime is trending downwards as well. And the number of terrorist attacks and deaths from terrorism around the globe has dropped markedly since the 1970s (contrary to the over-representation of terrorism in the media, it accounted for just 0.05% of global deaths in 2017).

Overall, a person born in the world today is far less likely to be a victim of violence than a person born at any prior time in human history. That’s a remarkable achievement!

Basic needs are becoming more affordable.

It may be hard to believe, but it’s true: basic needs such as food, water, healthcare, housing, and education are becoming more affordable around the world. We owe this development to government and non-profit initiatives to reduce basic costs to individuals and families, as well as advances in technology, transportation, agriculture, and the global economy (lower prices stemming from businesses competing on a global scale).

The International Telecommunications Union, a United Nations agency, reported in 2022 that the price of mobile-broadband services has dropped to just 1.5% of gross national income per capita. Almost two-thirds of the world population has access to the internet. This number continues to rise, along with ownership of mobile phones. With more accessibility and affordability, the world is also becoming increasingly connected. I believe that will be a very important part of furthering communication and cooperation to solve global challenges.

What Now? “Learned Optimism.”

I hope these examples have conveyed that there are many reasons to see hope in all our futures. Our natural negativity bias can lead to a sense of learned helplessness. I firmly believe in countering it by cultivating learned optimism. We are better equipped to take on problems when we have an accurate, factual view of the world. The overwhelming evidence shows that the future is looking positive!

Here’s another piece of good news: the myth-driven stigma around accessing mental health care is disappearing rapidly.

In my clinical work, I often draw upon dialectical behaviour therapy (DBT), which teaches skills to strengthen emotional resilience and build a life worth living. These skills include radical acceptance (seeing situations as they are and focussing on what you can control rather than what you cannot) and checking the facts (developing a more accurate and realistic understanding of a situation rather than relying solely on assumptions and emotions).

Therapy can be useful in overcoming negativity and developing a more positive outlook on life. This is not simply turning a blind eye to suffering. Instead, it is about developing the skills to face challenges with a helpful and more effective outlook.

If you’re struggling with negative thoughts or feelings of helplessness, it’s important to remember that you don’t have to face these challenges alone. Consider reaching out to our team of skilled clinicians to explore therapy options and start building a more helpful future.

What Is Dialectical Behaviour Therapy? – An Intern’s Perspective

What Is Dialectical Behaviour Therapy? – An Intern’s Perspective

What the Heck is DBT?

When I first heard the term, “Dialectical Behaviour Therapy” the concept of it completely went over my head and had me silently swearing that I was never having anything to do with this form of therapy. Chances are, I am not the only one who feels intimidated by this complex approach. I can definitely empathize with anyone for feeling uncertain or overwhelmed by this theory because there’s certainly a lot to it. If you’re curious about DBT and want to learn more about it, then this post is for you!

The goal of DBT is to learn new skills and techniques to transform negative thinking and unhelpful behaviours into positive outcomes.1,2 This approach started out specifically for those with chronic and severe suicidal ideation and suicide attempts, and later for those living with Borderline Personality Disorder (BPD), but has shown to be useful for individuals who struggle with lower thresholds of self-harming, eating disorders, substance abuse, major depression, and more.3

 

What is a Dialectic?

Let’s tackle the first part of DBT – the dialectic. In reference to counselling, a dialectic is finding a balance between two opposites. It’s the understanding that two ideas can be correct at the same time, letting go of black and white thinking, and understanding that there’s no universal truth.4 A real-life example of finding a dialectic would be having to opposing thoughts such as: “I can trust everyone,” or, “Nobody can be trusted,” which then the dialectic would be finding that sweet spot in the middle which would be, “I can trust some people, but not everyone I know,” and coming to terms with the fact that those two opposing beliefs, trust and distrust, can exist at the same time.4

In DBT, we encourage clients to ask themselves, “What is missing from my understanding?” instead of accepting a final answer or conclusion. This is a way of expanding our perceptions of things and understanding and validating another person’s perspective.4

 

What is the Behaviour part of DBT?

The behaviour part of DBT includes learning practical skills and helpful behaviours and letting go of the actions that interfere with our quality of life and personal wellbeing. There are four main modules that are covered in DBT to teach these skills:

  1. Interpersonal Effectiveness: this module includes being able to ask for what we need, reach our goals, and to cope with difficult interactions or conflicts.
  2. Distress Tolerance: this module builds the ability to notice situations that evoke a negative emotional response and to be able to see the impact it has on us. The purpose of this is to be able to make rational decisions about how we want to proceed.
  3. Emotion Regulation: this module encourages noticing our emotional experiences, but not letting the emotion completely take over. Clients learn to use self-soothing techniques to cope with the strong feelings and develop the skills to act mindfully and intentionally while experiencing emotions.
  4. Mindfulness: this module teaches us how to accept and cope with powerful emotions and to be able to notice the present moment we are experiencing, along with the emotions and sensations that come with it with a non-judgmental mindset.

 

What is the Therapy part of DBT?

DBT is implemented through a variety of ways, such as skills training group and individual therapy. The group is typically 6-12 months long and is meant to introduce us to skills that are intended to improve our coping and ability to manage powerful feelings. The individual sessions focus on increasing our motivation and skill application. Individual DBT sessions give us a chance to work towards our personal goals and to apply our skills in our day-to-day life.

 

Final Thoughts

I hope that this article helps you understand a bit more about DBT. It’s certainly been a big learning curve for me, and I’ve come to appreciate the complexity of issues it’s able to address. While it can still be daunting at times, the beauty of DBT is that it can be broken down into bite-sized, practical skills and steps that help us move forward.

If you think DBT could be helpful to you, or you just have some more questions about it, please feel free to give us a call, we’d love to hear from you!

 

Resources

  1. Centre for Addiction and Mental Health. (2019). Dialectical Behavioural Therapy, from https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/dialectical-behaviour-therapy
  2. Child Youth Mental Health. (2010, May). DBT Training. Lecture presented at DBT Training, Abbotsford
  3. Gleissner, G. (2016). What Is DBT? Retrieved March 18, 2019, from https://www.psychologytoday.com/us/blog/hope-eating-disorder-recovery/201609/what-is-dbt
  4. Miller, A. L., Rathus, J. H., & Linehan, M. (2007). Dialectical behavior therapy with suicidal adolescents. New York: Guilford Press.
What To Expect In A DBT Skills Group

What To Expect In A DBT Skills Group

Expectations, whether based on fact and experience, or our own assumptions and interpretations, have the tendency to either prepare or disappoint. Because of this, it’s important to understand what differentiates DBT skills groups from other therapeutic groups, so that you can make an informed decision about whether participating in a DBT skills group will be beneficial for you. Joining a DBT skills group is a 24-week commitment and although this experience can prove highly effective, it may not be a good fit for everyone.

 

How Are DBT Groups Different?

 

A common misunderstanding of DBT skills groups is that they are comparable to other therapeutic groups, such as process groups or support groups. Although the DBT skills group atmosphere often fosters feelings of peer support and understanding, the primary purpose of these groups is to learn effective skills.

 

The DBT skills group format allows for the sharing of personal information at the discretion of each group member, however, the majority of information shared within the DBT skills group is done in relation to the use of the DBT skills. This practice ensures that any difficulties implementing the skills may be addressed, by both the facilitators and group members. Although DBT skills groups encourage group member interaction and input there is a classroom-like component, as each week a new skill is taught. One of the benefits of participating in a DBT skills group is that each group member brings their own experiences and unique approaches to particular skills and situations. This opportunity the learn together, and from each other’s experiences helps us learn innovative ways to approach the skills.

 

A DBT skills group is an essential component of Dialectical Behaviour Therapy. While combining individual therapy and the DBT skills group is not mandatory, it is important to recognize that the main goal of a DBT skills group is to teach and support group members in effectively using new skills. The emphasis on teaching new skills – and the very nature of a group setting – allows for less 1-on-1 attention for each group member and is a reason that supplementing DBT skills group with individual therapy is recommended.

 

What Does a DBT Skills Group Session Look Like?

 

Each DBT group session will begin with mindfulness practice. Mindfulness can take many forms, ranging from mindful colouring to guided visualization, and is incorporated for both personal practice and group benefit. This practice can help group members become present and ready to engage and learn in a group.

 

Following mindfulness, each group member is given an opportunity to check-in and let the rest of the group know how their week has been, with an emphasis on skills tried and used. This can be an opportunity for group members to troubleshoot skills that were not as effective as they’d hoped or suggest alternate skills that may have been effective for the given situation or particular struggle. Group interaction and insight can be a particularly helpful addition to check-in. This can also be a time to review any homework or questions from the previous week’s group.

 

After a short break, the second half of the DBT group session is dedicated to learning a new skill. All DBT skills are separated into four main modules: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. These skills are taught with an emphasis on being effective in everyday life. Oftentimes real-life examples can be used to illustrate how each specific skill can be effective; group members are welcome to present a relevant personal situation where a skill may be useful to see its specific application if they so choose. As the founder of Dialectical Behaviour Therapy, Marsha Linehan would say, the goal of DBT is to create “a life worth living.” Through the learning of skills and the support of the group, clients can be supported in gaining control of their lives and moving toward a life worth living.

Click here to learn more about our youth and adult DBT groups!

How Can I Use Dialectical Behaviour Therapy Techniques Like Mindfulness?

How Can I Use Dialectical Behaviour Therapy Techniques Like Mindfulness?

One of the questions we get a lot is what are some of the specific Dialectical Behaviour Therapy (DBT) techniques that we teach clients? I think this is a great question and one that we can answer through some blog posts, so here’s the first one – I hope you like it!

Mindfulness is the at the core of dialectical behaviour therapy – it’s the foundation, if you will, that everything else is built upon. Mindfulness is the practice of being present in the moment, without judgement and without attachment to it. It sounds simple, but it is often very difficult for us to practice in our daily lives.

 

What are the goals of mindfulness, with respect to DBT, you might wonder? According to Dr. Marsha Linehan, the goals are threefold:

 

  1. Reduce suffering and increase happiness
  2. Increase control of your mind
  3. Experience reality as it is

 

The mindfulness skills learned through engaging in dialectical behaviour therapy help clients create their own mindfulness practice. A mindfulness practice involves incorporating different skills into a routine practice that is woven into our lives as a foundation for doing life. This can involve any or all of the skills, meditation, contemplation, and mindful movement.

There are three core mindfulness skills in dialectical behaviour therapy and I want to introduce one of my favourites because it’s one of the ones I’ve found most helpful: Wise Mind.

 

The Wild Mind

 

You won’t find this terminology in any DBT books, but it’s what I call the dance between the two extreme states of our minds: logic vs. emotion. In DBT terms, we’d call the two polar opposites Reasonable Mind and Emotion Mind.

Often, we tend toward one or the other especially when we’re under stress. Those of us who are more naturally prone to logic will rely on this part of our mind to make everything rational, logical, and pragmatic at the cost of ignoring emotional content. Others more naturally drawn to emotion will rely on this part of the mind to make everything about mood, feelings, and impulses to do or say things.

As you can probably tell, both of these approaches are likely to create problems because they focus on one area at the cost of ignoring the other. So, what’s the alternative?

 

The Wise Mind

 

The concept of Wise Mind within the framework of mindfulness involves combining the two minds, Reasonable Mind and Emotion Mind into a new framework – Wise Mind. Wise Mind balances the Reasonable Mind and Emotion Mind and allows us to follow a middle path.

Another description of Wise Mind is something we often call wisdom. In this case, it’s the wisdom within each of us that combines both our more rational, reasonable mind with the emotion-focused part to create a full picture. This focus allows us to see, and value both reason and emotion, bringing the left and right brains together as one.

I was just remarking to a client that someone once described wisdom to me this way:

 

Knowledge is knowing that a tomato is a fruit. Wisdom is not putting it in a fruit salad.

 

Apparently, this quote came from Miles Kingston, a journalist and musician, and what I like is that it helps explain the difference between wisdom and knowledge. In our case, knowledge is what each of our minds is telling us – our reasonable and our emotion mind. Wisdom is knowing how to combine that information and knowing what to do with it – our Wise Mind.

 

How Can I Get Started Using Wise Mind?

 

Mindfulness takes practice, as does listening to Wise Mind. Here’s an example exercise that you can try right now to see if you can listen to your inner wisdom using Wise Mind. It’s taken from the Mindfulness Handouts in the DBT Skills Training Manual from Dr. Marsha Linehan:

 

Asking is this Wise mind?

 

Breathing in, ask yourself, “Is this (action, thought, plan, etc.) Wise Mind?”

  • Breathing out, listen for the answer.
  • Listen, but do not give yourself the answer. Do not tell yourself the answer; listen for it.
  • Continue asking on each in-breath for some time. If no answer comes, try again another time.

This may not come naturally to you at first, in fact, it probably won’t. Repeat this exercise and see if you can allow yourself to enter a mindful space where you can notice what your Reasonable Mind and Emotion Mind are telling you, and then listen to your Wise Mind to see how you can trust your inner wisdom and operate out of an effective, mindful place in your decisions.

 

If you’d like help with this, we’re always happy to help! Please give us a call or contact us for options!

 

 

References

Linehan, M., M., (2014). DBT Training Manual. New York, NY: The Guilford Press.

Linehan, M. M. (2015). DBT® skills training handouts and worksheets (2nd ed.). New York, NY, US: Guilford Press.

 

You Are Richer Than You Think

You Are Richer Than You Think

“You are richer than you think.” This is the current slogan being used by Scotiabank. When I hear this slogan, I think of the clients who are participating in the various DBT groups here at Alongside You.  DBT is the short form of Dialectical Behavioural Therapy, created by Dr. Marsha Linehan, who is a psychologist working at the University of Washington in Seattle. This treatment is the gold standard for clients struggling with unstable identity, risky behaviours, chaotic relationships and an inability to regulate emotions and urges. The DBT skills taught in our groups focus on Distress Tolerance and Crisis Management, Interpersonal Effectiveness, Emotion Regulation and Mindfulness. There has been much research supporting this form of therapy that it is now also designated as the gold standard for Borderline Personality Disorder. The skills are also very helpful for clients trying to manage depression, anxiety and substance misuse.

In addition to skill building, learning and participating in a group format has many other benefits. I have facilitated groups of various kinds for 40 years and have been witness to so much growth in so many clients that I can say with confidence that a group experience is a very rich one. Dr. Irwin Yalom describes in his book, The Theory and Practice of Group Psychotherapy that the following factors occur when participating in group therapy:

  1. Instillation of Hope
  2. Universality
  3. Imparting of Information
  4. Altruism
  5. Corrective recapitulation of the primary family group.
  6. Development of socializing techniques
  7. Imitative behaviour
  8. Interpersonal learning
  9. Group cohesiveness
  10. Catharsis
  11. Existential factors

Dr. Roy Mackenzie in his book, Time-Managed Group Psychotherapy, identifies learning factors such as

  1. Modelling
  2. Vicarious learning
  3. Guidance
  4. Education
  5. Support
  6. Self-revelation and Insight

 

As the late famous American poet Maya Angelou says, “we are more alike than we are different.”  Why then do we sometimes we feel that we are left behind while others live their life without strife? This is certainly how it may appear on the various social media sites. More and more I see young clients who spend hours daily checking up on friends on the various social media platforms on the internet. It seems to me that it would be much more healthy to call a friend and plan to do an activity together. If we parallel play as young adults we are not growing psychologically. Attending a group is a good start to get back in the game of communicating both verbally and nonverbally with other people. People need people as we are social beings by nature. A group is a microcosm of society in general.  When clients feel supported in a genuine way they are likely to experience some or all of the healing factors mentioned above.

Another factor involved in a group setting is the undercurrent explained by the psychoanalyst, Wilfred Bion, in his book Experiences in Groups. Bion says that there are three basic assumptions working alongside any working group. These are mostly unconscious but are helpful for facilitators to consider if a group they are running is starting to struggle. The first basic assumption is the dependency and this happens when leaders are dialectically idealized and devalued. The second basic assumption is pairing in which two group members bond in an attempt to overthrow the leader. The third basic assumption is fight or flight, which happens when the group has a common enemy. It can be a taxing job to be teaching skills as well as observing the group process and the underlying basic assumptions all at the same time. Extra training on group skills is highly recommended when moving from individual therapist role to a group therapist role. I believe that this is one of the reasons our groups are so effective here at Alongside You. We work diligently to create the best atmosphere for people to learn and to grow.

Groups are a dynamic force and when change happens to the individual group members this impacts and creates a vibration which results in changes to the whole group. Systems theory suggests that groups over time tend to develop a self-organizing nature which works to maintain stability and minimize threats. Through this, clients can experience a safe space to explore their challenges and their successes, and learn from, and encourage each other.

My goal when I co-facilitate our Dialectical Behavioural Therapy group is to have clients leave after 24 weeks being even richer than they think they are, as they carry their new tools to help them achieve a “Life Worth Living.” Feel free to contact us to learn more about Dialectical Behavioural Therapy.