fbpx
Using Art and Mindfulness for Pain Control

Using Art and Mindfulness for Pain Control

Using Art and Mindfulness for Pain Control

 

“Art gives a face to the ambiguity of chronic pain…it gives a visual expression to something that is often elusive.”

– Dr. Steve Feinberg, American Chronic Pain Association

 

It’s Not Easy Being In Pain

 

How many of us have pinched a finger in a door, have sprained or broken a limb, have woken up with a back ache or gone to bed with a searing migraine? In some form or another, we can relate! After all, we are human. For some of us, however, either due to injury or illness, the pain never goes away. Day in and day out, pain follows us all the time. It is no surprise then, that pain impacts all aspects of our lives: our sleep, our ability to work or go to school, and even our social connections and family relationships. Using art and mindfulness for pain control can be an extremely helpful tool for our journey. Before we get into that, let’s look at some of the information on chronic pain and illnesses.

 

The Statistics

 

Did you know that nearly 8 million people in Canada live with chronic pain (or pain that persists for than three months)?i This means that 1 in 5 people suffer from prolonged pain. 1 in 5 children and youth experience ongoing pain and 1 in 3 adults 65 and older experience chronic pain.ii This can include but is not limited to conditions such as endometriosis, cancer, neurological disorders, fibromyalgia, and Lupus.

Like other chronic illnesses, the chronic pain experience is also impacted by other factors such as poverty, mental health and substance use issues, diversity in gender, race, ethnicity, abilities, and concurrent medical conditions.iii

 

The Stigma

 
Some of us have been on the receiving end of a dirty glare when parking in a handicap space, using the elevator meant for those with physical disabilities, or for not offering your seat on a bus to another person with physical disabilities. If only they knew! Because chronic pain is largely invisible, those affected by it can often feel disbelieved, unheard, or dismissed. The stigma builds as individuals are labeled as a “problematic and frequent patients,” mainly because they seek medical treatment regularly. The huge range of symptoms that one can have related to chronic pain makes it difficult to reach a diagnosis and plan for treatment. What begins is a search for effective, compassionate and quality help.
 

Facing Challenges

 
For people living with chronic pain or illness, getting help is not always straightforward.
In my own pain experience and in my work with others with chronic conditions, this seems to be a reoccurring experience. Navigating through our medical system is complex and confusing at times. For patients with chronic pain it’s certainly not a walk in the park!

To be fair, medical professionals do their best to care for their chronic pain patients but struggle to work within a health care system that is not always well-equipped to manage the complex nature of pain. With nearly 900,000 British Columbians without a family doctoriv, the limited amount of time with each patient, and long wait times in walk-in clinics and emergency wards, medical professionals are not always able to spend the time they need or want to with their patients.

As a result of this, chronic pain sufferers are faced with considerable challenges when seeking help?

  1. The need to review their medical history for every new practitioner. With each new doctor or specialist, patients are asked to review their medical challenges and ‘pain history’ and it is exhausting! If there is no continuity of care or no regular doctor who can follow your progress and prescribe effective treatments, those with chronic pain can be left with feelings of despair and frustration.
  2. Self-advocacy is hard. With many chronic pain symptoms being invisible, those of us with chronic conditions need to be forthright, consistent, and clear when we articulate our symptoms, and defend our state of being and need for treatment. This not a skill that everyone has and it forces already vulnerable people to go outside of their comfort zone or find an advocate who can be their spokesperson.
  3. It is hard to get timely help. It can take many months and even years to see specialists, receive surgery, or gain access to public pain programs. In the meantime, patients are left to cope, to seek out alternative forms of treatments. Sometimes it’s hard to know where to look, and see if they are accessible (financially, geographically, or demographically).
  4. Building a support network is not always easy or within reach. With prolonged reliance on friends and family for practical, financial, physical, emotional, and spiritual support, those with chronic pain may be left with changed or strained relationships. Asking for help regularly or relying on others may not always be an option due to life circumstances. Feelings of loneliness and of being a burden often weigh heavily on those with prolonged pain.

 

How Do We Address These Issues and Improve Quality of Life?

 
How many times have you heard, “You’re going to have to learn how to live with your pain?” We groan, yes, but it’s true. There is no magic wand, so how do we do this? The chronic pain experience is riddled with complexities; because it has both physiological and psychological components, taking a holistic approach in tackling chronic pain is the most effective treatment plan in retraining our body and brain. For a good discussion of the importance of a multi-disciplinary approach to pain management, check out this video.

When used together, interventions such as pain medication, surgical procedures, counselling, body work (occupational therapy, physiotherapy, massage therapy, exercise, acupuncture), and the arts (visual, performance, music, dance, literary), can reboot our nervous system, teach us productive skills to manage symptoms, and help us to connect with ourselves and others and have a better quality of life amidst our pain experiences.
 

The Role of Art and Mindfulness For Pain Control

 
Using the Arts and mindfulness for its health benefits is widely becoming a critical component of healthcare to positively enhance, impact, healv and strengthen overall health and well-being.vi Research shows that mindfulness, or the act of paying full attention to the present moment without judgement,vii is a very effective practice to provide relief for both physical and psychological symptoms of chronic pain. Jon Kabat-Zinn, leading researcher of MBSR (mindfulness-based stress reduction) advocates that mindfulness can alleviate symptoms of pain, reduce stress in the body, alter our negative thought distortions to more positive ones, create emotional balance, and enhance overall health.viii

It’s no surprise then, that combining the art making process with mindfulness can be an effective way to tackle pain management. The very act of creativity and expression can promote body awareness,ix be an effective practice for rehabilitation and lead to significant life changes. It also offers a tangible and fun way to learn mindfulness skills, and encourage self-compassionate creativity.
 

What types of art activities can we do to learn mindfulness?

 
There are a wide variety of artistic activities that can help us learn to be mindful. Here are a few ideas:

  • Activities such as drawing, paper marbling or knitting can provide temporary respite or healthy distraction from physical symptoms of pain,xi xii and allow chronic pain sufferers to lose themselves in the moment or artistic process.xii xiii
  • Reflective journaling and guided meditation connects both the physical body and the psychological mind, using the art making process to encourage positive self-care, and experimentation and risk-taking, two essential qualities of the art-making process.xiv
  • Creating a self-portrait or vision board is a way to explore understandings of self, improve self-confidence,xv process suffering or significant life changes, and provide a visual representation of the life you want to have moving forward.
  • Making art with others in a supportive environment can help us feel connected and understood by talking to others about pain experiences,xvi building companionship, and having a sense of belonging, and decreasing social isolation and loneliness.
  • Selecting from a range of colours, shapes or images in an art activity encourages experimentation,xvii affirms a sense of control over surroundings and the decision-making process, and builds upon and improves cognitive functions (memory processing and problem solving).xviii

 
Using art and mindfulness for pain control, along with healthy changes to our diet, sleep, and exercise regimes and with attentiveness to empathy and creativity can help lower stress levels, give our nervous system a rest, and helps to promote self-care habits. By using a variety of creative processes, health difficulties can be better expressed, understood, accepted, and help us build our resilience. xix

I hope this article has given you a taste of the benefits of using art and mindfulness for pain control. If you want to try something fun, meet others who understand and support you, and learn how to manage symptoms through the process of creating, join us in our Pain in the Arts class, where we will learn how to make art with a mindfulness lens.

If you want to learn more about our Arts in Health Program at Alongside You, please visit our page on Arts in Health.
 
 


i. Canadian Pain Task Force Report. 2021 Accessed July 13th, 2022. Link
ii. Canadian Pain Task Force Report. 2021 Accessed July 13th, 2022. Link
iii. Canadian Pain Task Force Report. 2021 Accessed July 13th, 2022. Link
iv. Xu, Xiao “Nearly 900,000 British Columbians don’t have a family doctor, leaving walk-in clinics and ERs swamped.” Globe and Mail. April 29 2022. Accessed July 13th. Link
v. Fancourt, Dr. Daisy; Warren, Katey and Augusterson, Henry. “Evidence summary for policy: The role of arts in improving health and wellbeing.” Report to the Department for Digital, Culture, Media, and Sport. April 2020. Accessed July 5th, 2022.
Link
vi. Link
viii. Gardner-Nix, Dr. Jackie and Lucie Costin-Hall. The Mindfulness Solution to Pain. New Harbinger Publicaitons, Inc. 2009: vii.
ix. Callahan, Margaret Jones. Mindfulness Based Art: The Sparks Guide for Educators and Counselors. Friesen Press. 2016.
x. Ann Behav Med. Eds. Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis.2017 Apr;51(2):199-213.Link
xi. Kabat-Zinn, J., Lipworth, L. & Burney, R. J The clinical use of mindfulness meditation for the self-regulation of chronic pain. Behav Med (1985) 8: 163.
xii. Dr. Daniel Potts. How art therapy enhances the life for Dementia Patients. 2014. Accessed September 15th, 2016. Link
xiii. “The Art of Pain Management.” American Chronic Pain Association: Link
xiv. McNiff, Shaun. Chapter 2: The Role of Witnessing and Immersion in the Moment of Arts Therapy Experience. P. 41. In In Mindfulness and the Arts Therapies: Theory and Practice. Laury Rappaport ed. Jessica Kingsley Publishers. 2014: 38-50.
xv. McNiff, Shaun. Chapter 2: The Role of Witnessing and Immersion in the Moment of Arts Therapy Experience. P. 40. In In Mindfulness and the Arts Therapies: Theory and Practice. Laury Rappaport ed. Jessica Kingsley Publishers. 2014: 38-50.
xvi. Monti, Daniel W., Caroline Peterson, et al. A Randomized, Controlled Trial of Mindfulness-based Art Therapy (MBAT) for Women with Cancer. Thomas Jefferson University, Philadelphia, PA, Psycho-Oncology 15:363–373 (2006)
xvii. McNiff, Shaun. Chapter 2: The Role of Witnessing and Immersion in the Moment of Arts Therapy Experience. P. 41. In In Mindfulness and the Arts Therapies: Theory and Practice. Laury Rappaport ed. Jessica Kingsley Publishers. 2014: 38-50.
xviii. Quintana Hernández DJ et all. The effects of a neuropsychology program based on mindfulness on Alzheimer’s disease: randomized double-blind clinical study. Revista Espanola de Geriatria y Gerontologia [2014, 49(4):165-172]
xix. McNiff, Shaun. Chapter 2: The Role of Witnessing and Immersion in the Moment of Arts Therapy Experience. P. 40. In In Mindfulness and the Arts Therapies: Theory and Practice. Laury Rappaport ed. Jessica Kingsley Publishers. 2014: 38-50.
Arts In Health – Why We Should Be Using Art In Healthcare

Arts In Health – Why We Should Be Using Art In Healthcare

What is Arts in Health?

 

The idea that The Arts have a role in the health of individuals and communities has a long history in cultures around the world.i Arts in Health (also known as Arts in Medicine or Art in Healthcare) incorporates The Arts (visual, performing, literary, music, and dance) to support and enhance the continuum of care and plays a critical role in the overall health and well-being of people seeking help for various conditions.

This growing field of research and inquiry is developing world-wide, especially in The United Kingdom, Australia, the United States, and across Europe.ii Increasingly, medical professionals are ‘socially prescribing’ non-medical, community-based activities and services that provide patients and practitioners greater health options when faced with complex medical and social problems.iii Though not as developed as in other countries, there are various health initiatives that incorporate The Arts with diverse creative holistic approaches to health across Canada.iv

This multi-disciplinary approach to health is becoming recognized both as an effective and creative way to positively impact health outcomes in both inpatient and outpatient healthcare and community settings, and boost mental, emotional, social, physical and brain health.

Specifically, participating in the art-making process:

 

  • Reduces stress, anxiety and depressionv
  • Improves self-confidence,vi self-awareness and empowermentvii
  • Encourages positive self-care skills
  • Provides a supportive setting to socialize, decreasing loneliness and social isolation
  • Is an effective preventative tool to manage symptoms of chronic pain and illness, and diseases such as Dementia, or Alzheimer’s disease
  • Improves and maintains neuro-spatial functions, memory processing and problem solving as we ageviii
  • Fosters emotional resilience, confidence, and personal growth
  • Is a healthy outlet and distraction tool to heal from physical, emotional, and psychological issues

To learn more, check out this infographic based on the research of Alain De Bolton and John Armstrong “Art As Therapy.”

 

Where does Arts in Health take place and what does it actually look like?

 
If you have ever been to a museum, a hospital, or community-based care home, you have most likely come across both art work and programs that fit under the umbrella of Arts in Health.

Museums and art galleries are accessible places where art can be viewed, questioned, created and bought. Artists and craftspeople are culture makers; they often play a huge role in cultural education and wellness. They are catalysts and bring people together through exhibitions, celebrations, ceremonial performances, and demonstrations. Artists can also showcase their work and sell their handcrafted art pieces.

Art work or painted murals are displayed in hospitals in hallways, waiting rooms, intensives care units, palliative and hospice wards, treatment and operating rooms and children’s wards. Outdoor art installations are also found on hospital grounds, music is played in high stress areas to benefit the patients and health-care staff, art activities are used at bedsides or during treatment (chemotherapy, radiation, and dialysis).

Community-based organizations such as rehabilitation and addiction centres, women’s shelters, day programs for people with diverse abilities, and immigrant services are just a few examples of where recreational forms of art-making are used to strengthen, to heal, and to communicate.
 

Who Benefits from Arts in Health Programs?

 
Along with other therapeutic interventions such as counselling, neurofeedback, Dialectical Behavioral Therapy (DBT), Cognitive Behavioral Therapy (CBT), occupational therapy and physiotherapy, The Arts allows us to discover, explore, practice, connect not only with others, but with ourselves. More specifically:
 

  • Kids and Teens: Approximately 20% of Canadian youth are affected by a mental illness or disorder.ix Extracurricular activities such as art making can be especially beneficial for both teens and children because it provides a fun, non-threating, and inclusive setting where they can be introduced to new skills, learn coping strategies, shore up defenses and can develop deeper understandings of themselves and others.x
  • Socially Isolated Individuals: Approximately 1 in 5 Canadians say that are not satisfied with their number of friends.xi Loneliness is real. Making art with others can promote social satisfaction and allow individuals to connect with others with similar interests
  • Caregivers or other individuals with overwhelming stress and anxiety: Using The Arts is good place to begin when coping with the stresses of everyday life. Picking up a paint brush or writing in a journal can be small but positive self-care steps to improve everyday life
  • Individuals with diverse needs, abilities, and diagnoses: People with diverse physical, intellectual, developmental, and emotional needs thrive when art activities are tailored to suit their individual interests and needs. Those with chronic pain or illnesses also benefit from the art making experience which helps in pain management
  • Individuals who just want to have fun! Making art in a beautiful space with a variety of different art, alongside others can really boost our mood. We can also receive individualized and collective support and guidance while working on creative projects
  •  

    Who is considered an Arts in Health practitioner?

     
    Arts in Health practitioners are composed of a variety of individuals: professionally trained artists, artists-in-residence, expressive arts practitioners (who use multiple forms of art), arts or health educators, art consultants, community-based support staff, other health-care professionals, recreational instructors in hospital or community programs, or other creative individuals who incorporate art in health disciplines.xii

    These practitioners provide patients, family members, and caregivers with opportunities for creative engagement in a variety of ways. Many artists are involved in fundraising efforts for health-related causes. From auction items, art commissions, internet sales, art shows, and community events, artists are uniquely woven into the commercial market, bridging artistic development to benefit healthcare initiatives. It is common for artists to work as educators inside schools or workplaces. They lead students, teachers, businesses and organizations in creating collaborative art pieces, and provide training and professional development on how to practice self-care and how to infuse wellness in their classroom or organization.

    Artists have always played a pivotal role in places of religious expression and places of worship, such as churches, mosques, temples and more. They help bridge creative expression (music, building architecture, prayers) with spiritual health and healing.

    Musicians, performance artists, dancers, visual and literary artists play a huge part in improving our collective quality of life, especially during challenging times. Throughout the pandemic, we have seen how The Arts have brought us together and helped us cope anxiety and stress.
     

    So why does Arts in Health matter?

     
    Increasingly, the health-care system is going thought a shift, one that focuses on treating the whole person (body/mind/soul), not just the condition. Medical programs are integrating the arts into training, teaching and research because of the overwhelming evidence-based research that shows a direct correlation between healing and the arts.xiii

    This infographic provides a great visual on the importance of community-based Arts in Health.

    Both on an Individual and community level, at Alongside You, we seek to reduce the burdens of illness, to foster connection, provide hope and build resilience so we can help others live vibrant and thriving lives. It is for these reasons that we offer Arts in Health programs at Alongside You. If you have any questions about how our Arts in Health programs can help you on your journey, please reach out to me and I’ll be glad to hear your experience and talk about how including arts in your health plan could help!
     

    “An active engagement with the arts – whether as a participant, or as a viewer – is one effective way for individuals and communities to address issues of public health. We recognize that prevention and health promotion are important in avoiding the costs and issues associated with acute care later on, down the road. This is where the arts are effective in health promotion.”

    – Sarah Chilvers, (former Program Director for Health and Social Development for the Vancouver Foundation)


    i. Clift, Stephen, and Paul M. Camic (eds). Oxford Textbook of Creative Arts, Health, and Wellbeing: International Perspectives on Practice, Policy and Research. Oxford University Press. 2016. Page 3.

    ii. Clift, Stephen, and Paul M. Camic (eds). Oxford Textbook of Creative Arts, Health, and Wellbeing: International Perspectives on Practice, Policy and Research. Oxford University Press. 2016. Page 4.

    iii. Wouldn’t it be great to have this in Canada?

    iv. To name a few: Dalhousie University’s Medical Humanities Program called Heals, that combines the arts and humanities with healthcare; The University of Prince Edward Island’s Advancing Interdisciplinary Research in Singing (AIRS) Research Environment that connects researchers across discipline with singing and well-being; McGill University’s leading researcher in neurosciences, Daniel Levitin’s work on the impact of music and the brain; Arts Health Network is hub that links research in arts and health knowledge across Canada; In Manitoba, University of Victoria’s Health Initiative (UHI) aims to enhance health research, healthy aging, indigenous health, and mental health.

    v. Repar, Patricia Ann DMA; Patton, Douglas Med. Stress Reduction for Nurses Through Arts-in-Medicine at the University of New Mexico Hospitals. The Departments of Music and Internal Medicine.

    Holistic Nursing Practice: July 2007 – Volume 21 – Issue 4 – p 182-186. University of New Mexico. Accessed July 14th, 2022. https://journals.lww.com/hnpjournal/Abstract/2007/07000/Stress_Reduction_for_Nurses_Through.4.aspx

    vi. McNiff, Shaun. Chapter 2: The Role of Witnessing and Immersion in the Moment of Arts Therapy Experience. P. 40. In In Mindfulness and the Arts Therapies: Theory and Practice. Laury Rappaport ed. Jessica Kingsley Publishers. 2014: 38-50.

    vii. McNiff, Shaun. Chapter 2: The Role of Witnessing and Immersion in the Moment of Arts Therapy Experience. P. 41. In In Mindfulness and the Arts Therapies: Theory and Practice. Laury Rappaport ed. Jessica Kingsley Publishers. 2014: 38-50.

    viii. Zeki, Semir. Art and the Brain. Journal of Consciousness Studies 6(6-7). 1999. Accesses September 14th, 2020. Link

    ix. Canadian Mental Health Association Statistics: Mental Health and Mental Illness. Link

    x. Coholic, Diana. Arts Activities for Children and Young People in Need. (2010). P. 11.

    xi. Canadian Mental Health Association. Coping with Loneliness. Link

    xii. Dewey, Patricia, Bettes, Donna et.all. Arts, Health and Wellbeing in America. (2017). Accessed July 15th, 2022. Link

    xiii. This is evident with the growing recognition amongst Canadian physicians the establishment of medical schools such as Queens University, Memorial University of Newfoundland, the University of Alberta that bridge medical training with The Arts.

Moving Out of the Comfort Zone

Moving Out of the Comfort Zone

I have had a year full of rich learning experiences. My training in dance/movement therapy began and I experienced movement in new ways as courses progressed throughout the year. With an artistic background in dance, I have been trained to look, move, and perform a certain way. Engaging in the therapeutic aspects of the movement has been an eye-opening and challenging experience. I found myself defaulting to the comfort zone of performing rather than allowing my innate internal rhythms to lead. It is emotionally safer to produce choreography and follow dance steps than it is to engage emotions and allow them to move through me. As I reflect on this past year, I realized the comfort zone can be a difficult place for many of us to leave.

 

Living in Greater Vancouver, the normal flow of life is going from one event to the next without taking a break to recalibrate our system and allow the body to catch up to our mind and emotions. Many of us go from dropping off our children at school, straight to work, to appointments or extracurricular activities, and then crash at the end of the day. Our nervous systems are being stimulated with sensory input at an 80/20 ratio throughout the day (80% incoming, 20% releasing).1 This can be extremely overwhelming for our systems, particularly for children. To release ourselves from the busyness of life requires us to move outside of our comfort zone and the life patterns we have created for ourselves.
 


The Mind-Body Disconnection

 

With the imbalance of incoming and outgoing stimulation, we risk losing our mind-body connection and become influenced by our external environment. Interoception information is received and transmitted from inside the body.2 When we are interoceptive, we are aware of things like hunger, pain, and body sensations our emotions elicit. The butterflies in our stomach when we’re nervous, the tightening of our chest when we’re angry and the crushing headaches associated with grief are all examples of interoception.

 

When we push through symptoms signalling us to slow down or take a break, we tend to lose our interoception. The accumulation of this mind-body disconnection has adverse effects on our health. We get fatigued, stressed, and sick. All emotions have a muscular pathway. If emotions are not permitted to sequence through the neuromuscular system, the consequences are ill health, both physically and mentally.3
 


Dance/Movement Therapy

 

Dance/movement therapy (DMT) takes individuals to the edges of their comfort zone to integrate the mind and body to support wholistic wellness. Deriving from modern dance, the field of dance/movement therapy began in the early 1930s. Marian Chace was a pioneer in the DMT field being the first to bring dance into hospital settings as an intervention for war veterans battling post-traumatic syndrome disorder.4 Chace developed therapeutic dance/movement interventions as mental health treatment and supported the creation of the American Dance Therapy Association, serving as the first president.

 

Today, dance/movement therapy is recognized world-wide with therapists serving in schools, hospitals, rehabilitation centres, forensic settings, prions, and more. The goals of dance/movement therapy are to support the integration of emotional, physical, cognitive, and social aspects of an individual. A common misconception is dance/movement therapy is limited to dancers. No dance experience is necessary to engage in DMT. Movement therapy occurs on a continuum of movement. Engaging in DMT can be as simple as discovering your breath pattern, moving your arms while sitting, or finding movement through speaking.

 

The body has a memory and sometimes those body-based memories arise without our understanding. In dance/movement therapy sessions, individuals may be answering questions non-verbally with a series of movements. Emotions always result in physical actions.5 The only way to work through the pre-verbal experiences is through the body. Dance/movement therapy allows individuals to integrate interoception with their externals worlds by sequencing innate movement patterns before verbally naming the process.

 

Discover Your Movement

 

Our first relationship is self-to-self. We are designed to move and our bodies are in constant motion. From blood surging through our veins to cells moving across our systems, we are in constant motion. Dance/movement therapy creates opportunities for us to connect to the self and embrace the motion within. When we are learning to be internally aware, moving can promote self-expression, rhythm, synchrony, and cohesion. The mind-body connection allows for self-integration, resulting in an improved understanding of the self and of others.

 

Beneath each movement lies a need. Movements may come as metaphors or communicate a clear need. Who are we as moving beings? Our bodies have a story to tell. May your courage move you to step out of your comfort zone and discover the flow of your unique movement.

 

* * *

 

Would you like to learn more dance/movement therapy? Join me on Tuesday, January 7, 2020, at 6:30 pm for a free information session at Alongside You. Discover the healing benefits of therapeutic dance/movement and how the mind-body connection contributes to wholistic well-being. Registration (while free) is required.


Saturday, January 28, 2020
Let’s Talk Hope Conference

If you have any questions, please feel free to connect me directly.

 

References:

  1. Kemble, H. S. (2019, September). Introduction to dance/movement therapy I: basic theory, methods, and techniques. Russian Hall, Vancouver, BC.
  2. Hindi, F.S. (2012). How attention to interoception can inform dance/movement therapy. American Journal of Dance Therapy, (34), 129-140.
  3. Kemble, H. S. (2019, December). Introduction to dance/movement therapy II: applying methods with clinical populations. Russian Hall, Vancouver, BC.
  4. Chaiklin, S. & Wengrower, H. Eds. (2009). The art and science of dance/movement therapy: life is dance. New York: Routledge.
  5. Betty, A. (2013). Taming Tidal Waves: A Dance/Movement Therapy Approach to Supporting Emotion Regulation in Maltreated Children. American Journal of Dance Therapy 35 (1), 39–59.
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.

3 Things You Can Do Between Counselling Sessions To Thrive

3 Things You Can Do Between Counselling Sessions To Thrive

When I meet with clients, I often remark that of the 168 hours in their week, I get 1 if I’m lucky. That’s assuming that I get to see them once per week, which is not necessarily the case. Most often I see clients every other week, or even further between sessions. In this case, the hours I don’t get to be with them becomes multiples of the 168. I highlight this because I want to encourage clients that as important as the work we do in-session is, it is truly what they do between sessions that promotes lasting change. It’s not that I discount the importance of what I do, I simply recognize the importance of what my client does day in and day out between our times together.

One thing that I love about Dialectical Behaviour Therapy (DBT) is the emphasis on skill development. In our DBT groups, we focus on both skills and process, but the homework in between groups is heavily focused on skill development. Whether it’s Mindfulness, Distress Tolerance, Emotion Regulation, or Interpersonal Effectiveness they’re working on, there are concrete activities and worksheets clients can follow in between sessions to work on these areas. Clients get all of these resources in a book as a part of the group and the clients who really work at this, come back each week with a well-worn book! It’s wonderful to see clients invested in their process.

One of the questions I am asked a lot is, “Why do you have so many different things at your clinic?” The answer to this is because we believe in a holistic approach to recovery. I’d like to highlight three things you can access in our clinic between counselling sessions that will promote your wellbeing and recovery in those in-between times. The great thing is that all of these also promote things you can do on your own at home that don’t cost more money!

 

Open Studio Sessions

One of the things people are most curious about in our clinic is our art studio. People regularly wonder why we have an art studio, but the answer is very simple: because it helps people recover. We do this both through 1:1 sessions, and our Open Studio Sessions. There is a large body of evidence showing the power of creativity and art to help people recover from mental health, chronic conditions, chronic pain, and more; it also helps people connect inter-generationally and with family members and friends. All of these are great things! In our studio, you can learn Mindfulness-Based Art Therapy (MBAT) techniques that you can use at home, and we can even help you figure out what materials you’ll need and give advice on where to source supplies for reasonable prices. Many of our clients come to the studio sessions to learn new techniques and then go home and use them in their daily life. You can come to connect or learn new things, and then work on them on your own at home!

 

Trauma Sensitive Yoga and Yoga Therapy

The second most surprising thing to people about our clinic is that we have a yoga studio. We have a yoga studio because we saw a need that people had that wasn’t being filled. As you might imagine, not everyone is comfortable with large studio yoga, particularly if they’re struggling with trauma, anxiety, depression, or other difficulties. Further, as wonderful as larger studio yoga is, it’s not specifically designed for people struggling with trauma and mental health, or physical health challenges. Our Trauma Sensitive Yoga (TSY) programs and Yoga Therapy programs are specifically geared toward helping people recover from these things. The techniques are evidence-based and the programs are designed specifically to each client’s unique needs. Once again, the goal is to help you recover and work on your own, in-between sessions. Our certified yoga therapist will work with you individually in our safe, trauma-informed space to design a program specifically for you that once you learn, can be done safely at home on your own. When you want to learn more or brush up on techniques, you can come back in for some sessions. It’s flexible, safe, and geared specifically to you and your unique needs. 

 

Mindfulness Practice

Mindfulness has become something of a buzz-word in pop psychology, but that is not a bad thing! Mindfulness is the practice of focusing on the present, allowing your brain and body to calm and be in the here and now. We’ve written previously about it on our blog, and you can look forward to more articles on this in future. It’s a vital practice that supports holistic health in body, mind, and soul. We can approach mindfulness training in a number of ways here: individual sessions with our DBT therapists and the curriculum from the dialectical behaviour therapy programs, one on one sessions in the art studio with Meg Neufeld to learn Mindfulness-Based Art Therapy techniques, or with our yoga instructors using breathwork and yoga techniques. Once again, all of these are skills you can learn and take home with you and practice on your own!

At Alongside You, our goal is to support you both in-session as we provide counselling, and outside of sessions to help you cope, grow, and thrive using holistic methods. This not only increases the effectiveness of your counselling, it also promotes autonomy, choice, and increases the chances of your recovery. Our belief is that all of our clients possess unique strengths and gifts that can be used to journey toward wholeness and resilience, and our job is to help identify these, support them, and encourage you. I hope this article gives you some ideas on how you can support yourself along the journey! If you are interested, feel free to contact us!

+