So What is DBT?

So What is DBT?

Many of us have heard of Cognitive Behaviour Therapy (CBT), which is a beneficial and effective therapy to help us change our thoughts and behaviours. However, you may have had Dialectical Behaviour Therapy (DBT) recommended to you and wondered ‘what’s the difference?’.

What’s different about Dialectical Behaviour Therapy?

DBT is one of several valuable therapies which came out of the CBT tradition.  Dr. Marsha Linehan, who developed the DBT framework, started her career by working with some of the most distressing symptoms which we see as counsellors – suicide attempts, self-harm, addictions and hopelessness. Part of the reason she did that was because – well, she’d been there herself1.

What’s with that word: ‘dialectical’?

The ’dialectical’ in DBT just means opposing – and we come across so many examples of that in our own lives. In DBT, we recognize that there are some things about ourselves and our lives that we may not like, but we have to accept in order to make progress. On the other hand, there are things which we can change, and if we can, we must. This apparent contradiction between acceptance and change (and how to tell the difference), is super-important, and can be very empowering.

DBT is a skills-based therapy. This can seem daunting, because there are quite a few skills to learn, and a full course of DBT skills here at Alongside You takes 24 weeks. However, let’s break down why this may be necessary. We can probably all agree that circumstances in our childhood may get in the way of us learning certain skills (eg emotion regulation). This will mean that, as adults, we will have to learn those skills. We often feel great shame about not having all this ‘at our fingertips’ – but if nobody had ever taught us to read, would we really be surprised if we struggled? Of course not! So we can start removing the shame, and working on learning the skills that will allow us to thrive.

Do I have to have BPD to benefit from DBT?

If you Google DBT, you are going to see reference to Borderline Personality Disorder (BPD). Often, DBT is recommended for BPD which is a distressing condition resulting in difficulties regulating our emotions. It’s clear that adverse childhood experiences are implicated in this condition (some sources suggest up to 90% of clients with BPD have experienced childhood trauma2).

However, this is NOT the only reason to attend a DBT skills group. DBT is a safe and effective therapy for many problems, including:

  • Anxiety
  • Depression
  • suicidal ideation
  • self-harming
  • rejection sensitivity dysphoria
  • and many more3.

I can say, as someone who facilitates these groups, that I personally use these skills every single day of my life. They are practical, simple to understand and relatively easy to implement. That being said, as with every single therapy or intervention, we will get out of it exactly what we put in. The more we practice, the better we’ll get and the easier it will become.

Does it have to be in a group?

Before I became a counsellor, the idea of ‘group therapy’ was something I would totally have rejected. I had a LOT of preconceptions (mostly based on tv and movies!) and a fear of sharing my ‘stuff’ in public. However, having been part of several groups now, I have seen (and felt) the benefits of being in groups. Firstly, concerns about confidentiality can be worrying – however confidentiality is absolutely the first thing we cover in group. Remember, others will be as careful of keeping your stuff private as they hope you’ll be in keeping their info safe! More than anything else, having the opportunity to share your experiences with others who really ‘get it’ and won’t judge you is a truly validating and safe experience. Being able to learn from others’ experiences, have them learn from you and share your triumphs and failures in a supportive environment cannot be overstated. It really is kind of magical – and highly-effective.

Being Effective

Talking about being effective, that’s one of the words you’ll hear most frequently in DBT. Once we start letting go of that judgement (which means letting go of our iron grip on ‘good and bad’ or ‘right and wrong’), we need a helpful way to assess our behaviour and how well it serves us. Enter ‘effectiveness’. Are the behaviours we are exhibiting effective in getting what we want? Or do they make us less effective? It’s a very powerful way for us to evaluate what we’re doing, and how things change when we change.

Freedom Through Control

So, here’s the ultimate ‘dialectic’ (or opposing) concept. When we aren’t good at regulating our emotions, very often our emotions do the reacting and behaving for us. If you’ve ever felt like you are watching yourself having a meltdown while completely unable to do anything about it – your emotions are in the driving seat. Paradoxically, when we gain more control over our emotions, it allows us to choose our response and our behaviour. When we have choices, we gain true freedom. This absolutely does not mean that we learn to squash our emotions down, or ignore them – quite the opposite. By giving them permission to be felt, we can learn how to cope with unpleasant or upsetting feelings, and deal with them in a better way than acting out, hurting others or hating ourselves.

I’m Interested – Now What?

Here is a link to an interview with Dr. Marsha Linehan which explains the essence and basics of DBT4. If you are interested in joining our fall group (starting October 28th), please contact us here to find out more. We look forward to answering any questions you might have!

 

Citations

1   Full Audiobook (Ed.). (2025, June 12). Building a Life Worth Living: A Memoir Audiobook by Marsha M. Linehan. YouTube. https://www.youtube.com/watch?v=j4x11qE6F-0&ab_channel=FullAudiobook

2     Bozzatello, P., Rocca, P., Baldassarri, L., Bosia, M., & Bellino, S. (2021). The Role of Trauma in Early Onset Borderline Personality Disorder: A Biopsychosocial Perspective. Frontiers in Psychiatry12, 721361. https://doi.org/10.3389/fpsyt.2021.721361

3     Core Evidence & Research. Behavioural Tech Institute. (n.d.). https://behavioraltech.org/evidence/

4     HSE Ireland. (2014, December 14). Marsha Linehan – Interview. YouTube. https://www.youtube.com/watch?v=fR7Oi0cyoVo&ab_channel=HSEIreland

 

What Does it Mean to Live Authentically?

What Does it Mean to Live Authentically?

Living authentically will vary from person to person. But an overarching explanation is living in a way that is aligned with your values and beliefs, rather than listening to and conforming to external expectations and pressures. It involves choosing with intention and accepting our vulnerability and imperfections. It is the courage to be who you are, by being honest with yourself and listening to yourself, even when you’re feeling sad, scared, or unsure. It’s not about constantly chasing happiness or avoiding discomfort, but about being present and true, even when it’s hard. This might look like saying, “This is what I actually feel,” instead of, “This is what I should feel.”

Why is it hard to live authentically?

Living in a world that constantly tells us who to be can make it challenging to connect with what we truly want or who we are. Other factors, like culture, societal expectations, childhood experiences, and trauma, can also make it challenging to live authentically. These external influences can leave us feeling like we have to perform or hide who we are to be accepted and liked.

But living authentically doesn’t mean doing everything on your own or shutting people out. It also doesn’t mean ignoring others’ opinions or advice, it’s about finding a balance. It means being open to feedback that helps you grow, without letting it shut out your own voice. It’s about being who you are, messy, growing, and just as you are.

Signs you may be living inauthentically

As we are being flooded with messages telling us who to be, how we should look, what success should mean, and how we’re supposed to feel or act, over time, all these messages can pull us away from who we really are. We adapt, we perform, we try to fit in. And often, we end up pushing down parts of ourselves to please others or meet expectations. While this might help us feel accepted, they can take a toll on ourselves. We may struggle with depression, low self-esteem, and feel disconnected from relationships. We can’t deeply connect with others if we are hiding our true selves.

Common signs of inauthentic living

  • Feeling a lack of direction and purpose
  • Feeling like something is missing
  • Constantly seeking external validation
  • Suppressing your opinion to please others
  • Constantly comparing yourself to others
  • Living by “shoulds”
  • Having difficulty making decisions

Ways to start living authentically

Living authentically doesn’t mean being bold all the time or rejecting every outside expectation. It’s more about making small, intentional choices that reflect what really matters to you, your values, even when it’s uncomfortable. And that often starts with simply noticing when you’re overriding your needs, when you’re performing, or when you’re living by “shoulds” that were never really yours to begin with.

It can begin with teasing apart your values and beliefs from those that have been imposed on you. This can be challenging, as we are constantly being overwhelmed with messages from a young age. But living authentically involves small, honest actions. It’s about being real, even if that means disappointing others to stay true to yourself. This could look like:

  • Taking a moment to reflect on your values, what matters to you, rather than what you’ve been told should matter
  • Noticing when you feel like you’re performing or putting on a front for others
  • Taking a small step by saying no when you don’t have the capacity
  • Giving yourself permission to rest without feeling guilty

While living authentically can sound easy, life is not always that simple and neat. Instead, it’s messy, constantly evolving and changing. Living authentically is not a one-time achievement, it’s a lifelong journey. So, if I were to say what living authentically means for me now, my answer would be pretty different from what it was a few years ago, and will likely be different a few years from now.

So, if you feel like you’re not living authentically, give yourself a break and some compassion. It’s common to lose touch with yourself from time to time, especially in a world that constantly pulls you in different directions. Living authentically isn’t a destination or a fixed state, it’s a practice. It’s something we return to again and again. Noticing that you’re out of alignment is already a powerful first step. You don’t have to overhaul your life overnight or even in a few days, just one honest choice at a time can begin to bring you back to yourself.

If you would like support in identifying your values and finding strategies to live authentically, contact us to learn how our team of counsellors can help.

Can You Avoid Emotion and Successfully Push It Down?

Can You Avoid Emotion and Successfully Push It Down?

Can I just push this emotion down and avoid what is there? Will this tension just go away?

This is a good question that often I ask or hear others ask.

Researcher and developmentalist Gordon Neufeld answers this question with some umfh

No.

He answers this through differentiating emotion and feelings, which I’ll explain below.

The Importance of Feeling and Expressing Emotions

We are exquisitely complex creatures, and one central aspect of our being is our ability to feel emotions and then let them “move us out” (the actual definition of emotion) into the world. Cultural narratives abound: “it’s just your feelings… get over it.” A familiar message to you? The norm tends to be dismissing these biological functions as irrational whims. It is true emotions can be extreme and regulating them is an important skill, but listening to them is essential. Even more, expressing them is essential.

Freud famously said, “we get sick when we fail to give expression to the emotions within us.”

More and more, research in the medical and psychological fields draws connections between the mind and body, agreeing with both Neufeld and Freud. 

Emotions vs. Feelings: Understanding the Difference

Neufeld uses a funny yet powerful image to drive this home: “It is as essential for emotions to be expressed as it is for bowels to be emptied.” Think about that for a moment.

Now here comes the differences between emotions and feelings: emotions just happen, you cannot change that fact. However, our ability to feel and express these emotions (how he defines feelings) is our response to these inevitable emotions that come and go. For example, while you are at your work emotions might come up, and you could choose not to feel them if they seem to disruptive at the time. However, if these emotions stay underground for too long or never find expression, we face problems. Namely, anger issues, low-level persistent anxiety, and emotional distance from the people we care about.

Emotions Require Movement to Function Properly

How do you ride a bike? Not through staying still, but through movement and motion. In the same way, emotions require this motion to function properly. This requires that, after a stressful day, we have a safe home base to return to, in order to move through the emotions that exist within us. Can you think of someone or place that is this home base for you? A place to express what is going on inside.

A big problem we face is that expressing our emotions requires a safe environment, and this can often feel like a luxury many of us don’t have time or space for. Our fast paced culture, our competitive society, and our fractured social bonds all contribute to this challenge of expressing and understanding our emotions. 

Perhaps it’s time to slow down, take a breath, and take a pulse of how we are doing, what is going on beneath the surface, and risk expressing what we find there. You’ll notice the difference. You’ll feel more attuned to yourself and the world around you, and your vision will be filled with colour as you tap into these wonderful adaptive biological parts of ourselves.

You’ll start living from this centered place: calm, clear, curious, courageous, creative, and connected.

Sounds good to me.

 

Get the Support You Deserve

If you’re feeling overwhelmed by your emotions or struggling to express them, you’re not alone. Seeking support from a professional can help you better understand and navigate your emotional landscape. Our team at Alongside You is here to provide a safe, compassionate space where you can explore your feelings, build emotional resilience, and gain the tools you need to thrive.

Contact Us to learn more.

You’re Not Broken, You’re Adapting

You’re Not Broken, You’re Adapting

 
 

Many people come to therapy with the belief that something is amiss, broken, or “wrong” with them. Sometimes I wish it were easier to convince people this isn’t true – most of the time, the people that come to sit in my office are “working” just fine. Have they been thrown an unfair number of lemons by life? Sure, maybe. Have they responded to those experiences creatively and adaptively, in a way that has both helped and hindered them? In every case, yes. That said, you’re not broken, you’re adapting.
 

How Does Adaptation Happen?

 

Genetics is one element that explains our wonderful human diversity, and another is environment and experience – we all have a rich tapestry of experiences, and no two tapestries are anything close to alike. Those tapestries, I believe, are all quite beautiful.1, I’ve noticed people generally prefer movies that end happily, but when it comes to art and music, it can be the mournful, the bleak, the dark, the unsettling and unresolved, that has more power and meaning for us.2 The darker shades in those tapestries are worth sitting back and soaking in, they touch us deeply. This is one of the many reasons I love my job so much. Another is that sometimes, one of my coworkers brings in muffins.

Ok, back to the thing. Neuroscience has known for many years now about the incredible plasticity of the brain, an organ that readily and creatively adapts to its environment. Most of us have heard that people who experience blindness have a more heightened sense of hearing and smell. One reason for this is that the brain takes unused real estate – certain areas devoted to visual processing – and The Man Who Mistook His Wife For a Hat, the neurologist Oliver Sacks shares stories of brain-damaged patients who have responded with unbelievable neurological adaptations. Sacks comments “…there is always a reaction, on the part of the affected organism or individual, to restore, to replace, to compensate for and to preserve its identity, however strange the means may be…” (p.6). Brains find a way to preserve and reinvent themselves in the face of damage, and people find a way to preserve themselves in the face of challenge. Trauma and anxiety are prime examples: a dog bite when you are three years old might give you a paralyzing fear of dogs for the rest of your life. Your three-year-old brain saw that your life was in danger and it made a high priority, instantly accessible file labeled DOGS = DEATH -> AVOID that pumps you full of anxiety and adrenaline when a dog might be nearby.

Many of our adaptations are not all that dramatic and some are more complex. Maybe our dad told us not to be a baby when we cried, and so to preserve that relationship (our brain knew this was more important) we created a file that evokes anxiety when something might feel sad. Now, we are an expert at avoiding not only physical sadness, but things that even might make us feel sad based on our experiences.
 

What Do We Do About Our Adaptations?

 

Your adaptations are there for a reason, and that’s ok. They might not be as helpful as they once were – you’re an adult now, and dogs aren’t all that dangerous most of the time – they’re actually awesome. Avoiding sadness was functional before, but now you find yourself feeling depressed more often than not. In your last relationship, it made sense to be angry with your partner, because it felt like the only way to get through to them – but in your other relationships, that anger is less useful.

Adaptations in our life are unavoidable and necessary, and this is a good thing. If you lacked the ability to adapt, then I might agree that something is wrong with you. But I’ve never met anyone for whom that was true. You see, blind folks don’t tell their brains to reuse that real estate for hearing, brains just do it, which is so cool. And our brains, as wonderful as they are, don’t always make the best long-term choices. They find a way to stop us from driving after we have a bad accident, terrified that we might die, convinced that losing our job is better than death. When we are frustrated at ourselves and sad about the loss of that job, they talk us into pouring a drink, and when it works, they think “Perfect!” and they keep doing it. When people close to us start to bother us, they might solve the problem by helping us avoid relationships altogether (great idea for a week, but not for a year, or a lifetime). When our coworker brings in muffins, they talk us into stress-eating four of them, because the first one was oh. so. good. I think you get the point.
 

Working With Our Adaptations

 

We can get to know our adaptations, and be brave enough to set aside those we no longer need (and adjust the ones we do). We can come to see that our adaptations are actually strengths – the lengths that we go to in order to avoid something can spark incredible creativity. These are some things we might do in therapy. But first, we might work on the belief that there is something wrong with you in the first place – and, wouldn’t you know it, our brains are fantastic at holding onto those beliefs. So, if you take nothing else out of this article, make it the belief that you – whoever you are – are mostly just fine, and you are weaving a meaningful and worthwhile tapestry with the threads you are being given.

If you’re struggling with some of your adaptations, give us a shout. We’re here to help. Remember, you’re not broken; you’re adapting.

 
Notes

1. You’ll have to let me have this one – I’m an incredible, unabashed sap, for better and worse.
2. I have a client who is a fantastic artist, and I sometimes have the privilege of seeing some of what she’s made – it reflects her experiences, and it also connects me to some of my own. Art in many forms has that effect, and those who do it well are a real gift to the world. Meg, who runs the therapeutic art program here at Alongside You, often uses a wide range of colours and tones to create pieces that seem able to capture any mood under the sun – a few seconds soaking these in are seconds well spent.
3. On the tapestry metaphor note, his op-ed in the Times on his terminal cancer diagnosis is a worthwhile read along with this blog post – here’s a link to it.

Pandemic Tips for Teens

Pandemic Tips for Teens

 

My Best Pandemic Tips For Teens

 

I see a lot of clients in the high-school-or-close-to-it age bracket, who I tend to think are getting hit worse than anyone right now by this pandemic. Teens, this article is for you. Some of you love that you spend less time in school now, others hate it; some of you are going insane being cooped up inside, and some of you relish not having to deal with people quite as much. Whatever the case, a lot of us want tools (this is probably the thing I am asked most commonly for). While I love talking to people, if it’s just tools you want (and most commonly it isn’t), here are some of my best pandemic tips for teens!

Your Brain and Your Emotions Play Tricks on You

 

In the 13-22 or so age range, you feel feelings more intensely than your 25+ year old counterparts. It’s just how the brain works. This has both advantages and disadvantages: your lows are lower, and your highs are higher. Your lows will suck, and it’s likely that the adults in your life will struggle to relate to that, try as they might.

What To Do With The Lows

 

Unfortunately, we are a culture that tends to discourage negative feelings, especially strong ones. Many teens I see believe that there is something wrong with them, or that they are mentally unwell, both which are quite often untrue. While it is taboo to say, a good many of our minds will travel to a place that says we would be better off dead, and the world would be better off not having us. I really hope you’re not there, but if you are sometimes, come talk to us about it. Or to someone else – anyone you trust. It’s surprisingly normal. Please trust me when I say that difficult feelings are important, and worth experiencing (though they are best experienced alongside someone we trust). If you want someone to talk to but don’t want anyone else to know about it, send us an email and we will see if we can help, or point you to someone that can.

Managing Your Highs

 

Since your highs will be higher, that’s a good thing to take advantage of. You can enjoy a movie or YouTube clip way more than most of us can, you can get more joy from spending time with friends (please do this), you can laugh harder and longer, your runner’s highs will be higher. You can feel closer to your pet than we can, which I’m a little jealous of – pets are awesome (at the risk of making a few enemies, especially dogs). Use that – when you’re up, relish it and use the energy it brings.

If there was a pill that would cost nothing, that you could take that would help you sleep better, improve your mood, boost your immune system, help your brain and memory function better, reduce anxiety and depression, reduce stress, and generally make you feel better about yourself, would you take it? I think everyone probably would. Surprise, there is. Bet you didn’t see that coming in an article on the best pandemic tips for teens, did you?

The Magic Pill That’s Free

 

There is indeed a mysterious, free pill. Most people get really excited about this until they hear what it is. It’s exercise. I know that trickery was the last thing you probably wanted to hear, but exercise is literally one of the best things anyone can do for themselves, period. Doesn’t matter what it is, just get moving, and if you can, get your heart rate up. It might be hard at first, but the more of it you do, the better you’ll feel. I should also tell you that you should be sleeping more, but you know that already, and you probably aren’t going to. If you want help in that department, talk to your doctor. In addition to exercise, you can also try cutting out screens in favour of books in the couple hours before bed, or at the very least get yourself a pair of extremely trendy blue light blocking glasses.

You Already Have Skills That You Don’t Realize

 

Because you’re a human being, you have a whole bunch of adaptations the you’ve obtained over the course of a long life. These are great at getting you through tough times. One of my adaptations I used when I was younger was daydreaming, and another was making a joke out of everything. Some other common ones are overthinking/rationalizing, using alcohol or drugs, playing too many video games, or gluing oneself to TikTok.

Some of these are better than others, and they are mostly OK if used sparingly. Though we don’t want to overuse our adaptations, you have them for a reason – they’ve worked before, and they’ll work again. Don’t be too hard on yourself for using them, and I would probably recommend expanding your repertoire to include some more healthy ones.

Exercise (again), art, writing, music, hobbies, gardening, spelunking – the list goes on. If you’re feeling angry or stressed and are already not going to do your homework anyway, you could split your time between something mindless like video games, and something a little more mindful like going outside and collecting a bunch of bugs, or baking some cookies. If your parents hassle you about it, tell them a counsellor said you were allowed to. Probably do the bugs and cookies first – video games are hard to stop once you start. Healthier time-wasters will also give you a little mental boost in case you do decide you want to actually do some homework.

Make Good Use of Your Energy

 

Try to notice where your energy is going. Maybe you’re worrying a ton about your grades, and it’s exhausting. Maybe you don’t care at all about grades, but your parents do, and a lot of your energy goes to fighting with them. Maybe someone at school is really bothering you and it is eating you up inside. Maybe you’re in love and can’t think of anything else but that person you want so badly to be with. Maybe you’re putting everything you have into YouTube or Fortnite, hoping to make some money off streaming someday.

There is nothing wrong with any of these, but anything can be a drain on your mental and emotional resources. Make a list of the things that are the most draining: your biggest worries, the things you are committed to (sports, etc.), tough relationships. Divide this list into things you might be able to change, and those you can’t. The things you have a little more control over are great targets, and even the things you feel totally helpless about may not be as impossible as they seem. If you have a counsellor, talk to them about these things – it is likely you are burning more fuel in a given area than you have to be. These are also the things that can take you into dark places, or towards less healthy coping strategies.

Be Kind To Yourself

 

Above all, be kind to yourself. So far, I haven’t spent time with someone I didn’t end up liking, and this is because all of us are likeable. Seriously – I know that sounds stupid, but it’s true. You can’t be perfect, and you’re going to come out on the other side of this ok. As I’ve said already, come talk to us if you would like to – even if we can’t help, we can likely direct you to someone who can.