Connect With Me, Robot

It’s a complement to therapy. It’s good for validation. It’s free and never knows tiredness. In its own words, it is “not a licensed therapist, but can help in meaningful ways.”

There are numerous studies about ChatGPT and other large language models (LLMs) serving as “therapists.” A solid article from the journal Nature in 2024 states that it’s “an easily accessible, good (and currently free) place to go for people with mental-health problems who have not yet sought professional help and have no psychotherapeutic experience” (Nature, 2024). The article lists many pros and cons, and is worth a read.

Curious about the experience of sitting down on the couch in ChatGPT’s office, I tested it out, acting as a patient with anxiety and depression who was having trouble sleeping. ChatGPT was immediately validating with language like “when everything’s piling up and you’ve been running on empty for a while, your body and mind start sounding the alarm — and trouble sleeping is one of the first signs.” Spot-on, I thought. It felt good hearing that. And then, lower in the paragraph, it wrote: “Or if you’re just looking for someone to sit with you in it for a second, I can do that too.”

And the charade shattered. The void of the dark-mode chat screen did not feel like nervous system co-regulation; it felt like I was still alone. Despite that feeling, I kept typing.

Again, ChatGPT provided plenty of validation – and advice, lots of advice. Advice is good to hear every so often, but the laundry list of to-dos, after ChatGPT broke things “down into parts” was a lot, and I told it so. It recommended we prioritize – a good tactical shift – and then offered the grounding technique of 5 things you can see, 4 you can touch, etc. That was useful and even helpful – but it was not connection. And that’s what I realized about using ChatGPT for a therapist: it can give rational approaches to problems, you can talk to it all night, but it can’t hug you (and true, your therapist probably shouldn’t be hugging you either, but you know what I mean).

Humans have outranked ChatGPT with certain interventions, like with this CBT study in psychiatry.org, and I understand that in America, where health insurance is costly and scarce, having a free resource to “talk to” can be helpful and warranted. And that’s cool. It doesn’t help, though, when one of the biggest issues we have is an upward trend in isolation and loneliness – a trend exacerbated by tools like ChatGPT. Maybe ChatGPT can help someone enough that they venture out into the world to reduce their own loneliness, though I’m going to surmise that the robot’s therapeutic skills are not quite at the level of understanding long-term emotional cues and patterns.

LLM’s continue to advance at an astounding pace. The Nature article from last year is based on an outdated model, and the psychiatry.org article used a model that will also be surpassed, probably this year. The models will get smarter, they will learn new therapeutic techniques, and they will be the best mimic of humanity that humanity has ever produced. But will LLMs provide the connection and meaning that comes from sitting together in a room, across from your therapist after you said something subtle yet meaningful, and your tone was just so, and the therapist picked up on it and recognized its importance – and said nothing back, only smiled?

References:

https://www.psychiatry.org/news-room/news-releases/new-research-human-vs-chatgpt-therapists

https://www.nature.com/articles/s41599-023-02567-0

Are you stuck in a stress cycle?

We live in a fast-paced, information-saturated world, making it nearly impossible to go through a day without feeling stressed. Whether it is simply your commute or something as big as racism, stressors are everywhere. Stressors activate the stress cycle in our bodies, and research shows that chronic stress has negative health impacts – physically and mentally. When we get stuck in this cycle, stress hangs around longer than needed, causing worse outcomes.

First, let’s define some terms.

Stressors are the things in your life that make you feel overwhelmed, anxious, or activated in some way. They are potential threats. They are commonly external (like capitalism, the news, or work) however they can also be internal (like negative self-talk or your trauma history).

Stress is how your body responds to the stressor. Stress is the physiological and neurological changes that happen in your body as a result of the stressor. This is an evolutionary response designed to keep you alive.

The stress cycle is a biological process triggered by stressors. It has a beginning, middle, and end.

• It begins with the initial activation – increased heart rate, blood pressure, and cortisol levels.
• The middle phase is how you respond to the stressor – fight, flight, freeze, or fawn.
• The end is returning to a calm, restored state.

Completing this full cycle is important for well-being, as it allows the body to regulate itself and return to a state of homeostasis.

To paint a clearer picture, let’s look at a classic example – being chased by a lion.

Here, the lion represents the stressor – the threat. When the lion begins to run towards you, your stress response is activated. Your body responds instinctively: adrenaline surges, blood pumps into your muscles, and the focus shifts to survival. Somehow you make it to your house, run inside, and lock the door before the lion gets to you. You feel relieved, you cry and hug your family. You are safe.
In this example, you move all the way through the entire stress cycle – from threat to response to safety. In more modern examples, like a challenging phone call, we can fail to take actions to arrive at the stage of resolution, leaving us in the middle of the cycle with the stress remaining stuck inside our bodies.

 The stress response cycle is here to keep us alive by responding to immediate threats. The only problem is that our modern stressors are typically not life-threatening, yet our bodies react as if they are. So, we have this wonderful system in place to keep us alive, but it is getting activated by things that will not kill us. Our physical safety is not at risk yet our body is filtering these situations as life or death. As such, we need to meet our bodies where they are and help them remember – you are safe now, let’s turn off all the alarms and return to rest.

How to complete the stress cycle?

This isn’t about solving any problems or making the stressor go away. This is all about finding a way to communicate to your body that it is safe and it survived the stressful situation.

1. Physical activity – running, shaking, walking, dancing
2. Intentional breathing – make your exhale longer than your inhale
3. Positive social interactions – talking with a friend
4. Authentic laughter
5. Affection – 20-second hug from someone you trust
6. A good cry
7. Creative expression

My personal favorites are running, singing, crying, and shaking. Anything that gets my heart pumping a little bit faster is usually what works for me.

As the Nagoski sisters say in their book Burnout: The Secret to Unlocking the Stress Cycle, “stress is not the problem”. The problem is when we do not release the stress from our bodies. “The goal isn’t to live in a state of perpetual balance and peace and calm; the goal is to move through stress to calm, so that you’re ready for the next stressor, and to move from effort to rest and back again.”

While stressors are inevitable in our lives, how we respond to these stressors is within our control. By integrating these cycle-completing activities into our routines, we can effectively manage our stress, promoting a healthier mind and body.

Next time you find yourself feeling stressed, ask yourself, how can I allow this stress to be released from my system? How can I show my body that it is safe?

References:

Nagoski, E., & Nagoski, A. (2019). Burnout: the secret to unlocking the stress cycle. First edition. New York, Ballantine Books.

As the saying goes, “To err is human; to forgive, divine.” We humans can forgive, too, and it often helps us to forgive people who have hurt us, even if it’s only in our own minds and hearts. It’s amazing how much this can free us from anger and pain. While it may seem almost impossible to do, letting go of a grudge can improve our health.

Reaching Out Beyond Oneself

Pumla Gobodo-Madikizela, a specialist in Transgenerational Trauma, explains that forgiveness can be “an incredibly frightening concept to embrace” (2024). Forgiveness requires an effort that can seem, at first, like excusing or forgetting trauma or betrayal. “Forgiveness emerges from both within and outside the place of hurt, and it requires a degree of intentional openness, of reaching out beyond oneself toward the other. Therein lies both its transformative potential and its moral ambiguity — and this is what is most frightening about forgiveness. The inward psychological journey necessary before we can forgive enables us to see the humanity of those responsible for our wounding, and, having forgiven them, admit them into our world of common humanity.” It is by releasing the emotional burden associated with the hurt one has experienced that starts the healing process.

Journey Toward Repair

Forgiveness requires us to let go of anger and a desire for revenge, which can leave us feeling that our issue remains unresolved. However, Dr. Gobodo-Madikizela clarifies by explaining that “what brought about the rupture must be mourned” (2024). We must move beyond bitterness and resentment in order to experience a sense of relief and peace. “Perhaps what we fear is the word “forgiveness” itself. It seems to suggest a fixed position or an ending, evoking the act of leaving something behind, moving on without looking back… Yet… forgiving stands as the opening of a new chapter, not its closure — the beginning of the journey toward repair” (Gobodo-Madikizela, 2024).

Benefits

Forgiveness helps us to shift our focus away from negative emotions and towards growth and healing. Holding on to grudges can lead to chronic stress, which affects mental and physical health. We reduce our anxiety and depression when we let go of our feelings of hurt and free up that mental and emotional space for constructive and positive thoughts and feelings. Our self-esteem improves, as well, as we realize we can handle difficult situations with strength and maturity (Singh & Singh, 2023). We can focus on our own growth rather than being consumed by negative feelings. Forgiveness also fosters resilience, as we realize we can bounce back from conflicts or setbacks more effectively and maintain better mental health in challenging situations. Lastly, forgiveness promotes better relationships. It fosters empathy, understanding, and trust, which are vital for meaningful connections with others.

Forgiveness is not about letting others off the hook, but about liberating oneself from the negative emotions that can otherwise take a toll on our mental and physical health. It is a powerful tool that promotes emotional healing, reduces negative emotions, strengthens relationships, and supports overall well-being. Integrating forgiveness into one’s life can lead to greater happiness, peace of mind, and resilience in the face of life’s challenges.

References

Gobodo-Madikizela, P. (2024, June 17). Why Do We Fear Forgiveness? The New York Times.
https://www.nytimes.com/2024/06/17/special-series/south-africa-apartheid-forgiveness-fear.html

Singh, G. and Singh, S. (2023). Effect of forgiveness on happiness and well-being. Indian Journal of Positive Psychology, 14(3).

Talking about sex can be hard, even in the best of circumstances. It’s really quite normal to have concerns about your sexuality given the generally sex-negative culture we live in. Even in a profession as intimate as therapy, we still cordon sex off and make it a specialty (sex therapy) despite the drastic importance sex has on most people’s lives. However, one of the values of working with a therapist well-versed and comfortable discussing sexual issues is that it creates space and the opportunity for you to consider possibilities that you might not have considered in the past. Further, sex really can’t be separated from our identities, such as gender, sexual orientation, race, class, religious upbringing, and others. All different parts of ourselves come into the room when we want to be intimate, and that’s why it can be valuable to bring sexuality concerns to a therapist.

In my experience, the most important part of my journey was connecting to my sexuality in a space that was not inherently sexual. For many, including myself, we only really think about sex in the context of a partner(s), rather than taking time to explore outside of the mix of relational challenges. Exploring who I was within a container that included education, unconditional support, and nonjudgement was what I needed to begin letting go of unhelpful narratives and behaviors.

There’s so much bound up in our ideas and experiences of sex, but I once heard that sex is how adults play. If we think about sex from the perspective of play, it becomes clear that one of the first foundations we must introduce is safety. Do you have trouble finding safety, trust, and relaxation in intimate settings? This may be for any number of reasons, from sexual assault to feelings of shame and unworthiness. Maybe you’re concerned that your desires fall outside of “normal,” or you want to change your relationship style beyond monogamy. Maybe you’re not interested in sex. Perhaps you’re worried it has become an addiction. Or maybe your body isn’t cooperating. Perhaps sex is painful, and you don’t know why, or you can’t “perform” like you think you should. Maybe you and your partner don’t seem to match up sexually.

Personal experience has shown me that any one of these questions leads to a rabbit hole of indecision and shame. When sex isn’t working, for whatever reason, it creates or compounds feelings of something being wrong with you. It can be very tempting to ignore signs that you’re uncomfortable, unfulfilled, or in distress. Kinks, non-hetero orientation, and non-monogamy relationship configurations are all ways of being that deviate from the rest of society, and this can create distress. Unfortunately, it’s also quite common to seek support for sexual trauma and recovery. If nothing else, know that these concerns and issues are common and that there are approaches that can help.

In therapy, you can work on skills such as communication and boundaries. You can explore your past to understand more about your sexual desires. Learning from a professional in an open and accepting space is sometimes exactly what’s needed. Mindfulness is another avenue to explore sexuality. For all the talk these days about the importance of embodiment, having sex might be the place where you most want to be aware of the sensations you are experiencing. In my experience, women in particular are likely to get caught in a cycle of performance that distances them from their own pleasure. It can be much easier to follow a script that has worked in the past rather than taking a risk to interrupt patterns. Getting clear on what your body is saying can be the first step to unpacking what may be not quite flowing.

Pleasure is the measure. Your sex life doesn’t need to pass any kind of test. If everyone involved is enjoying themselves, then that is enough. There is a lot of information that can help you orient and understand that you’re not alone, but at the end of the day the most important thing is that you feel connected to your own truth.

It’s easy to find ourselves overwhelmed and stretched thin within our personal relationships, our work commitments, or societal expectations. But by establishing and maintaining healthy boundaries, we can protect our well-being and create a life that aligns with our values. Let’s take a look at the significance of setting healthy boundaries, and how they contribute to maintaining a healthy sense of self.

Boundaries are the limits and guidelines we set for ourselves and others in various aspects of life. They define what is acceptable and what isn’t in terms of our personal space, time, emotions, and relationships. Boundaries act as safeguards, protecting our physical and mental well-being from being compromised.

One of the most vital aspects of setting healthy boundaries is the preservation of emotional energy. When we establish boundaries, we can avoid emotional exhaustion by setting limits on the amount of emotional labor we’re willing to invest in others. It allows us to focus on our own needs and prioritize self-care without feeling guilty or overwhelmed. By doing so, we can protect our mental and emotional well-being by filtering out negativity and toxic influences, and by promoting positive and nurturing environments. By setting boundaries around our personal space and time, we can recharge, engage in activities that bring us joy, and practice self-reflection. Personally, although it was a very challenging task for me to embrace, setting boundaries with loved ones and even dismissing some important people in my life ended up being one of the best moves I’ve made. I no longer feel trapped in their toxic lives, and finally

feel free to focus on myself. Although I’ve missed some of these individuals dearly, I know these actions have allowed me more space to truly find myself and grow.

I can’t emphasize enough how crucial communication is when setting boundaries. It serves as a foundation for establishing mutual understanding, respect, and clarity in our relationships. We can then clearly express our expectations and limits to others. By openly discussing our boundaries, we provide others with a clear understanding of what is acceptable and what isn’t. This clarity helps prevent misunderstandings and promotes healthier interactions. We also gain a deeper understanding of our own needs, limits, and values through communication. By expressing our boundaries to others, we become more self-aware and develop a stronger sense of self. This self-awareness enables us to assert our needs confidently and authentically.

I’ve found that some of the most important factors when establishing boundaries are managing stress and burnout. By recognizing our limits and prioritizing self-care, we can prevent ourselves from taking on too much and spreading ourselves too thin. Boundaries allow us to say “no” when necessary, delegate tasks, and create a healthier work life balance. By doing so, we assert our personal autonomy and empower ourselves to grow. By establishing limits on what we accept and what we don’t, we create space for personal development, self-improvement, and the pursuit of our goals. Boundaries enable us to focus on what truly matters to us, leading to a greater sense of fulfillment. Again, this is all easier said than done, but let me tell you, communicating and saying “no” in certain aspects of my life has been a game changer. If you fail to communicate struggles or feelings of burnout to your work, friends, or family, they will never know what is actually occurring in your life and this stress can show up in damaging ways. Although the conversation may feel uncomfortable, take it from me, it is so worth it, and it gets easier!

In a world where demands and expectations seem endless, setting healthy boundaries becomes a transformative act of self-care. By understanding and respecting our limits, we nurture our mental, emotional, and physical well-being. Setting boundaries allows us to maintain healthy relationships, preserve our energy, and protect our sense of self. Embrace the power of boundaries and watch as they unlock a life that aligns with your values and brings you joy and contentment. Remember, setting boundaries is not selfish — it’s an essential step towards a healthier, more fulfilling life! You deserve to have the opportunity to live your best life!

I’m sure you can think of times where you may have laughed so hard you cried, or your cheeks felt sore from smiling for so long. Maybe you remember the lightness you experienced in your body afterwards. Laughter is a powerful tool we all have available to us that can benefit our emotional and physical health. Laughter, like crying, allows us to release emotions and energy in a healthy way. When we laugh, it has been found that cortisol and epinephrine, two of the body’s stress hormones, are reduced, which can help decrease the intensity of anxiety symptoms. When I am feeling stuck in an endless to-do list or overwhelmed with situations outside of my control, calling a friend or watching a funny dog video can feel like the reset I need. Contemporary research from positive psychology has found a correlation between positive styles of humor and lower perceived stress (Lonczak, 2023). The categorization of positive styles of humor refers to self-enhancing humor meaning humor that does not put yourself down or minimize any struggles you may be facing, but rather allows a reframe and reprieve from negative thoughts. Using humor can help problems feel less daunting, reframing them as obstacles to overcome rather than permanent, impassable “roadblocks”. Along with reducing the level of stress hormones, humor can also increase the production of antibody producing cells, strengthening the immune system. The saying “laughter is the best medicine” is clearly onto something when we are aware of all the impacts it has on our body’s hormones and endorphins.

Laughter and Humor in Therapy

While there are times and places that humor may not always be viewed as “appropriate,” therapy sessions do not fall into that category. That’s right—you’re allowed to laugh in therapy! Humor is a healthy way of expressing ourselves and coping with things we cannot fully make sense of yet. It may even allow you to feel safer with your therapist as your relationship develops

and you begin to dig deeper into the challenges and difficulties you have been facing. This does not mean that you should feel pressured to “make light” of your situation or engage in self-deprecating rhetoric; when we rely too heavily on humor, it can interfere with the deeper work needed for healing. But, when used in small to moderate doses in therapy, humor can allow you to discuss what is troubling you in an accessible way, instead of covering up or suppressing the emotions you may be experiencing. In my experience facilitating groups for those in recovery from substance abuse, I witnessed greater connection and more vulnerable discussion when participants were able to laugh with each other. Laughter, like smiling, is a pro-social behavior that can strengthen your connections and comfort with others. I’d like to share a guided Laughing Meditation and invite you to try it. It may be uncomfortable to begin. The first time I participated in a laughter meditation, I remember feeling slightly embarrassed at first. But after the first few minutes, I couldn’t help but give in to the genuine laughter. I started with a forced laugh and deep breaths, and as I continued to force the laughter I started really laughing, and before I knew it everyone participating in the meditation was in tears from laughing so hard. This is a fun meditation to do with others, especially those you want to re-connect with. Laughing is contagious and brings us together. If you do participate in this meditation, try to bring awareness to the sensations you notice in your body before and after. Notice if you feel lighter or heavier, more relaxed or tense. There isn’t a wrong or right way to feel after this exercise. Of course, laughter and humor are not the answer to every problem, but they are beneficial tools to aid in the therapy and healing journey.

Sources:

Lonczak, H. S. (2023, April 6). Humor in psychology: Coping and laughing your woes away. PositivePsychology.com. https://positivepsychology.com/humor-psychology/

Scott, E. (2020, March 7). How laughter can relieve stress and help your immune system. Verywell Mind. https://www.verywellmind.com/the-stress-management-and-health-benefits-of-laughter-3145084

YouTube. (2020). Laughing Meditation. YouTube. Retrieved June 16, 2023, from https://www.youtube.com/watch?v=XqkaOE-2HR8.

When we feel overwhelmed, anxious, down, or whatever big emotion we are experiencing, something as simple as moving our body can make a world of difference. Mindfulness is not only reserved for yoga instructors or experts; it can be as simple as doing one of the movements listed below. Here are a few key moves to incorporate into your toolbox of coping skills for when big emotions come up. These moves are for all ages, all bodies, and all abilities. Feel free to modify or change these as needed. They can be done at work, at home, or when you are out and about. I have found these tips to be extremely beneficial when I don’t have time or space to process them in the moment. These simple skills allow me to ground my mind, connect with my body, and compartmentalize the overwhelmed feeling until I am in a better spot to revisit my feelings. I’ve relied on these tools through the years, and hope they can benefit you as well! 

Drink some Water  

 Something as simple and common as water can help us access the present moment. When you are overwhelmed, take a second to pick out a glass or grab your water bottle. Before you fill it with water, ask yourself: how does the cup feel? Is it heavy? Smooth? Notice how you hold the glass. Next, fill it with water, pour as much or as little as you need, and take a drink. As you do so, think about how the water tastes. How it feels in your mouth? What temperature is the water? Is it shocking to your system? How do you feel when the water travels to your stomach? What does your stomach feel like when the water reaches it? After you’ve taken a sip of water, try to take a deep breath. Focus on your breathing for a moment before returning to your emotions. 

Sit in the Sunshine 

We are lucky to live in Colorado, where most days are full of sun. Sometimes the best thing for us is a moment in the sunshine. When feeling overwhelming emotions but the sun is shining, take a moment to go stand or sit in outside. If you are unable to go outside, consider opening the blinds to a sunny window and sitting in front of it for a few moments. As you let the sun wash over your face, close your eyes and let yourself feel the warmth. Where are you able to feel it most? As you soak in the sun, take a few deep breaths in and out. Be conscious of how it feels when your chest and stomach rise and fall, and how your body feels as you breathe in and out. Sit in the sun for as long as you need, until returning to your emotions seems a bit more manageable.  

Mindful Walk 

The goal of mindfulness is to connect your physical body to your emotional mind. When we take a moment to disengage with our minds and focus on our bodies/physical world, we are better able to integrate the two, allowing for more space to process our emotions. Connecting our physical body to our emotional mind can be very beneficial when working towards maintaining balance in our lives. There are a lot of different options that may help, but one I would like to share is going on a mindful walk. This can be at your favorite park, your favorite hike, around your neighborhood, or just to the mailbox and back. Before you begin your walk, make sure you’re wearing comfortable clothing and shoes. Start by taking a moment to close your eyes and breathe deeply as you center yourself in the moment. Next, begin to walk, taking time and energy to consider how your body feels. How does the ground feel at your feet? What kinds of steps are you taking? Where do your arms naturally fall? How do they swing? How fast are you walking? What does your heart feel like beating in your chest? What does your breathing feel like? Can you take a moment to only think about the breath that you take? What can you see? Hear? Smell? Touch? Are there any leaves or flowers you can pick up to mark your mindful walk? Take your time as you walk, go at a comfortable pace, and try to focus on connecting with your body. If your brain begins to drift and think about your emotions, gently navigate it back to something physical. Walk for as long as you need to, and when you are done, re-engage with your senses. 

There are many ways to engage both your mind and your body besides going on a walk. Some of these include yoga, stretching, deep breathing, closing your eyes and considering where in your body you may feel a certain emotion, etc. The goal of this practice is to integrate what we experience in our bodies with what we experience in our minds, allowing for alignment and balance.  

In a fast-paced world filled with endless responsibilities and demands, it is easy to neglect components of life. Over the last few months, I noticed myself feeling “heavy”, irritable and less effective in my life. I began to research and learn more about what it means to live a wellness-focused life. In this blog post, I share the strategies and tips to help live a life centered around well-ness found in my research. 

1. Nurturing Physical Health:Physical health forms the foundation of our overall well-being. Start by incorporating regular exercise into your routine, whether it’s walking, yoga, or dancing. Choose a majority of nutritious, whole foods that fuel your body and provide essential nutrients. Sleep is also paramount to recharge and rejuvenate. Remember, small changes can lead to significant improvements over time. 
2. Prioritizing Mental and Emotional Well-being: Caring for our mental and emotional health is equally important. Make time for self-reflection, meditation, or mindfulness practices to cultivate a calm and centered mind. Engage in activities that bring you joy, such as pursuing hobbies, reading, or spending quality time with loved ones. Seek support when needed, and don’t hesitate to consult professionals who can guide you on your journey. 
3. Practicing Self-Care: Self-care is a vital component of a wellness-focused life. It involves nourishing your mind, body, and soul. Dedicate time to activities that promote relaxation, such as taking soothing baths, listening to music, or indulging in a favorite hobby. Set boundaries and learn to say no to obligations that drain your energy. Remember, self-care isn’t selfish; it’s necessary for your well-being. 
4. Cultivating Meaningful Connections: Strong social connections have a profound impact on our happiness and overall wellness. Invest time and effort in nurturing healthy relationships with family, friends, and community. Engage in meaningful conversations, practice active listening, and create opportunities for shared experiences. Surround yourself with positive influences that inspire and support your growth. 
5. Striving for Work-Life Balance: Achieving a healthy work-life balance is crucial for overall well-being. Identify your priorities and set realistic boundaries to avoid burnout. Take breaks, delegate tasks, and create a schedule that allows time for relaxation, hobbies, and spending quality time with loved ones. Remember that your well-being matters, and finding harmony between work and personal life is key. 
6. Embracing Continuous Learning: Never stop learning and growing. Engage in activities that expand your knowledge and challenge your intellect. Pursue new interests, take up courses, or delve into books that inspire you. Embracing lifelong learning fosters personal growth, enhances creativity, and provides a sense of fulfillment. 
7. Creating a Nurturing Environment: Your environment plays a significant role in your well-being. Create a space that reflects your values and promotes tranquility. Declutter your living space, incorporate elements of nature, and surround yourself with meaningful objects. Whether it’s through gardening, enjoying outdoor activities, or bringing nature indoors, connecting with the environment can have a positive impact on your well-being.

 Living a wellness-focused life is a journey that requires conscious choices, self-compassion, and dedication. By nurturing your physical, mental, and emotional health, practicing self-care, cultivating meaningful connections, striving for work-life balance, embracing continuous learning, and creating a nurturing environment, you can embark on a path toward holistic well-being. This seems intense and overwhelming but, remember, it is a journey of ups and downs, and you may need support. In my next blog post I will share more of my learning about the 8 core components of the wellness model. 

References

Stoewen D. L. (2017). Dimensions of wellness: Change your habits, change your life. The Canadian veterinary journal = La revue veterinaire canadienne, 58(8), 861–862. 

Sutton, J. (2020, August 17). The self-care wheel: Wellness worksheets, activities & PDF. PositivePsychology.com. https://positivepsychology.com/self-care-wheel/ 

Swarbrick, P. J. Y., & Yudof, J. (n.d.). Wellness – Center on Integrated Health Care and self-directed recovery. https://www.center4healthandsdc.org/uploads/7/1/1/4/71142589/wellness_in_8_dimensions_booklet_with_daily_plan.pdf 

Mood swings with feelings of euphoria to deep depression. Intense anger that causes you to lash out immediately followed by extreme guilt. Impulsive and potentially dangerous behavior. Chronic feelings of emptiness and suicidality. These are some common characteristics of Borderline Personality Disorder (BPD). BPD is categorized as a personality disorder. These mental disorders are typically categorized by an unhealthy pattern of thinking, functioning, and behaving. 

Dialectical Behavior Therapy or DBT was created by Marsha Linehan who was diagnosed with BPD herself. Initially diagnosed with schizophrenia and treated with electroconvulsive therapy, Linehan felt that she should have instead been diagnosed with BPD, especially since she dealt with suicidal behavior, a common symptom of BPD. 

Linehan studied psychology in her undergraduate and graduate programs and continued on to teach psychology, psychiatry, and behavior sciences. During her work, Linehan realized two important concepts within mental health:

1. To achieve meaningful and happy lives, people must learn to accept things as they are.
2. Change is necessary for growth and happiness

These two concepts laid the foundation for DBT. Using concepts from Cognitive Behavioral Therapy (CBT) and her own experience with mental health, DBT was born.

For individuals with BPD, it can be incredibly difficult to manage emotions. This lack of control then often leads to impulsivity and can affect how the individual sees themself. DBT sought to give individuals skills to help navigate these emotions and interrupt impulsive thoughts and behaviors. The four key skills of DBT are mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance. Below are how each skill can help with BPD.

Mindfulness

Mindfulness skills are broken up into two types, “what” skills and “how” skills. “What” skills teach you how to be fully present in the moment; observe, describe and participate fully in what is currently going on. These skills help resolve impulsive or emotion-driven behaviors as you are present without awareness of impulsive thoughts. “How” skills focus on being effectively present in the moment without having a judgmental mindset and focusing on one thing at a time. Individuals with BPD often ruminate on the past or future and these skills help keep you focused on what is the “here and now.”

Interpersonal Effectiveness

Relationships can be a difficult thing to maintain for someone who struggles with BPD. Often, individuals have a history of abuse, neglect, or invalidation that leads to insecure attachment which affects relationships later in life. Interpersonal effectiveness teaches people how to ask for what they need, how to say “no” to inappropriate demands and cope with interpersonal conflict. The goal is to maintain respect for yourself in addition to holding onto meaningful relationships. 

Emotional Regulation

people who are diagnosed with BPD struggle with intense emotions that often feel uncontrollable. These intense emotions can often lead to dysfunctional behaviors, especially behaviors that work to avoid negative emotions. Emotional regulation helps you to regain control over personal emotions. By working to identify emotions, you can begin to understand the function of the behavior the emotion leads to. Once you’ve identified the emotions, you can begin to change emotions and behaviors. 

Distress Tolerance

Distress is something everyone experiences. But for people with BPD, this distress can feel chronic or debilitating. Distress Tolerance teaches you how to experience your current situation non-judgmentally without trying to change it. It is important to note that accepting your situation does not mean you must approve it. Through crisis survival and acceptance strategies, you can learn how to soothe and adjust your thoughts in the moment. 

While there is no cure for BPD, Dialectal Behavior Therapy can begin to provide hope and the tools to support people struggling with BPD. Schedule a session with a DBT specialist today.

Sources:

Dialectical Behavior Therapy | Behavioral Research & Therapy Clinics. (n.d.). Retrieved March 16, 2023, from https://depts.washington.edu/uwbrtc/about-us/dialectical-behavior-therapy/

Linehan, M. (2015). DBT skills training manual (Second edition). The Guilford Press.

May, J. M., Richardi, T. M., & Barth, K. S. (2016). Dialectical behavior therapy as treatment for borderline personality disorder. The Mental Health Clinician, 6(2), 62–67. https://doi.org/10.9740/mhc.2016.03.62

Moeller, F. G., Barratt, E. S., Dougherty, D. M., Schmitz, J. M., & Swann, A. C. (2001). Psychiatric Aspects of Impulsivity. American Journal of Psychiatry, 158(11), 1783–1793. https://doi.org/10.1176/appi.ajp.158.11.1783

Although anger is a prickly emotion to experience, it’s an important one to pay attention to. Anger can be a signal that a boundary needs to be put up or that a need is not being met.  Many people were never taught how to healthily express their anger and have learned to suppress this uncomfortable emotion. When we don’t express our anger in a healthy way or push it down, it can come out in other ways, such as reactivity or rage. Therapy can be a safe place to explore this anger and learn new ways to understand, manage and express it in a productive way. 

What Therapy Might Look Like

Therapy is a place where you can better understand yourself. A therapist can support you in managing your anger by first getting to know it. Where does it show up? What is your response to the feeling of anger? What are the drawbacks of expressing (or not expressing) your anger in this way? From here, your therapist may incorporate tools to help you become more comfortable with the feeling of anger without reacting to it. An example of this might be offering grounding techniques , such as naming the emotion or engaging your senses in some way. 

A Word on Radical Acceptance

Perhaps your feelings of anger stem from a situation or event that is out of your control. Another approach your therapist may use to help you address anger (or any painful emotion) is radical acceptance, a foundational skill taught within Dialectical Behavioral Therapy. Radical acceptance means to fully acknowledge the reality of whatever circumstance is causing you distress. This can be applied to a recent death of a family member, a loss of a job, or processing a natural disaster. Although radical acceptance can be an empowering skill to develop in taking back control of your emotions, it is important to note what radical acceptance doesn’t mean. Radical acceptance doesn’t mean you think the situation is acceptable. Radical acceptance doesn’t mean you are throwing in the towel. Radical acceptance doesn’t mean you are sweeping the issue under the rug. Ultimately, radical acceptance can be a valuable tool in managing anger and reactivity by allowing the reality of whatever circumstance you are in to exist, ultimately, diminishing your reaction to it. 

Whether you’re needing guidance to navigate and problem solve the source of your feelings of anger or support in moving toward radical acceptance, you don’t have to do it alone. 

Sources:

DBT Skills List. (n.d.). DBT Self Help. Retrieved March 16, 2023, from https://dbtselfhelp.com/dbt-skills-list/

Frazier, S. N., & Vela, J. (2014). Dialectical behavior therapy for the treatment of anger and aggressive behavior: A review. Aggression and Violent Behavior, 19(2), 156-163. https://doi.org/10.1016/j.avb.2014.02.001

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

McKay, M., Wood, J. C., & Brantley, J. (2019). The dialectical behavior therapy skills workbook: Practical DBT exercises for learning mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. New Harbinger.