Thursday, April 03, 2008

Therapist, heal thyself

I'm studying DBT, and one of the first things you do is teach the client how to get through a crisis. A crisis is defined as a stressful event or traumatic moment that you can't work on solving right away. The challenge is to get through the crisis without hurting or killing yourself or anyone else, destroying property, or doing anything else harmful and unproductive, because "making things worse will make your life worse."

We watched a video of Marsha Linehan, the inventor of the therapy, describing two strategies for doing this: distracting yourself or self-soothing. I found that several aspects of the strategies are things I do anyway. Which I guess means I'm mentally healthier than the average DBT client. I suppose that's progress.

Linehan recommends making a list, when not in crisis, of ways to distract yourself. There's an acronym for this strategy (DBT is big on acronyms; they're good mnemonic aids): ACCEPTS.

A is for mindful activities, like reading an engrossing book, exercising, cleaning, hobbies, or going to an event. Anything that will keep your mind off the crisis. I thought, "I like doing crossword puzzles when I'm stressed out, and watching movies, and reading mystery novels."

C is for contributing -- focus your mind on someone or something else that you might be able to help. I always forget about my anger or distress when I'm focused on my clients.

C is for comparisons -- compare your situation to something worse, either in your own life or affecting other people. I never find this very helpful. Even though I know I'm more fortunate than most of the planet, I still manage to resent those who are more fortunate.

E is for emotions -- induce an opposing emotion in yourself to distract yourself from the current one. Listen to uplifting or soothing music; read an engrossing book; watch something funny. I do this a lot. I go online and watch reruns of funny, witty sitcoms like "Coupling" or "Friends."

P is for pushing away -- when you just can't cope, make a list of the main problems that are on your mind, number them, and ask a) whether you can do anything about each item and b) if now is a good time to try. If the answer to both a) and b) is no, then place a check next to the item and envision yourself putting it in a box and putting each box up on a high shelf. Supposedly this is a really great intervention; I haven't tried it yet, and I don't know if it will help me. But I've got a huge project due on Wednesday so I'll really have to focus this weekend; I might try pushing away my anger and sadness.

T is for thoughts -- focus on thoughts, not your emotions. Count and/or name things you see; if you're with a person who is making you upset, say to yourself, "He's wearing a jacket, a shirt, a tie, pants, glasses..." Haven't tried this yet either.

S is for sensations -- distract your mind with harmless sensations (as opposed to cutting, which a lot of DBT clients do). Take a hot bath or a cold shower, or hold a piece of ice in your hand. I might fill my ice tray and try this one.

Self-soothing techniques remind me of a quote from The Picture of Dorian Gray: to cure the soul by means of the senses, and the senses by means of the soul.

Look at something beautiful like art or flowers.

Listen to soothing music, talk to a friend, or call an 800 number and listen to the recorded voice.

Smell something nice -- I do this with aromatherapy.

Taste something pleasant and strong, like an herbal tea or a peppermint candy. (After she said this, I put a stick of sugarless peppermint gum in my mouth. I got to class late and missed the first few minutes of the video, and I hate it when that happens.)

Touch something soft, like velvet or a pet; hold someone's hand or hold your own hand; put lotion on your body and rub it in well.

One of my old therapists said that the happiest people were cognitive-behavioral therapists, because they're constantly practicing the principles of managing their emotions. But Buddhist monks are probably happier than CBT therapists. And DBT is based in part on Buddhist concepts like mindfulness and radical acceptance. So maybe learning DBT will help me manage my own chaotic emotions.
Copyright (c) "Ayelet Survivor"

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