Tolerating Overwhelming Emotions

We see this confusion in our clients as well. Our clients (and some of us) confuse emotions with thoughts, rumination or even the facts of a situation.

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In 1884, William James wrote an article, What is an Emotion? Scientists are still debating this question today.  As clinicians, however, most of us would describe an emotion as a natural instinctive state of mind triggered by circumstances, mood or relationships, or something similar.

Emotion is a relatively recent concept. The English word emotion derives from the 16th century French word émotion used to describe mental agitation. Before the word was introduced into the English language, people used words such as appetites, passions, affections or sentiments. Besides being a relatively recent concept, emotion is culturally-based and some languages do not have an equivalent word to this day.

We see this confusion in our clients as well. Our clients (and some of us) confuse emotions with thoughts, rumination or even the facts of a situation.  They say, “He made me angry” rather than seeing emotions as a natural instinctive state of mind.  They believe emotions are bad or a weakness.  They judge themselves for having emotions.  Saying someone is emotional is an epithet.

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How To Defeat Depression

I spend my days teaching clients how to use skills … to reduce tough symptoms of depression. One day, one of those same clients taught me a valuable lesson — it’s not about the individual skills, it’s about what they can do in combination.

A mighty oak will not fall in one swing of the ax; a formidable foe will not fall after a single punch; a powerful army will not raise the white flag after one shot fired; and a chess master will not resign after the very first move. In that same regard, depression will not be quelled following a single application of a therapeutic intervention – not a fact I like very much, but a fact nonetheless.

As a therapist who specializes in treating intense and unrelenting depression and anxiety often associated with chronic mental illness and personality disorders, I spend my days teaching clients how to use skills like deep breathing, distraction, positive activity scheduling, thought restructuring, and mindfulness to reduce tough symptoms of depression. One day, one of those same clients taught me a valuable lesson — it’s not about the individual skills, it’s about what they can do in combination.

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DBT for High Conflict Couples

Mary and John have had the same predictable fight week after week for almost five years. They have it down to who says what when. They both could benefit from DBT.

Imagine — Mary and her husband, John, have the same predictable fight week after week. John cheated on Mary five years ago and she can’t let it go.  When John is late getting home from work, which happens frequently, she obsesses he’s having another affair and is going to leave her.  By the time he gets home, she is so worked up she accuses him of cheating and threatens suicide if he leaves.  He dreads walking in the door because he knows what’s coming.  By the time he pulls in the driveway, he’s just as worked up as she is.  According to script, he rages while she cries and begs and throws things. He starts drinking and she goes to the bathroom to cut away the pain with a razor blade.  The next morning, she apologizes and he goes about his business silent and hung over.  She calls him six times over the course of the day to apologize.  He refuses her calls.  In between calls, she beats herself up for what happened.  She can’t let go of the thought that he is going to leave and it will be her fault. 

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Storytelling: Changing the Narrative

Our memories of past events come from “narrative truth,” rather than “historical truth.” We remember the stories we tell ourselves about what happened, not what actually happened.

A couple of blogs ago, I talked about the five options our clients (and we) have when confronted with a problem. We can:

  • Solve the problem in whole or part
  • Change the way we think and feel about it
  • Radically accept it
  • Make ourselves miserable
  • Make the situation worse

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When A Client Says – “It’s So Unfair!”

Radical acceptance is not easy. Getting hit by a drunk driver is not fair. Mental illness is not fair. Experiencing trauma is not fair. But only our clients can solve the problems that result.

Mature man with depressed look

Clients come to me with mental illness or a history of trauma. Most of my clients have both.  New clients often will say “it’s so unfair.”  What they really are saying is “I shouldn’t have to deal with this.  I don’t want to be here.  Why me?  Why now?”  My response is always the same.  “You may not have caused the problem but you are the only one who can solve it.”

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Splitting in People with BPD

A client told me that splitting allows her to divide people and the world into good and bad, making them easier to understand.

What Splitting Is

“No one has ever understood me the way you do. Past therapists have just sat there, taken my money, and basically fallen asleep while I’m talking. You’re the only one who has ever listened to me at all.”

Many therapists have heard this before. People with borderline personality disorder (BPD) may have a hard time seeing gray areas and, as a result, resort to a defense mechanism known as splitting. Splitting can also be identified when a person with BPD interprets people, thoughts, emotions, and situations as black or white, all or nothing, wonderful or evil. Continue reading “Splitting in People with BPD”

Graduating Therapy

When people identify what’s not working for them and change the underlying behaviors, their lives get better. When their lives get better, their thinking about the past and future changes. The future looks brighter and the past is just that, past.

 

triumphant male on mountain horizontal web small

It is always a bittersweet moment when a client “graduates.”  I am happy to see their hard work pay off yet sad to see them go.  But, of course, the goal of therapy is healing and that means letting go when the time comes.

From the first session, my goal is to help clients heal to the point of graduation. Some people come at a turning point and want a course correction; others want a major overhaul.  Their lives are out of control and they are feeling hopelessly caught in a downward spiral.

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