Welcome to she persisted I'm your host Sadie Saxton a 19 year
old from the Bay Area studying psychology at the University of
Pennsylvania. She persisted is the Teen Mental
Health podcast made for teenagers by a team in each
episode. I'll bring you authentic
accessible and relatable conversations about every aspect
of mental Wellness. You can expect evidence-based,
Tina, proof resources, coping skills, including lots of DBT,
insights and education. In each piece of content, you
consume, she persisted It offers you a safe space to feel
validated and understood in your struggle.
While encouraging you to take ownership of your journey and
build your life worth living. So let's dive in this week on.
She persisted when you engage in these maladaptive coping
mechanisms, there are repercussions and you are the
one that's going to take accountability.
And so if we can focus on not even making things better,
because that is an overwhelming and distressing Prospect to the
moment, but just not making things worse.
You can save yourself a lot of And a lot of problems down the
road. Hello.
Hello, and welcome back to. She persisted.
I'm so excited to hear today, happy mental health, awareness
month. When I was thinking about what I
wanted to do for this episode, I wanted to do like a
comprehensive Deep dive and I've done these in the past on things
like skills for depression skills for anxiety, exposure
therapy, Etc. And I wanted to do one of those
comprehensive resources, where you listen, you learn about the
background, the context and then we talked about the skills you
can use. Use to navigate the situation
and sprinkling in some personal experiences of course.
And so, for today's episode, what we're going to talk about
is a new term that I've decided to coin for myself.
This concept that is definitely a thing in the therapy world but
it's advice that I always give to individuals when they come to
me and they're struggling with their mental health and it's the
idea of keeping things net neutral as what we're calling
it. I love a good alliteration.
This one is not the best name for this so if you can come up
with a better, Name for this concept, please do you have me
at all? Officially renamed it.
But the idea of keeping things in that neutral is that you're
not necessarily focusing on things better, but you're just
not making things worse for yourself.
You might be really overwhelmed. You might be struggling with
your mental health. The idea of completely shifting,
your behaviors, or thoughts, your urges asking for help
restructuring. Your support system is
incredibly overwhelming so rather than diving into that,
and being like, this is what I'm going to do.
I'm going to change my entire life, I'm going To turn my
mental health around in this moment, what you're going to
focus on is not making things worse.
So let's dive into it. So some context that's very
helpful to understand here, from DBT, or dialectical behavioral
therapy. If you're new here, you're like,
what the heck is DBT? First off, I have to tell you
that I'm doing daily, DBT skills on Instagram and Tech talk for
mental health awareness month. So, if you want some DBT skills
to mental health education, sprinkled into your feed.
Go follow me on there but DB T stands for dialectical
behavioral therapy. It was a therapy protocol that
was developed by Marsha Linehan that addresses individuals that
are struggling with borderline personality disorder and
suicidal ideation. So it's individuals that are
struggling in a really big way, they're struggling to regulate
their emotions. They're struggling to be
interpersonally, effective and things across the board are
really tough, and they've had a challenges in the past, with
getting support in therapy seeing things.
Get better shifting, their emotions, their thoughts, their
urges Etc. Another interesting caveat Here,
I'll give you two more kind of interesting things about the
development of DBT and the philosophies that kind of guide.
It one is that with these patients in particular, they had
a history of not being super popular, will say it with
therapist because they were struggling really intensely.
With either really overwhelming, urges maladaptive, coping
mechanisms, suicidal ideations and then the one additional
caveat that I will give two DBT treatment and the philosophy
there that is helpful to Stand so idea, of acceptance and
changed. So when Marsha Linehan started
developing DBT, she found that with these really depressed,
suicidal struggling patients. That if you told them to accept
their situation, they rejected that they were like, you're
saying things can't change. You're saying I'm stuck.
Like this forever. You're not able to help me with
the heck is your job that they would get really upset and
pissed off. But then when you told them to
change their situation they would say this is my fault.
Like what are you talking about? Like I didn't do this to myself.
Why do I have to do with this is my problem.
And so with DBT, there's this Perfect Blend of the two.
It's a dialectic, which is why DBT is called dialectical
behavioral therapy. So you're balancing acceptance
and change and you're accepting the situation that you're in and
you're working to change it and you're doing both of those
things at the same time. And Marsha Linehan found that
this was a really effective way to validate patients and also
motivate them to work on what it was that they were dealing with.
So, as I Enter in this population that DBT was
developed for had a lot going on.
There is all of these crises that they were dealing with on a
daily basis on a weekly basis. When you came to therapy, it was
like and I can speak from my own experience, going to DBT.
It was like, I had this maladaptive coping mechanism.
Come up icon in this giant argument with my parents.
I hate this aspect of my life. I'm so hopeless here, I have no
motivate. Like, everything is basically a
burning fire, overwhelming, Code, Red.
Everything is the worst always all the time.
So you have all of these crises going on and in DBT they've come
up with a really effective way to address these in a hierarchy
in which you deal with these things to get effective therapy
outcomes and to make sure that you're doing the correct order
of operation, we've all heard of order of operations, probably
from math. Like first we're going to do
parentheses and then we're going to do our exponents and then
we're multiplying and dividing and then we're doing dishes and
subtraction same thing exists for therapy.
And In therapy. There's four stages in stage 1
we are addressing severe behavioral dis control and Stage
2 we're talking about quiet. Desperation and stage, 3 were
addressing problems and living in stage 4 is incompleteness.
There's actually even a DVT House of treatment and I'll put
a link in the show notes so you can have the visual.
If you're watching this on Instagram and this is a clip
that ends up there, you'll see the house.
But basically the bottom house is on fire as we talked about,
we are a hot mess at this point. When Marsha Linehan developed
DBT, her guiding principle and mission in life was to help.
Get people out of hell is how she described it.
She struggled immensely with her mental health, as a young adult.
So once she pulled herself out of how her goal in life was to
go back and help other people pull themselves out of there
too. And that's why she made DB T, we
love Marcia. So when we look at this DBT
house, sometimes people will call the first stage living in
hell, because that's what the experience is for.
A lot of people, it's Overwhelmed stressed.
It's constantly being unhappy and ineffective.
And so when you see the DBT house, the first floor is
actually on fire. And so, this is the stage 1 of
addressing severe behavioral dysfunction.
This is also called addressing life-threatening behaviors.
So when we're in stage one, we're getting in control.
So we are addressing life-threatening behaviors.
We are talking about threats to treatment or major threats to
quality of life and this means committing to using skills.
Having contingency plans, if maladaptive coping mechanisms
are engaged in. So the goal here is to control
Behavior by increasing motivation.
Having a goal to get better and committing to DBT and committing
to using your skills. And So, within this
life-threatening Behavior, it's things like self-harm suicidal,
ideation anything that increases those urges, those thought
patterns, Etc. What's interesting about DBT is
that things like substance use, binge eating, not taking
prescribed medication. Get in trouble with the law.
Like none of those are considered life-threatening
behaviors was are considered quality of life interfering
behaviors. So again when we are in stage 1,
we are only focusing on life-threatening behaviors and
within that does include self-harm.
And so when we have this idea of life-threatening behavior, is
that is including not only the actions, you're taking the
behaviors are engaging in current and future experiences,
but also the urges that are coming up and past experiences
with those maladaptive coping mechanisms so that is the
Baseline. That's the floor of the House
were on fire were overwhelmed, were distressed.
That is stage 1. That is what you are addressing
when you're going into DP T treatment.
So with in stage 1, we also address therapy, interfering
behaviors because sure it's great.
If you've agreed to use the skills, but if you're not even
showing up to therapy, none of that's going to matter.
So our therapy, interfering behaviors include things, like,
not going to sessions. Missing them being late, not
doing your diary cards in DBT, how you're tracking these
life-threatening behaviors. Maybe you are not Saying your
phone coaching correctly or any interpersonal Dynamics between
you and the therapist. So that's also addressed in
stage 1 but not as applicable of this episode.
So we're skating over at now, we're on the second floor of the
house. This is stage 2, this is called
quiet, desperation. And this stage you are getting
in touch. So stage one, we were getting in
control here or getting in touch and we're working on a motional
experiencing and we're doing both exposure therapy and also
doing some cognitive restructuring to work to reduce
your overall Suffering and within this encapsulates, your
quality of life interfering Behavior.
So things like drug use binge eating not taking prescribed
medication legal problems, relationship issues.
High-risk sexual behavior job loss and financial issues there
is overall quality of life. Interfering behaviors are not
life-threatening, but they are impacting your quality of life
and those are addressed in stage 2 and then stage three is
problems in living. So we've gotten control, we've
gotten in touch. Now we're getting a life.
So we are identifying working towards our life.
Rules were increasing our self-respect and we're both
increasing happiness and decreasing unhappiness, but it's
in a more normal scale. So it's called Ordinary
happiness and unhappiness. So we're not in stage.
One, the house is on fire were constantly overwhelmed.
It's like a normal wave of emotions.
And then the final stage, the roof of the house is in
completeness because we know that the journey is never over.
You're not like, okay, I got to the top of the house, I've gone
through DBT. My life is perfect.
You're going to continue to implement those skills to the
rest of your life. So it's that radical acceptance
of like okay, I've done the work.
I've given myself the skills to be able to navigate the
challenges that life throws at me and this is not the ending
point, life continues, life goes on and I will be okay.
So within this stage, we talk spiritual fulfillment.
This is where like the mindfulness part of DVT comes in
expanded awareness of your experience.
And then having a capacity for sustained Joy.
So that's the TBT house. And while it depends on what
therapist you're working with and what modality of therapy
you're doing it. Most cases they're going to do
that order of operations of what is life-threatening?
What is therapy interfering then?
What is quality of life interfering.
So the goal of this episode is to intervene us into the
life-threatening Behavior. Chunk the goal is to take that
off the table and to just sit above floor one, we're not on
fire, but we're also a little bit in quiet.
Desperation. So we're not making things
worse, we're not working on, climbing up the house and
getting to our spiritual fulfillment yet, but we're just
Just not going further down the floors.
So there are a couple of different things at play here
and one of them is the idea of accountability, especially in
therapy. You are the only one that's
going to be accountable for the coping skills, you choose to
engage in and the way that you handle your emotional distress.
So if you are choosing to engage with a maladaptive coping
mechanism, you're the one that's going to have to take
accountability for that. You are the one that's going to
have to deal with the repercussions, whether that's
trust in your relationships, trust with your therapist, what
you're able to address in sessions and Can that looks like
if you're engaging these negative behaviors and DBT.
There's this almost like again. There's this contingency, which
I mentioned a little bit earlier when you engage in these
behaviors, you don't get phone coaching for 24 hours and it
might be different in each DBT program, but the idea is that
you didn't ask for support. You didn't ask for, help in the
moment of Crisis, you chose to engage in a maladaptive coping
mechanism and of course, lots of intention emotions arise after
engaging in a maladaptive coping mechanism and your therapist Is
not going to be able to be there and talk you through that, over
the phone like that. Something that would be reserved
for in a session but also in the crisis moment you chose not to
use that resource. You're also not going to be able
to use it in the aftermath and so that's it very specific
example but it's true across the board and that when you engage
in these maladaptive coping mechanisms there are
repercussions and you are the one that's going to take
accountability and so if we can focus on not even making things
better because that is an overwhelming and Satan Prospect
the moment, but just not making things worse.
You can save yourself, a lot of challenges, and a lot of
problems down the road, so to paint you a picture.
If you're like, my mental health is struggling.
I think I need to go to therapy. I think I need to get support
when you think about why your mental health is struggling,
it's probably those quality of life, interfering behaviors,
maybe it's your relationships, maybe it's your routine.
Maybe its core belief, you hold about yourself, you're never
going to be able to address any of those or work on any of those
things. Until you spend the weeks
months, etcetera, working through analyzing and addressing
these maladaptive coping mechanisms that you've chosen to
engage in. And the thing with coping skills
is that we can almost think about it as like, a neural
pathway. So if we're choosing to engage
in something like restricting or overeating, or self-harm or
suicide, validation, whatever it is.
Every time we engage with that coping skill, rather than deep
breathing, or distraction, or whatever it is, you are
strengthening the neural pathway between emotional distress and
them. Active coping mechanism.
So it's going to become more challenging to choose the
effective option because you are strengthening the relationship
between the Q, which is the emotional distress, and the
response, which is the maladaptive coping mechanism.
So it's also going to be more challenging long-term to use
your coping skills if you solidify that pathway in that
habit and that strategy. And if you're listening to this
episode, I want to add this caveat here and you're like I
have already engaged in a lot of coping skills that maybe weren't
the most effective. You can integrate this like net
neutral plan. An approach at any point because
if you can cut off the - trajectory and just stay where
you're at, you are saving yourself so much suffering, so
much challenge, so much distress and then you can eventually work
on your positive trajectory. So with all of that context of
what happens when you get engaged in a negative coping
scale, what happens when that becomes one of the symptoms that
you're presenting with what happens when that becomes a
solidified neural pathway. So with all of that, context of
solidifying, neural, Ways making it more challenging to engage in
coping skills, long-term with knowing that you always have a
decision with knowing what it looks like when you then go to
treatment and you do have these maladaptive coping mechanisms
for my experience, having engaged in an effective coping
mechanisms for years, you will save yourself so much challenge,
so much suffering, so much distress, if you can just stay
neutral again. We don't have to focus on
getting better. We don't have to focus on trying
to completely turn our life around just focus on not making
it worse. So now, getting into the more
skill space, part of this episode, we're going to talk
about skills that you can use in the moment and long-term to keep
things at net neutral. And when we talked about
solidifying, neural Pathways with negative coping skills, the
same thing, works with positive ones, average time you choose to
engage in an effective coping mechanism, you're solidifying
that pathway that relationship that strategy.
So, as you use these skills, you kind of are improving.
But we're not even focused on that right now we're just
focused on not making things worse.
So I think it's important to first address what we're going
to do in. Isis mode because yes, we will
talk about long-term what you can do to improve your mood and
keep things constant. And when you're not in crisis,
keep things at a neutral place. But when it comes down to it,
when you're in crisis mode, if you're engaging in those
behaviors, none of those long-term things are really
going to matter because you again are making things worse
for yourself. So, let's talk crisis mode.
Whenever you are experiencing a really intense emotion.
We're talking like an 8 to a 10 out of your emotional intensity,
and it could be a thought. It could be an urge, it could be
an emotion. The first thing that I want you
to do is use the stop scale. This is an acronym that stands
for stop. Take a step back, observe and
proceed mindfully and I'm going to go over the scales pretty
quickly so that we can get through a bunch of them.
But there are tons of episodes explaining these in more depth
or you can always Google the name of the scale DBT worksheet.
You can see the exact worksheets that they teach in DBT for that
skill. So with the stop scale again
stop take a step back, observe proceed mindfully.
So we're physically and mentally stopping.
We're either stopping engaging in the urge.
We are stopping engaging in the fiscal.
Situation that's causing distress.
If it's an argument, you're physically stopping, then we're
going to take a step back that is both mentally emotionally and
physically. So again, if it's an argument,
you're leaving the room, if it's an urge, you're going to be
like, okay, I'm have a surge, let's take a step back.
Let's observe, what's going on here.
How did I get to this point? Etc, and that's leading right
into observations. Once you taken a step back from
the emotional state, thought you're having the physical
situation you're in, you're observing, how did I get to this
point? What are the thoughts, emotions
urges that are currently happening.
What is the effective way to maybe?
Cope with that's what would be the ineffective way to coping.
But that's because we always have that choice and then how
can I proceed mindfully and effectively?
And this is when you would choose to do, let's not even
focus on, like, making things totally better and doing this
really comprehensive overwhelming.
Coping skill, plant. Let's just focus on, not making
things worse. So that would be the proceed
mindfully. Now, when we're proceeding
mindfully, there are three skills that I'm going to give
you. And then one caveat that I want
to give this another DBT scale called mindfulness of current
emotion. You can also apply this To your
thoughts in your urges. So in DB teen mindfulness,
there's two acronyms Neo and eeo and pod pod and that is what
you're doing when you're being Mindful and how you're doing it.
So what you're doing is you're participating, you're observing
and you're describing and how you're doing, it is
non-judgmentally effectively in one mindfully.
So when you're in that observed, part of the stop scale, when
you're observing your thoughts, the emotions that are coming up
for you. The interaction that just
occurred, you're going to do that by being fully present in
the moment, fully Painting not going on.
I thought spiral of like oh my God, this was so ineffective.
This was not the gold bubble, a lot.
We're just fully participating in the observation part of it.
When we are observing, we are going to be paying attention to
the emotions that have come up. The physical, Sensations
thoughts, the urges, the interactions that have taken
place, and then we're going to describe it in one word,
describe in. This is where the how skills
come in. So we're being non-judgmental.
We are literally just objectively stating what
happened? I said this thing, this emotion
came up this The Surge is going through my head when we're doing
it. One mindfully again, we're not
second-guessing and doing a fault spiral about.
Like how did I get into this? What am I going to do to get
myself out of the situation? We're just focusing on observing
and then the effective part of it.
I skipped over again. This is where we're choosing to
not make things worse for ourselves.
You're doing what is the most effective way to navigate the
situation? What will make the most sense?
So adding that little caveat for the Stop scalp, the next goal
that I'm going to give you four crisis mode.
Is this tip Scout talk about this all the time because it's a
Change. I wish everyone had the skill in
their toolkit because it's a skill that works 100% of the
time. It's not often that you can say
this will work for 100% of your mental health challenges when it
comes to like intense emotions. So whether you're angry, you're
anxious, you're depressed. This skill will work.
So when you're at an 8 out of 10, you're in crisis mode, you
can't think straight A lot of the times their physiological
symptoms that go with that. Whether it's increased heart,
rate, increased breathing rate, are you having a panic attack?
What's going on? There's probably some physical
Well, that is also tied to that emotional distress and a lot of
the times that becomes the predominant focus of your
attention. You can even think about like,
okay, let me analyze the situation and figure out how to
proceed mindfully. Because you're so overwhelmed
with the fact that you can't breathe.
And so that's where the tips go comes in.
So it's an acronym that stands for temperature, intense
exercise paced, breathing, and paired muscle relaxation.
You've probably seen the temperature part of it on Tech.
Talk, basically, what you do is you take a bowl of ice water and
you some Your face in it for 10 to 15 seconds between breaths.
Take a deep breath and then keep doing it until your heart rate
and your breathing rate decrease, it will work 100% of
the time because it stimulates your vagus nerve and Romanian
diving reflex and so your body thinks you're jumping into cold
water and your body's like, I'm going to be underwater, like, I
need to stop producing carbon dioxide because I don't know
what I'm going to get my next breath.
So your body, lowers your heart rate, it lowers your breathing,
right. And as it's doing that, it's
also lowering it past that threshold that it was elevated
to. Cuz of the emotional distress
intense exercise Works in a similar fashion.
It's also great for distress tolerance, but you're going to
do something like burpees Sprint's.
I'm not really gets your heart rate going.
And what you're doing is, you're raising your heart rate past the
threshold that it was at when you were emotionally
overwhelmed, and then, as your body does, its natural system of
lowering your heart rate. After exercise, it lowers it
past the threshold. It was at from the emotional
distress, it's also really effective when you're
overwhelmed to do something that physical you're like, okay, that
felt good like I need to put this energy somewhere.
My thoughts are going insane doing that.
Exercise feels really good emotionally and Dish into
helping the physical distress and then pays breathing a muscle
relaxation will talk about together.
You are doing paced breathing, so you're doing your exhale
longer than your inhale. I like to do two counts.
Inhale, pause three counts for an exhale and you are again,
lowering your breathing rate past.
But it was at because the emotional distress with paired
muscle relaxation. We know that we carry a lot of
tension when were mostly just trashed.
So like, if you're super angry, Angry.
Your fists are clenched, your shoulders are tight.
So as you're inhaling, you're clenching your muscles.
And as you're exhaling, you're releasing that tension and
you're releasing it past what it was at when you are emotionally
distressed. So that's like the quickest run
down, ever of the tips Cal amazing.
When I say use the stop skill and proceed mindfully.
My recommendation of your super distress like the proceed
mindfully is just tip. We know that that's our next
step, that's what we dive into and then I'll figure out what to
do next. So the third skill that I want
to give you four crisis mode is the distractions.
Out distraction is a really effective skill when we're in
crisis mode because it will distract us from the emotions,
the thoughts, whatever it is that we're currently having so
that we can calm down enough to be able to cope with the
emotions effectively. But the issue was distraction is
that, if we're constantly avoiding, our emotions will just
come back and in a bigger way. We know this for anxiety,
avoidance, amplifies the anxiety.
And this is true across the board with your emotions.
If you avoid a thought, it's like all you can think about in
your head, if you avoid an urge, it just keeps coming back more
strongly. So we're using distraction, but
we're using. Seeing it in a short-term way.
So with distraction, there's two acronyms in DBT, but I'm gonna
go over the super quickly because you know, how to
distract yourself. You're watching a show, you're
listening to loud music or talking to someone except ra.
So, the way, the DBT breaks down distraction is that with the
except scale, you're doing activities contributing
comparisons, emotional, opposites, pushing away,
thoughts and Sensations, and with improve you are doing
imagery. Meaning, prayer, relaxation, one
thing at a time, vacation and encouragement.
So, distraction, sure. Term resource long-term not
effective because then it loses its Effectiveness.
And I always give the example is, I love the office whenever
I'm like, overwhelmed or stressed, I'll turn on the
office, but if I watch the office 24 hours a day, it would
not be effective in a time of Crisis.
I'm like, this is just background noise.
I, I'm used to this people a skill that I'm going to give you
four crisis mode. Is something called riding the
wave. This is one of my favorite
skills and I use this. Now, actually, for migraines,
which sounds kind of odd, but it's super effective and the
Idea that nothing in life is impermanent.
This is a quote that was actually set on she persisted
and I'm obsessed with it. I say it all the time.
I'm mentally say to myself constantly life is impermanent
and then impermanence will be on your side.
No emotion, no thought no urge, no physiological distress will
last forever. That's just not how life Works.
Our bodies and capable of it, our mind is incapable of it.
Our distress will decrease at some point, something has to
give something has to shift. And so when you're in crisis
mode and you're really Whelmed with energy.
Like I just think that I'm going to engage in this Behavior at.
Can't stop having the surge circle in my head.
What you're going to do is pay 100% attention to those salts.
You're having and you're going to notice that the intensity of
the urge comes in a wave certain promises drones like physics or
something, but I promise this works, you're like wow these are
just really strong. Like I don't even know if I'm
gonna be able to resist it and then it gets a little bit lesser
and then it lessens and then it's going to be more intense
again and then it lessens same thing for anger or anxiety like
oh my God, I can't breathe. With okay, my mind is a little
bit quieter now but then it's a tense again and then it's
lesser, it works in a wave. And so what you're doing rather
than trying to avoid the emotion or force, it to go away, you're
just sitting with the emotion and you're riding the wave.
And you're really leaning into those moments where it lessons
and intensity and being like, see it's getting less intense
and this too will pass. And so when I use this for
migraines, if you've ever had a headache, you're like this is
comparable. And what I try to do is sleep
them off. So like a lot of times, I get
ahead. At the end of the day and I'm
like, I've tried shower, I've tried drinking a lot of water of
taking Advil, nothing is working.
I just need to fall asleep and I can't fall asleep because my
head hurts so bad. So rather than having thoughts
going crazy in my mind. And also having this like
throbbing going on in my head, I focus all of my energy on the
pain itself and you notice that it's more intense, you like oh
this is terrible and then it lessens you like oh my gosh,
there's that sense of relief and so as you really, lean into
those moments of relief or like, okay, I got this I can do.
This, I can push through and then it's also really effective
to be mindful and then I just go to sleep.
It's great. That's the ride.
The wave skill. I'm going to give you three more
skills that you can use not in crisis mode, that will help you
keep things at a net neutral point.
We're not making things worse, we're not necessarily focusing
on re shifting our entire life but we're just going to focus on
coping with the right now. Not adding more things to our
plate. So the first one that I'm going
to tell you about is radical acceptance.
We talked about how in DBT accepting loan wasn't Active and
changing alone wasn't effective, because it doesn't satisfy all
the emotional needs and it leads to more distress.
So, the idea with radical acceptance at that, you are
accepting Life On Life's terms. And if you can do this, keeping
things, net neutral, choosing not to engage in those
maladaptive coping skills. In my experience is a bit
easier. So reading straight from the DBT
worksheet here. What is radical acceptance?
It's when you cannot keep painful events and emotions from
coming your way. You're still going to have the
urges. You're still going to have the
stressor. As you're experiencing, but you
can do some radical acceptance. So what does that mean?
It means radically accepting all the way completely, totally,
you're accepting with your mind, your heart and your body.
And when you stop fighting reality, when you stop
resisting, when you stop throwing a tantrum, when things
are, not the way you want it, and let go of bitterness that is
radical acceptance. And so there are a couple of
things that need to be accepted and you can use radical
acceptance for any situation whenever I get news that I'm not
excited about or I will. Things were different.
I'm not accepting. But in DB T, we are radically
accepting. These four pillars across the
board. Just to accept that.
This is how life works and that we can't prevent painful things
from happening. So we're accepting that reality
is as it is the facts about the past the facts about the
present. And even if you don't like the
situation, the cards you've been dealt.
Those are The Facts of Life. The second one is that there are
limitations on the future for everyone, but only realistic
limitations need to be accepted. So one example of this Is when I
was starting treatment, I had this core belief that I would
never be capable of recovering, that didn't need to be radically
accept it because it wasn't a realistic limitation.
I was capable of getting support and shifting my behaviors and
asking for help. So, that's example of like, what
are we radically accepting? What are we?
Not radically accepting third is that everything has a cause
including events and situations that cause you pain and
suffering. So this is again, we're almost
addressing this with this net neutral plan where when were
engaging in negative coping skills, the Is us.
We have to take accountability there.
And so if we can even avoid that from happening in the first
place, saves his pain and suffering and then the last
pillar that were accepting is that life can be worth living
even with painful events in it and this is hard.
This is a tough pill to swallow when you are in so much
distress. But as your emotional intensity
lessons, with time, as you regulate your emotions more
effectively, the painful events, you're experiencing become less
intense and life really can be worth living.
Being so that is what we are accepting and why we're
accepting it is that rejecting reality does not change it.
If we are resisting the truth of life it's not going to change
it. It just makes things worse for
ourselves. Second is that changing reality
first requires accepting reality.
So again we are accepting and changing but to change we first
have to accept three pain. Can't be avoided.
It's Nature's Way of signaling that something is wrong telling
us to some extent effective the way that we're coping with life,
the relationships were engaged in, aren't working for us
something new. Chef, so pain is a signal for
rejecting reality, turns pain into suffering.
There's a difference between pain and suffering and when we
reject reality, we suffer more and I almost sometimes see those
maladaptive coping mechanisms as a way of rejecting reality and
increasing that suffering. So that's why we're nipping it
in the bud and trying to avoid that 5 refusing to accept
reality can keep you stuck in unhappiness, bitterness anger
sadness, shame and other painful emotions.
It's acceptance may lead to sadness, but deep calmness.
Usually follows, again nothing is permanent and that
impermanence will be on your side and 7 the path out of hell
is through misery, but refusing to accept the misery.
That is part of climbing out of hell.
You fall back into hell and we picture house.
The bottom floors on fire and burning and overwhelming.
But unless we climb up that and get through that stage 1, we can
address anything else. And so one little Mantra that is
used for radical acceptance. Is that everything is as it
should be and everything. This is a test so to just
reiterate the points we just talked about in slightly
different language on a different DBT, work shape,
freedom from suffering requires acceptance from deep within of
what is Let Yourself Go. Completely with what is and let
go of fighting reality. Acceptance is the only way out
of how pain create suffering. Only when you refused to accept
the pain deciding to tolerate and under the moment is
acceptance, acceptance is acknowledging.
What is to accept? Something is not the same as
judging it is good or approving of it.
You're just saying. This is the Cards.
I'm being dealt, even if I don't like them.
And lastly acceptance is turning suffering into pain that I can
endure. So that's radical acceptance.
We love radical acceptance. I want to do like a whole
episode on that at some point because it's such a freaking
good scale. It's hard, but it's amazing.
It's like mind-altering paradigm-shifting.
And then the second Alaska, I'm going to teach you is Copa had.
We want to set ourselves up for success.
And if we know that we are emotionally vulnerable to
experiencing urges, to wanting to engage in a maladaptive
coping mechanism, we want to set ourselves up for success and
This one, we're using, the Copa had skull, so we're mentally
walking through like, what's the situation?
Like, I know that when I'm sitting in bed at night and just
laying there, and I'm alone with my thoughts, I am more likely to
have like a negative urge pop into my head or I know that when
I am alone for a really long time, those negative thoughts
pop up, or when I have lots of a routine, I'm more likely to
engage in this Behavior because I feel really hopeless, whatever
it is be aware of what those triggers are with.
Those vulnerabilities are. And then we're going to set up a
plan for how you're going to deal with the urges one.
They arise in that situation. So again we're going to pull
from those crises skills. We just talked about I'm going
to use this stops go first. Then I'm going right into tip,
then we're doing some distraction and then once I loop
back to the original thought, we're going to ride the wave and
we're going to work through it and we're going to accept it.
So give yourself a plan. What thoughts are going to come
up? What you're just going to come
up. What skill am going to use and
how am I going to deal with it? Right it out make it super
detailed and give yourself a plan to follow the last going to
teach you. Is accumulating positives.
This one simple and it's one of my favorite skill of DBT because
your Things that you like and the idea here is that when
you're accumulating positive, you're not only increasing Joe
and making your life, more worth living but you're improving your
Baseline of functioning. So when we look at like a chart
and we're like okay, sometimes I my mood is really high,
sometimes it's really low and there's a big gap between that
emotional high in that emotional low.
We're sprinkling in accumulating positives throughout our day
throughout a routine throughout our life.
We become more neutral and emotions were experiencing.
So again, having pain in life can be worth living and it's
more worth living when the emotions are less intense and
there is not that Whiplash from like, oh my God, I just had a
great day and then I'm like at an absolute low.
So sprinkle in the accumulating positives and the key here is
you have to plan them. They have to be intentional.
So plan your cup of coffee plan. The book you're going to read
plan the TV show, you're going to watch the friend, you're
going to see whatever it is. That brings you Joy plan those
moments and accumulate them throughout your day.
So we're reducing suffering, we're not rejecting reality.
We are staying neutral. We're not overwhelming ourselves
to try to make things better. We're just not Things worse,
taking accountability over the fact that we have a choice when
we engage in maladaptive coping mechanisms and then we have a
really comprehensive plan of how to deal with those.
So that's today's episode. I really hope you enjoy this.
If you do share with a friend or family member, if you shout
social media, tag me that she persisted podcast.
I was repost and give you a little shout out.
And thank you for listening and I'll see you next week.
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