1 00:00:00,200 --> 00:00:04,200 Welcome to she persisted I'm your host Sadie Saxton a 19 year 2 00:00:04,200 --> 00:00:07,100 old from the Bay Area studying psychology at the University of 3 00:00:07,100 --> 00:00:10,400 Pennsylvania. She persisted is the Teen Mental 4 00:00:10,400 --> 00:00:13,800 Health podcast made for teenagers by a team in each 5 00:00:13,800 --> 00:00:15,400 episode. I'll bring you authentic 6 00:00:15,400 --> 00:00:18,300 accessible and relatable conversations about every aspect 7 00:00:18,300 --> 00:00:21,600 of mental Wellness. You can expect evidence-based, 8 00:00:21,600 --> 00:00:25,100 Tina, proof resources, coping skills, including lots of DBT, 9 00:00:25,100 --> 00:00:28,300 insights and education. In each piece of content, you 10 00:00:28,300 --> 00:00:31,700 consume, she persisted It offers you a safe space to feel 11 00:00:31,700 --> 00:00:33,800 validated and understood in your struggle. 12 00:00:34,000 --> 00:00:36,400 While encouraging you to take ownership of your journey and 13 00:00:36,400 --> 00:00:40,900 build your life worth living. So let's dive in this week on. 14 00:00:40,900 --> 00:00:44,200 She persisted when you engage in these maladaptive coping 15 00:00:44,200 --> 00:00:46,800 mechanisms, there are repercussions and you are the 16 00:00:46,800 --> 00:00:48,800 one that's going to take accountability. 17 00:00:48,800 --> 00:00:51,800 And so if we can focus on not even making things better, 18 00:00:51,800 --> 00:00:55,200 because that is an overwhelming and distressing Prospect to the 19 00:00:55,208 --> 00:00:57,900 moment, but just not making things worse. 20 00:00:58,100 --> 00:01:01,900 You can save yourself a lot of And a lot of problems down the 21 00:01:01,900 --> 00:01:03,100 road. Hello. 22 00:01:03,100 --> 00:01:05,500 Hello, and welcome back to. She persisted. 23 00:01:05,500 --> 00:01:08,400 I'm so excited to hear today, happy mental health, awareness 24 00:01:08,400 --> 00:01:10,200 month. When I was thinking about what I 25 00:01:10,200 --> 00:01:13,400 wanted to do for this episode, I wanted to do like a 26 00:01:13,400 --> 00:01:16,800 comprehensive Deep dive and I've done these in the past on things 27 00:01:16,800 --> 00:01:20,000 like skills for depression skills for anxiety, exposure 28 00:01:20,000 --> 00:01:23,600 therapy, Etc. And I wanted to do one of those 29 00:01:23,600 --> 00:01:27,000 comprehensive resources, where you listen, you learn about the 30 00:01:27,000 --> 00:01:29,900 background, the context and then we talked about the skills you 31 00:01:29,900 --> 00:01:32,200 can use. Use to navigate the situation 32 00:01:32,200 --> 00:01:35,000 and sprinkling in some personal experiences of course. 33 00:01:35,000 --> 00:01:38,100 And so, for today's episode, what we're going to talk about 34 00:01:38,100 --> 00:01:42,100 is a new term that I've decided to coin for myself. 35 00:01:42,100 --> 00:01:46,600 This concept that is definitely a thing in the therapy world but 36 00:01:46,600 --> 00:01:49,500 it's advice that I always give to individuals when they come to 37 00:01:49,500 --> 00:01:51,900 me and they're struggling with their mental health and it's the 38 00:01:51,900 --> 00:01:55,000 idea of keeping things net neutral as what we're calling 39 00:01:55,000 --> 00:01:57,300 it. I love a good alliteration. 40 00:01:57,300 --> 00:01:59,700 This one is not the best name for this so if you can come up 41 00:01:59,700 --> 00:02:02,000 with a better, Name for this concept, please do you have me 42 00:02:02,000 --> 00:02:03,700 at all? Officially renamed it. 43 00:02:04,000 --> 00:02:06,500 But the idea of keeping things in that neutral is that you're 44 00:02:06,500 --> 00:02:09,300 not necessarily focusing on things better, but you're just 45 00:02:09,300 --> 00:02:11,500 not making things worse for yourself. 46 00:02:12,000 --> 00:02:14,600 You might be really overwhelmed. You might be struggling with 47 00:02:14,600 --> 00:02:17,000 your mental health. The idea of completely shifting, 48 00:02:17,000 --> 00:02:19,800 your behaviors, or thoughts, your urges asking for help 49 00:02:19,800 --> 00:02:21,900 restructuring. Your support system is 50 00:02:21,900 --> 00:02:25,100 incredibly overwhelming so rather than diving into that, 51 00:02:25,100 --> 00:02:27,400 and being like, this is what I'm going to do. 52 00:02:27,400 --> 00:02:30,600 I'm going to change my entire life, I'm going To turn my 53 00:02:30,600 --> 00:02:33,300 mental health around in this moment, what you're going to 54 00:02:33,300 --> 00:02:35,900 focus on is not making things worse. 55 00:02:36,400 --> 00:02:39,500 So let's dive into it. So some context that's very 56 00:02:39,500 --> 00:02:43,400 helpful to understand here, from DBT, or dialectical behavioral 57 00:02:43,400 --> 00:02:45,500 therapy. If you're new here, you're like, 58 00:02:45,500 --> 00:02:48,100 what the heck is DBT? First off, I have to tell you 59 00:02:48,100 --> 00:02:51,300 that I'm doing daily, DBT skills on Instagram and Tech talk for 60 00:02:51,300 --> 00:02:54,000 mental health awareness month. So, if you want some DBT skills 61 00:02:54,000 --> 00:02:56,000 to mental health education, sprinkled into your feed. 62 00:02:56,000 --> 00:02:59,200 Go follow me on there but DB T stands for dialectical 63 00:02:59,200 --> 00:03:01,800 behavioral therapy. It was a therapy protocol that 64 00:03:01,800 --> 00:03:06,300 was developed by Marsha Linehan that addresses individuals that 65 00:03:06,300 --> 00:03:08,900 are struggling with borderline personality disorder and 66 00:03:08,900 --> 00:03:11,000 suicidal ideation. So it's individuals that are 67 00:03:11,000 --> 00:03:14,200 struggling in a really big way, they're struggling to regulate 68 00:03:14,200 --> 00:03:15,700 their emotions. They're struggling to be 69 00:03:15,700 --> 00:03:18,400 interpersonally, effective and things across the board are 70 00:03:18,400 --> 00:03:21,800 really tough, and they've had a challenges in the past, with 71 00:03:21,800 --> 00:03:24,100 getting support in therapy seeing things. 72 00:03:24,100 --> 00:03:26,800 Get better shifting, their emotions, their thoughts, their 73 00:03:26,800 --> 00:03:30,400 urges Etc. Another interesting caveat Here, 74 00:03:30,400 --> 00:03:33,300 I'll give you two more kind of interesting things about the 75 00:03:33,300 --> 00:03:37,600 development of DBT and the philosophies that kind of guide. 76 00:03:37,600 --> 00:03:42,000 It one is that with these patients in particular, they had 77 00:03:42,000 --> 00:03:45,200 a history of not being super popular, will say it with 78 00:03:45,200 --> 00:03:47,900 therapist because they were struggling really intensely. 79 00:03:48,200 --> 00:03:51,200 With either really overwhelming, urges maladaptive, coping 80 00:03:51,200 --> 00:03:54,500 mechanisms, suicidal ideations and then the one additional 81 00:03:54,500 --> 00:03:59,000 caveat that I will give two DBT treatment and the philosophy 82 00:03:59,000 --> 00:04:02,400 there that is helpful to Stand so idea, of acceptance and 83 00:04:02,400 --> 00:04:04,300 changed. So when Marsha Linehan started 84 00:04:04,300 --> 00:04:08,300 developing DBT, she found that with these really depressed, 85 00:04:08,300 --> 00:04:12,800 suicidal struggling patients. That if you told them to accept 86 00:04:12,800 --> 00:04:15,800 their situation, they rejected that they were like, you're 87 00:04:15,800 --> 00:04:17,899 saying things can't change. You're saying I'm stuck. 88 00:04:17,899 --> 00:04:20,100 Like this forever. You're not able to help me with 89 00:04:20,100 --> 00:04:23,100 the heck is your job that they would get really upset and 90 00:04:23,100 --> 00:04:25,400 pissed off. But then when you told them to 91 00:04:25,400 --> 00:04:27,900 change their situation they would say this is my fault. 92 00:04:27,900 --> 00:04:30,000 Like what are you talking about? Like I didn't do this to myself. 93 00:04:30,100 --> 00:04:32,800 Why do I have to do with this is my problem. 94 00:04:33,600 --> 00:04:36,900 And so with DBT, there's this Perfect Blend of the two. 95 00:04:37,200 --> 00:04:40,200 It's a dialectic, which is why DBT is called dialectical 96 00:04:40,200 --> 00:04:43,000 behavioral therapy. So you're balancing acceptance 97 00:04:43,000 --> 00:04:46,200 and change and you're accepting the situation that you're in and 98 00:04:46,200 --> 00:04:48,500 you're working to change it and you're doing both of those 99 00:04:48,500 --> 00:04:51,200 things at the same time. And Marsha Linehan found that 100 00:04:51,200 --> 00:04:55,600 this was a really effective way to validate patients and also 101 00:04:55,600 --> 00:04:59,200 motivate them to work on what it was that they were dealing with. 102 00:04:59,400 --> 00:05:02,100 So, as I Enter in this population that DBT was 103 00:05:02,100 --> 00:05:04,900 developed for had a lot going on. 104 00:05:05,100 --> 00:05:08,000 There is all of these crises that they were dealing with on a 105 00:05:08,000 --> 00:05:12,300 daily basis on a weekly basis. When you came to therapy, it was 106 00:05:12,300 --> 00:05:15,100 like and I can speak from my own experience, going to DBT. 107 00:05:15,100 --> 00:05:17,400 It was like, I had this maladaptive coping mechanism. 108 00:05:17,400 --> 00:05:19,800 Come up icon in this giant argument with my parents. 109 00:05:20,100 --> 00:05:23,100 I hate this aspect of my life. I'm so hopeless here, I have no 110 00:05:23,100 --> 00:05:26,400 motivate. Like, everything is basically a 111 00:05:26,400 --> 00:05:29,800 burning fire, overwhelming, Code, Red. 112 00:05:30,100 --> 00:05:32,100 Everything is the worst always all the time. 113 00:05:32,300 --> 00:05:36,200 So you have all of these crises going on and in DBT they've come 114 00:05:36,200 --> 00:05:39,800 up with a really effective way to address these in a hierarchy 115 00:05:39,800 --> 00:05:42,800 in which you deal with these things to get effective therapy 116 00:05:42,800 --> 00:05:45,300 outcomes and to make sure that you're doing the correct order 117 00:05:45,300 --> 00:05:48,200 of operation, we've all heard of order of operations, probably 118 00:05:48,200 --> 00:05:50,700 from math. Like first we're going to do 119 00:05:50,900 --> 00:05:54,800 parentheses and then we're going to do our exponents and then 120 00:05:54,800 --> 00:05:57,100 we're multiplying and dividing and then we're doing dishes and 121 00:05:57,100 --> 00:05:59,800 subtraction same thing exists for therapy. 122 00:05:59,800 --> 00:06:03,100 And In therapy. There's four stages in stage 1 123 00:06:03,100 --> 00:06:06,800 we are addressing severe behavioral dis control and Stage 124 00:06:06,800 --> 00:06:10,800 2 we're talking about quiet. Desperation and stage, 3 were 125 00:06:10,800 --> 00:06:14,800 addressing problems and living in stage 4 is incompleteness. 126 00:06:14,800 --> 00:06:19,000 There's actually even a DVT House of treatment and I'll put 127 00:06:19,000 --> 00:06:20,600 a link in the show notes so you can have the visual. 128 00:06:20,600 --> 00:06:22,400 If you're watching this on Instagram and this is a clip 129 00:06:22,400 --> 00:06:24,100 that ends up there, you'll see the house. 130 00:06:24,500 --> 00:06:27,800 But basically the bottom house is on fire as we talked about, 131 00:06:27,800 --> 00:06:31,500 we are a hot mess at this point. When Marsha Linehan developed 132 00:06:31,500 --> 00:06:35,300 DBT, her guiding principle and mission in life was to help. 133 00:06:35,300 --> 00:06:37,800 Get people out of hell is how she described it. 134 00:06:37,800 --> 00:06:41,100 She struggled immensely with her mental health, as a young adult. 135 00:06:41,100 --> 00:06:44,600 So once she pulled herself out of how her goal in life was to 136 00:06:44,600 --> 00:06:48,600 go back and help other people pull themselves out of there 137 00:06:48,600 --> 00:06:50,600 too. And that's why she made DB T, we 138 00:06:50,600 --> 00:06:53,100 love Marcia. So when we look at this DBT 139 00:06:53,100 --> 00:06:56,700 house, sometimes people will call the first stage living in 140 00:06:56,700 --> 00:06:59,000 hell, because that's what the experience is for. 141 00:06:59,000 --> 00:07:01,800 A lot of people, it's Overwhelmed stressed. 142 00:07:01,800 --> 00:07:05,600 It's constantly being unhappy and ineffective. 143 00:07:05,900 --> 00:07:08,700 And so when you see the DBT house, the first floor is 144 00:07:08,800 --> 00:07:12,200 actually on fire. And so, this is the stage 1 of 145 00:07:12,200 --> 00:07:14,500 addressing severe behavioral dysfunction. 146 00:07:15,000 --> 00:07:18,300 This is also called addressing life-threatening behaviors. 147 00:07:18,300 --> 00:07:20,700 So when we're in stage one, we're getting in control. 148 00:07:20,700 --> 00:07:22,900 So we are addressing life-threatening behaviors. 149 00:07:22,900 --> 00:07:26,300 We are talking about threats to treatment or major threats to 150 00:07:26,300 --> 00:07:30,000 quality of life and this means committing to using skills. 151 00:07:30,100 --> 00:07:34,200 Having contingency plans, if maladaptive coping mechanisms 152 00:07:34,200 --> 00:07:37,500 are engaged in. So the goal here is to control 153 00:07:37,500 --> 00:07:40,200 Behavior by increasing motivation. 154 00:07:40,200 --> 00:07:43,300 Having a goal to get better and committing to DBT and committing 155 00:07:43,300 --> 00:07:45,300 to using your skills. And So, within this 156 00:07:45,300 --> 00:07:48,100 life-threatening Behavior, it's things like self-harm suicidal, 157 00:07:48,100 --> 00:07:52,000 ideation anything that increases those urges, those thought 158 00:07:52,000 --> 00:07:55,100 patterns, Etc. What's interesting about DBT is 159 00:07:55,100 --> 00:07:58,200 that things like substance use, binge eating, not taking 160 00:07:58,200 --> 00:08:01,000 prescribed medication. Get in trouble with the law. 161 00:08:01,000 --> 00:08:03,000 Like none of those are considered life-threatening 162 00:08:03,000 --> 00:08:05,700 behaviors was are considered quality of life interfering 163 00:08:05,700 --> 00:08:07,700 behaviors. So again when we are in stage 1, 164 00:08:07,700 --> 00:08:10,500 we are only focusing on life-threatening behaviors and 165 00:08:10,500 --> 00:08:12,500 within that does include self-harm. 166 00:08:12,500 --> 00:08:15,400 And so when we have this idea of life-threatening behavior, is 167 00:08:15,400 --> 00:08:17,800 that is including not only the actions, you're taking the 168 00:08:17,800 --> 00:08:21,200 behaviors are engaging in current and future experiences, 169 00:08:21,500 --> 00:08:24,800 but also the urges that are coming up and past experiences 170 00:08:24,800 --> 00:08:28,200 with those maladaptive coping mechanisms so that is the 171 00:08:28,200 --> 00:08:30,400 Baseline. That's the floor of the House 172 00:08:30,400 --> 00:08:32,900 were on fire were overwhelmed, were distressed. 173 00:08:32,900 --> 00:08:35,100 That is stage 1. That is what you are addressing 174 00:08:35,100 --> 00:08:37,100 when you're going into DP T treatment. 175 00:08:37,100 --> 00:08:40,500 So with in stage 1, we also address therapy, interfering 176 00:08:40,500 --> 00:08:43,200 behaviors because sure it's great. 177 00:08:43,200 --> 00:08:45,700 If you've agreed to use the skills, but if you're not even 178 00:08:45,700 --> 00:08:48,300 showing up to therapy, none of that's going to matter. 179 00:08:48,500 --> 00:08:51,400 So our therapy, interfering behaviors include things, like, 180 00:08:51,400 --> 00:08:54,700 not going to sessions. Missing them being late, not 181 00:08:54,700 --> 00:08:57,500 doing your diary cards in DBT, how you're tracking these 182 00:08:57,500 --> 00:09:00,700 life-threatening behaviors. Maybe you are not Saying your 183 00:09:00,700 --> 00:09:03,300 phone coaching correctly or any interpersonal Dynamics between 184 00:09:03,300 --> 00:09:06,600 you and the therapist. So that's also addressed in 185 00:09:06,600 --> 00:09:08,700 stage 1 but not as applicable of this episode. 186 00:09:08,700 --> 00:09:11,900 So we're skating over at now, we're on the second floor of the 187 00:09:11,900 --> 00:09:14,100 house. This is stage 2, this is called 188 00:09:14,100 --> 00:09:17,600 quiet, desperation. And this stage you are getting 189 00:09:17,600 --> 00:09:19,300 in touch. So stage one, we were getting in 190 00:09:19,300 --> 00:09:22,200 control here or getting in touch and we're working on a motional 191 00:09:22,200 --> 00:09:25,800 experiencing and we're doing both exposure therapy and also 192 00:09:25,800 --> 00:09:29,000 doing some cognitive restructuring to work to reduce 193 00:09:29,000 --> 00:09:32,400 your overall Suffering and within this encapsulates, your 194 00:09:32,408 --> 00:09:34,300 quality of life interfering Behavior. 195 00:09:34,300 --> 00:09:37,000 So things like drug use binge eating not taking prescribed 196 00:09:37,000 --> 00:09:40,000 medication legal problems, relationship issues. 197 00:09:40,000 --> 00:09:43,500 High-risk sexual behavior job loss and financial issues there 198 00:09:43,500 --> 00:09:46,000 is overall quality of life. Interfering behaviors are not 199 00:09:46,000 --> 00:09:48,900 life-threatening, but they are impacting your quality of life 200 00:09:49,000 --> 00:09:52,800 and those are addressed in stage 2 and then stage three is 201 00:09:52,800 --> 00:09:55,600 problems in living. So we've gotten control, we've 202 00:09:55,600 --> 00:09:57,500 gotten in touch. Now we're getting a life. 203 00:09:57,500 --> 00:09:59,900 So we are identifying working towards our life. 204 00:10:00,100 --> 00:10:03,200 Rules were increasing our self-respect and we're both 205 00:10:03,200 --> 00:10:06,500 increasing happiness and decreasing unhappiness, but it's 206 00:10:06,500 --> 00:10:09,700 in a more normal scale. So it's called Ordinary 207 00:10:09,700 --> 00:10:12,100 happiness and unhappiness. So we're not in stage. 208 00:10:12,100 --> 00:10:14,900 One, the house is on fire were constantly overwhelmed. 209 00:10:14,900 --> 00:10:16,900 It's like a normal wave of emotions. 210 00:10:17,700 --> 00:10:20,000 And then the final stage, the roof of the house is in 211 00:10:20,000 --> 00:10:22,800 completeness because we know that the journey is never over. 212 00:10:23,100 --> 00:10:25,200 You're not like, okay, I got to the top of the house, I've gone 213 00:10:25,200 --> 00:10:26,900 through DBT. My life is perfect. 214 00:10:26,900 --> 00:10:28,800 You're going to continue to implement those skills to the 215 00:10:28,800 --> 00:10:31,400 rest of your life. So it's that radical acceptance 216 00:10:31,400 --> 00:10:32,800 of like okay, I've done the work. 217 00:10:32,800 --> 00:10:35,100 I've given myself the skills to be able to navigate the 218 00:10:35,100 --> 00:10:38,000 challenges that life throws at me and this is not the ending 219 00:10:38,000 --> 00:10:41,400 point, life continues, life goes on and I will be okay. 220 00:10:41,500 --> 00:10:44,500 So within this stage, we talk spiritual fulfillment. 221 00:10:44,500 --> 00:10:46,800 This is where like the mindfulness part of DVT comes in 222 00:10:46,800 --> 00:10:48,700 expanded awareness of your experience. 223 00:10:49,200 --> 00:10:52,000 And then having a capacity for sustained Joy. 224 00:10:52,000 --> 00:10:56,100 So that's the TBT house. And while it depends on what 225 00:10:56,100 --> 00:10:58,800 therapist you're working with and what modality of therapy 226 00:10:58,800 --> 00:11:01,700 you're doing it. Most cases they're going to do 227 00:11:01,700 --> 00:11:04,300 that order of operations of what is life-threatening? 228 00:11:04,300 --> 00:11:06,300 What is therapy interfering then? 229 00:11:06,300 --> 00:11:08,000 What is quality of life interfering. 230 00:11:08,400 --> 00:11:11,800 So the goal of this episode is to intervene us into the 231 00:11:11,800 --> 00:11:15,700 life-threatening Behavior. Chunk the goal is to take that 232 00:11:15,700 --> 00:11:20,900 off the table and to just sit above floor one, we're not on 233 00:11:20,900 --> 00:11:23,200 fire, but we're also a little bit in quiet. 234 00:11:23,200 --> 00:11:25,300 Desperation. So we're not making things 235 00:11:25,300 --> 00:11:27,300 worse, we're not working on, climbing up the house and 236 00:11:27,300 --> 00:11:29,900 getting to our spiritual fulfillment yet, but we're just 237 00:11:30,000 --> 00:11:32,000 Just not going further down the floors. 238 00:11:32,000 --> 00:11:34,300 So there are a couple of different things at play here 239 00:11:34,300 --> 00:11:37,200 and one of them is the idea of accountability, especially in 240 00:11:37,200 --> 00:11:39,000 therapy. You are the only one that's 241 00:11:39,000 --> 00:11:42,000 going to be accountable for the coping skills, you choose to 242 00:11:42,000 --> 00:11:45,500 engage in and the way that you handle your emotional distress. 243 00:11:45,900 --> 00:11:48,400 So if you are choosing to engage with a maladaptive coping 244 00:11:48,400 --> 00:11:50,500 mechanism, you're the one that's going to have to take 245 00:11:50,500 --> 00:11:52,700 accountability for that. You are the one that's going to 246 00:11:52,708 --> 00:11:55,000 have to deal with the repercussions, whether that's 247 00:11:55,000 --> 00:11:58,100 trust in your relationships, trust with your therapist, what 248 00:11:58,100 --> 00:12:01,300 you're able to address in sessions and Can that looks like 249 00:12:01,500 --> 00:12:03,800 if you're engaging these negative behaviors and DBT. 250 00:12:03,800 --> 00:12:06,900 There's this almost like again. There's this contingency, which 251 00:12:06,900 --> 00:12:09,100 I mentioned a little bit earlier when you engage in these 252 00:12:09,100 --> 00:12:12,100 behaviors, you don't get phone coaching for 24 hours and it 253 00:12:12,100 --> 00:12:15,300 might be different in each DBT program, but the idea is that 254 00:12:15,300 --> 00:12:19,300 you didn't ask for support. You didn't ask for, help in the 255 00:12:19,300 --> 00:12:22,600 moment of Crisis, you chose to engage in a maladaptive coping 256 00:12:22,600 --> 00:12:26,600 mechanism and of course, lots of intention emotions arise after 257 00:12:26,600 --> 00:12:30,200 engaging in a maladaptive coping mechanism and your therapist Is 258 00:12:30,200 --> 00:12:33,500 not going to be able to be there and talk you through that, over 259 00:12:33,500 --> 00:12:35,100 the phone like that. Something that would be reserved 260 00:12:35,100 --> 00:12:39,500 for in a session but also in the crisis moment you chose not to 261 00:12:39,500 --> 00:12:41,400 use that resource. You're also not going to be able 262 00:12:41,400 --> 00:12:45,100 to use it in the aftermath and so that's it very specific 263 00:12:45,100 --> 00:12:48,900 example but it's true across the board and that when you engage 264 00:12:48,900 --> 00:12:51,200 in these maladaptive coping mechanisms there are 265 00:12:51,200 --> 00:12:53,700 repercussions and you are the one that's going to take 266 00:12:53,700 --> 00:12:57,300 accountability and so if we can focus on not even making things 267 00:12:57,300 --> 00:13:01,000 better because that is an overwhelming and Satan Prospect 268 00:13:01,000 --> 00:13:03,700 the moment, but just not making things worse. 269 00:13:04,000 --> 00:13:06,800 You can save yourself, a lot of challenges, and a lot of 270 00:13:06,800 --> 00:13:09,600 problems down the road, so to paint you a picture. 271 00:13:09,600 --> 00:13:11,500 If you're like, my mental health is struggling. 272 00:13:11,500 --> 00:13:14,500 I think I need to go to therapy. I think I need to get support 273 00:13:14,800 --> 00:13:16,800 when you think about why your mental health is struggling, 274 00:13:16,800 --> 00:13:19,800 it's probably those quality of life, interfering behaviors, 275 00:13:19,800 --> 00:13:22,600 maybe it's your relationships, maybe it's your routine. 276 00:13:22,900 --> 00:13:26,300 Maybe its core belief, you hold about yourself, you're never 277 00:13:26,300 --> 00:13:29,100 going to be able to address any of those or work on any of those 278 00:13:29,100 --> 00:13:31,200 things. Until you spend the weeks 279 00:13:31,200 --> 00:13:35,300 months, etcetera, working through analyzing and addressing 280 00:13:35,300 --> 00:13:38,200 these maladaptive coping mechanisms that you've chosen to 281 00:13:38,200 --> 00:13:40,900 engage in. And the thing with coping skills 282 00:13:40,900 --> 00:13:42,600 is that we can almost think about it as like, a neural 283 00:13:42,600 --> 00:13:45,000 pathway. So if we're choosing to engage 284 00:13:45,000 --> 00:13:48,200 in something like restricting or overeating, or self-harm or 285 00:13:48,200 --> 00:13:49,900 suicide, validation, whatever it is. 286 00:13:50,200 --> 00:13:53,300 Every time we engage with that coping skill, rather than deep 287 00:13:53,300 --> 00:13:56,100 breathing, or distraction, or whatever it is, you are 288 00:13:56,100 --> 00:13:59,700 strengthening the neural pathway between emotional distress and 289 00:13:59,700 --> 00:14:01,500 them. Active coping mechanism. 290 00:14:01,700 --> 00:14:04,600 So it's going to become more challenging to choose the 291 00:14:04,600 --> 00:14:07,400 effective option because you are strengthening the relationship 292 00:14:07,400 --> 00:14:09,800 between the Q, which is the emotional distress, and the 293 00:14:09,800 --> 00:14:12,500 response, which is the maladaptive coping mechanism. 294 00:14:12,700 --> 00:14:15,500 So it's also going to be more challenging long-term to use 295 00:14:15,500 --> 00:14:18,300 your coping skills if you solidify that pathway in that 296 00:14:18,300 --> 00:14:21,000 habit and that strategy. And if you're listening to this 297 00:14:21,000 --> 00:14:23,100 episode, I want to add this caveat here and you're like I 298 00:14:23,100 --> 00:14:26,100 have already engaged in a lot of coping skills that maybe weren't 299 00:14:26,100 --> 00:14:28,800 the most effective. You can integrate this like net 300 00:14:28,800 --> 00:14:32,100 neutral plan. An approach at any point because 301 00:14:32,200 --> 00:14:36,000 if you can cut off the - trajectory and just stay where 302 00:14:36,000 --> 00:14:39,900 you're at, you are saving yourself so much suffering, so 303 00:14:39,900 --> 00:14:43,500 much challenge, so much distress and then you can eventually work 304 00:14:43,500 --> 00:14:47,700 on your positive trajectory. So with all of that context of 305 00:14:47,700 --> 00:14:49,900 what happens when you get engaged in a negative coping 306 00:14:49,900 --> 00:14:52,700 scale, what happens when that becomes one of the symptoms that 307 00:14:52,700 --> 00:14:54,800 you're presenting with what happens when that becomes a 308 00:14:54,808 --> 00:14:58,800 solidified neural pathway. So with all of that, context of 309 00:14:58,800 --> 00:15:02,000 solidifying, neural, Ways making it more challenging to engage in 310 00:15:02,000 --> 00:15:04,500 coping skills, long-term with knowing that you always have a 311 00:15:04,508 --> 00:15:06,800 decision with knowing what it looks like when you then go to 312 00:15:06,800 --> 00:15:10,200 treatment and you do have these maladaptive coping mechanisms 313 00:15:10,400 --> 00:15:13,000 for my experience, having engaged in an effective coping 314 00:15:13,000 --> 00:15:16,900 mechanisms for years, you will save yourself so much challenge, 315 00:15:16,900 --> 00:15:20,600 so much suffering, so much distress, if you can just stay 316 00:15:20,700 --> 00:15:23,800 neutral again. We don't have to focus on 317 00:15:23,800 --> 00:15:26,000 getting better. We don't have to focus on trying 318 00:15:26,000 --> 00:15:28,700 to completely turn our life around just focus on not making 319 00:15:28,700 --> 00:15:31,500 it worse. So now, getting into the more 320 00:15:31,500 --> 00:15:33,900 skill space, part of this episode, we're going to talk 321 00:15:33,900 --> 00:15:37,300 about skills that you can use in the moment and long-term to keep 322 00:15:37,300 --> 00:15:40,100 things at net neutral. And when we talked about 323 00:15:40,100 --> 00:15:42,500 solidifying, neural Pathways with negative coping skills, the 324 00:15:42,500 --> 00:15:45,300 same thing, works with positive ones, average time you choose to 325 00:15:45,300 --> 00:15:48,300 engage in an effective coping mechanism, you're solidifying 326 00:15:48,300 --> 00:15:50,700 that pathway that relationship that strategy. 327 00:15:50,900 --> 00:15:53,000 So, as you use these skills, you kind of are improving. 328 00:15:53,000 --> 00:15:54,800 But we're not even focused on that right now we're just 329 00:15:54,800 --> 00:15:56,800 focused on not making things worse. 330 00:15:56,900 --> 00:15:59,100 So I think it's important to first address what we're going 331 00:15:59,100 --> 00:16:01,500 to do in. Isis mode because yes, we will 332 00:16:01,500 --> 00:16:04,300 talk about long-term what you can do to improve your mood and 333 00:16:04,300 --> 00:16:06,600 keep things constant. And when you're not in crisis, 334 00:16:06,900 --> 00:16:10,200 keep things at a neutral place. But when it comes down to it, 335 00:16:10,200 --> 00:16:12,100 when you're in crisis mode, if you're engaging in those 336 00:16:12,100 --> 00:16:14,300 behaviors, none of those long-term things are really 337 00:16:14,300 --> 00:16:17,400 going to matter because you again are making things worse 338 00:16:17,400 --> 00:16:19,700 for yourself. So, let's talk crisis mode. 339 00:16:19,900 --> 00:16:23,100 Whenever you are experiencing a really intense emotion. 340 00:16:23,100 --> 00:16:26,500 We're talking like an 8 to a 10 out of your emotional intensity, 341 00:16:26,500 --> 00:16:28,300 and it could be a thought. It could be an urge, it could be 342 00:16:28,300 --> 00:16:30,100 an emotion. The first thing that I want you 343 00:16:30,100 --> 00:16:32,900 to do is use the stop scale. This is an acronym that stands 344 00:16:32,900 --> 00:16:35,000 for stop. Take a step back, observe and 345 00:16:35,000 --> 00:16:37,500 proceed mindfully and I'm going to go over the scales pretty 346 00:16:37,500 --> 00:16:39,200 quickly so that we can get through a bunch of them. 347 00:16:39,200 --> 00:16:42,300 But there are tons of episodes explaining these in more depth 348 00:16:42,300 --> 00:16:45,600 or you can always Google the name of the scale DBT worksheet. 349 00:16:45,600 --> 00:16:49,400 You can see the exact worksheets that they teach in DBT for that 350 00:16:49,400 --> 00:16:51,400 skill. So with the stop scale again 351 00:16:51,400 --> 00:16:54,000 stop take a step back, observe proceed mindfully. 352 00:16:54,300 --> 00:16:55,900 So we're physically and mentally stopping. 353 00:16:55,900 --> 00:16:57,700 We're either stopping engaging in the urge. 354 00:16:57,700 --> 00:16:59,700 We are stopping engaging in the fiscal. 355 00:16:59,800 --> 00:17:01,200 Situation that's causing distress. 356 00:17:01,200 --> 00:17:03,400 If it's an argument, you're physically stopping, then we're 357 00:17:03,408 --> 00:17:06,599 going to take a step back that is both mentally emotionally and 358 00:17:06,599 --> 00:17:08,200 physically. So again, if it's an argument, 359 00:17:08,200 --> 00:17:10,599 you're leaving the room, if it's an urge, you're going to be 360 00:17:10,599 --> 00:17:12,400 like, okay, I'm have a surge, let's take a step back. 361 00:17:12,400 --> 00:17:13,700 Let's observe, what's going on here. 362 00:17:13,700 --> 00:17:16,400 How did I get to this point? Etc, and that's leading right 363 00:17:16,400 --> 00:17:18,500 into observations. Once you taken a step back from 364 00:17:18,500 --> 00:17:21,000 the emotional state, thought you're having the physical 365 00:17:21,000 --> 00:17:23,200 situation you're in, you're observing, how did I get to this 366 00:17:23,200 --> 00:17:25,900 point? What are the thoughts, emotions 367 00:17:26,000 --> 00:17:27,700 urges that are currently happening. 368 00:17:27,900 --> 00:17:29,500 What is the effective way to maybe? 369 00:17:30,100 --> 00:17:32,500 Cope with that's what would be the ineffective way to coping. 370 00:17:32,500 --> 00:17:35,000 But that's because we always have that choice and then how 371 00:17:35,000 --> 00:17:37,000 can I proceed mindfully and effectively? 372 00:17:37,000 --> 00:17:39,900 And this is when you would choose to do, let's not even 373 00:17:39,900 --> 00:17:42,700 focus on, like, making things totally better and doing this 374 00:17:43,000 --> 00:17:44,400 really comprehensive overwhelming. 375 00:17:44,400 --> 00:17:46,300 Coping skill, plant. Let's just focus on, not making 376 00:17:46,300 --> 00:17:48,500 things worse. So that would be the proceed 377 00:17:48,500 --> 00:17:50,300 mindfully. Now, when we're proceeding 378 00:17:50,300 --> 00:17:53,300 mindfully, there are three skills that I'm going to give 379 00:17:53,300 --> 00:17:55,100 you. And then one caveat that I want 380 00:17:55,100 --> 00:17:57,800 to give this another DBT scale called mindfulness of current 381 00:17:57,800 --> 00:18:00,000 emotion. You can also apply this To your 382 00:18:00,000 --> 00:18:02,900 thoughts in your urges. So in DB teen mindfulness, 383 00:18:02,900 --> 00:18:08,200 there's two acronyms Neo and eeo and pod pod and that is what 384 00:18:08,200 --> 00:18:11,000 you're doing when you're being Mindful and how you're doing it. 385 00:18:11,200 --> 00:18:13,900 So what you're doing is you're participating, you're observing 386 00:18:13,900 --> 00:18:16,400 and you're describing and how you're doing, it is 387 00:18:16,400 --> 00:18:19,000 non-judgmentally effectively in one mindfully. 388 00:18:19,400 --> 00:18:21,700 So when you're in that observed, part of the stop scale, when 389 00:18:21,700 --> 00:18:23,900 you're observing your thoughts, the emotions that are coming up 390 00:18:23,900 --> 00:18:25,200 for you. The interaction that just 391 00:18:25,200 --> 00:18:28,600 occurred, you're going to do that by being fully present in 392 00:18:28,600 --> 00:18:30,700 the moment, fully Painting not going on. 393 00:18:30,700 --> 00:18:33,400 I thought spiral of like oh my God, this was so ineffective. 394 00:18:33,400 --> 00:18:35,000 This was not the gold bubble, a lot. 395 00:18:35,300 --> 00:18:38,400 We're just fully participating in the observation part of it. 396 00:18:38,500 --> 00:18:41,800 When we are observing, we are going to be paying attention to 397 00:18:41,800 --> 00:18:44,300 the emotions that have come up. The physical, Sensations 398 00:18:44,300 --> 00:18:47,100 thoughts, the urges, the interactions that have taken 399 00:18:47,100 --> 00:18:50,300 place, and then we're going to describe it in one word, 400 00:18:50,300 --> 00:18:52,500 describe in. This is where the how skills 401 00:18:52,500 --> 00:18:54,200 come in. So we're being non-judgmental. 402 00:18:54,200 --> 00:18:56,100 We are literally just objectively stating what 403 00:18:56,100 --> 00:18:58,800 happened? I said this thing, this emotion 404 00:18:58,800 --> 00:19:01,600 came up this The Surge is going through my head when we're doing 405 00:19:01,600 --> 00:19:03,300 it. One mindfully again, we're not 406 00:19:03,300 --> 00:19:05,100 second-guessing and doing a fault spiral about. 407 00:19:05,100 --> 00:19:07,000 Like how did I get into this? What am I going to do to get 408 00:19:07,000 --> 00:19:10,200 myself out of the situation? We're just focusing on observing 409 00:19:10,500 --> 00:19:12,400 and then the effective part of it. 410 00:19:12,400 --> 00:19:15,600 I skipped over again. This is where we're choosing to 411 00:19:15,600 --> 00:19:17,000 not make things worse for ourselves. 412 00:19:17,000 --> 00:19:19,300 You're doing what is the most effective way to navigate the 413 00:19:19,300 --> 00:19:22,400 situation? What will make the most sense? 414 00:19:22,500 --> 00:19:25,700 So adding that little caveat for the Stop scalp, the next goal 415 00:19:25,700 --> 00:19:27,300 that I'm going to give you four crisis mode. 416 00:19:27,300 --> 00:19:29,700 Is this tip Scout talk about this all the time because it's a 417 00:19:29,800 --> 00:19:31,400 Change. I wish everyone had the skill in 418 00:19:31,400 --> 00:19:34,000 their toolkit because it's a skill that works 100% of the 419 00:19:34,000 --> 00:19:36,200 time. It's not often that you can say 420 00:19:36,200 --> 00:19:39,900 this will work for 100% of your mental health challenges when it 421 00:19:39,908 --> 00:19:43,500 comes to like intense emotions. So whether you're angry, you're 422 00:19:43,500 --> 00:19:46,700 anxious, you're depressed. This skill will work. 423 00:19:46,700 --> 00:19:49,100 So when you're at an 8 out of 10, you're in crisis mode, you 424 00:19:49,100 --> 00:19:52,400 can't think straight A lot of the times their physiological 425 00:19:52,400 --> 00:19:54,900 symptoms that go with that. Whether it's increased heart, 426 00:19:54,900 --> 00:19:57,800 rate, increased breathing rate, are you having a panic attack? 427 00:19:57,800 --> 00:19:59,600 What's going on? There's probably some physical 428 00:19:59,700 --> 00:20:03,300 Well, that is also tied to that emotional distress and a lot of 429 00:20:03,300 --> 00:20:06,500 the times that becomes the predominant focus of your 430 00:20:06,500 --> 00:20:08,900 attention. You can even think about like, 431 00:20:08,900 --> 00:20:11,900 okay, let me analyze the situation and figure out how to 432 00:20:11,900 --> 00:20:15,000 proceed mindfully. Because you're so overwhelmed 433 00:20:15,100 --> 00:20:16,500 with the fact that you can't breathe. 434 00:20:16,500 --> 00:20:18,300 And so that's where the tips go comes in. 435 00:20:18,700 --> 00:20:21,200 So it's an acronym that stands for temperature, intense 436 00:20:21,200 --> 00:20:24,100 exercise paced, breathing, and paired muscle relaxation. 437 00:20:24,100 --> 00:20:25,900 You've probably seen the temperature part of it on Tech. 438 00:20:25,900 --> 00:20:29,100 Talk, basically, what you do is you take a bowl of ice water and 439 00:20:29,100 --> 00:20:33,700 you some Your face in it for 10 to 15 seconds between breaths. 440 00:20:33,700 --> 00:20:36,300 Take a deep breath and then keep doing it until your heart rate 441 00:20:36,300 --> 00:20:39,100 and your breathing rate decrease, it will work 100% of 442 00:20:39,108 --> 00:20:42,000 the time because it stimulates your vagus nerve and Romanian 443 00:20:42,000 --> 00:20:45,700 diving reflex and so your body thinks you're jumping into cold 444 00:20:45,700 --> 00:20:48,200 water and your body's like, I'm going to be underwater, like, I 445 00:20:48,400 --> 00:20:50,700 need to stop producing carbon dioxide because I don't know 446 00:20:50,700 --> 00:20:52,100 what I'm going to get my next breath. 447 00:20:52,400 --> 00:20:54,800 So your body, lowers your heart rate, it lowers your breathing, 448 00:20:54,800 --> 00:20:56,400 right. And as it's doing that, it's 449 00:20:56,400 --> 00:20:58,800 also lowering it past that threshold that it was elevated 450 00:20:58,800 --> 00:21:01,300 to. Cuz of the emotional distress 451 00:21:01,500 --> 00:21:04,000 intense exercise Works in a similar fashion. 452 00:21:04,000 --> 00:21:06,000 It's also great for distress tolerance, but you're going to 453 00:21:06,000 --> 00:21:08,300 do something like burpees Sprint's. 454 00:21:08,300 --> 00:21:10,500 I'm not really gets your heart rate going. 455 00:21:10,700 --> 00:21:13,100 And what you're doing is, you're raising your heart rate past the 456 00:21:13,100 --> 00:21:14,900 threshold that it was at when you were emotionally 457 00:21:14,900 --> 00:21:18,000 overwhelmed, and then, as your body does, its natural system of 458 00:21:18,000 --> 00:21:20,700 lowering your heart rate. After exercise, it lowers it 459 00:21:20,700 --> 00:21:23,000 past the threshold. It was at from the emotional 460 00:21:23,000 --> 00:21:26,100 distress, it's also really effective when you're 461 00:21:26,100 --> 00:21:29,100 overwhelmed to do something that physical you're like, okay, that 462 00:21:29,100 --> 00:21:31,500 felt good like I need to put this energy somewhere. 463 00:21:31,500 --> 00:21:33,500 My thoughts are going insane doing that. 464 00:21:33,500 --> 00:21:36,300 Exercise feels really good emotionally and Dish into 465 00:21:36,300 --> 00:21:39,400 helping the physical distress and then pays breathing a muscle 466 00:21:39,400 --> 00:21:41,600 relaxation will talk about together. 467 00:21:41,800 --> 00:21:44,700 You are doing paced breathing, so you're doing your exhale 468 00:21:44,700 --> 00:21:47,000 longer than your inhale. I like to do two counts. 469 00:21:47,000 --> 00:21:50,900 Inhale, pause three counts for an exhale and you are again, 470 00:21:50,900 --> 00:21:52,300 lowering your breathing rate past. 471 00:21:52,300 --> 00:21:55,200 But it was at because the emotional distress with paired 472 00:21:55,200 --> 00:21:57,100 muscle relaxation. We know that we carry a lot of 473 00:21:57,100 --> 00:21:58,600 tension when were mostly just trashed. 474 00:21:58,600 --> 00:22:00,100 So like, if you're super angry, Angry. 475 00:22:00,100 --> 00:22:02,300 Your fists are clenched, your shoulders are tight. 476 00:22:02,400 --> 00:22:04,300 So as you're inhaling, you're clenching your muscles. 477 00:22:04,300 --> 00:22:06,500 And as you're exhaling, you're releasing that tension and 478 00:22:06,500 --> 00:22:09,500 you're releasing it past what it was at when you are emotionally 479 00:22:09,500 --> 00:22:11,500 distressed. So that's like the quickest run 480 00:22:11,500 --> 00:22:14,100 down, ever of the tips Cal amazing. 481 00:22:14,300 --> 00:22:17,000 When I say use the stop skill and proceed mindfully. 482 00:22:17,100 --> 00:22:19,800 My recommendation of your super distress like the proceed 483 00:22:19,800 --> 00:22:21,900 mindfully is just tip. We know that that's our next 484 00:22:21,900 --> 00:22:24,600 step, that's what we dive into and then I'll figure out what to 485 00:22:24,600 --> 00:22:27,500 do next. So the third skill that I want 486 00:22:27,500 --> 00:22:29,600 to give you four crisis mode is the distractions. 487 00:22:29,800 --> 00:22:32,000 Out distraction is a really effective skill when we're in 488 00:22:32,000 --> 00:22:34,400 crisis mode because it will distract us from the emotions, 489 00:22:34,400 --> 00:22:36,700 the thoughts, whatever it is that we're currently having so 490 00:22:36,700 --> 00:22:39,000 that we can calm down enough to be able to cope with the 491 00:22:39,000 --> 00:22:42,200 emotions effectively. But the issue was distraction is 492 00:22:42,200 --> 00:22:44,800 that, if we're constantly avoiding, our emotions will just 493 00:22:44,800 --> 00:22:47,500 come back and in a bigger way. We know this for anxiety, 494 00:22:47,500 --> 00:22:49,300 avoidance, amplifies the anxiety. 495 00:22:49,600 --> 00:22:51,800 And this is true across the board with your emotions. 496 00:22:52,100 --> 00:22:54,600 If you avoid a thought, it's like all you can think about in 497 00:22:54,600 --> 00:22:57,200 your head, if you avoid an urge, it just keeps coming back more 498 00:22:57,200 --> 00:22:59,300 strongly. So we're using distraction, but 499 00:22:59,300 --> 00:23:01,600 we're using. Seeing it in a short-term way. 500 00:23:01,800 --> 00:23:05,700 So with distraction, there's two acronyms in DBT, but I'm gonna 501 00:23:05,700 --> 00:23:07,300 go over the super quickly because you know, how to 502 00:23:07,300 --> 00:23:09,000 distract yourself. You're watching a show, you're 503 00:23:09,000 --> 00:23:11,400 listening to loud music or talking to someone except ra. 504 00:23:11,900 --> 00:23:14,700 So, the way, the DBT breaks down distraction is that with the 505 00:23:14,700 --> 00:23:17,200 except scale, you're doing activities contributing 506 00:23:17,200 --> 00:23:19,900 comparisons, emotional, opposites, pushing away, 507 00:23:19,900 --> 00:23:22,900 thoughts and Sensations, and with improve you are doing 508 00:23:22,900 --> 00:23:25,400 imagery. Meaning, prayer, relaxation, one 509 00:23:25,400 --> 00:23:28,300 thing at a time, vacation and encouragement. 510 00:23:28,400 --> 00:23:32,300 So, distraction, sure. Term resource long-term not 511 00:23:32,300 --> 00:23:35,200 effective because then it loses its Effectiveness. 512 00:23:35,400 --> 00:23:38,100 And I always give the example is, I love the office whenever 513 00:23:38,100 --> 00:23:39,900 I'm like, overwhelmed or stressed, I'll turn on the 514 00:23:39,900 --> 00:23:43,500 office, but if I watch the office 24 hours a day, it would 515 00:23:43,500 --> 00:23:45,300 not be effective in a time of Crisis. 516 00:23:45,300 --> 00:23:46,800 I'm like, this is just background noise. 517 00:23:46,800 --> 00:23:50,000 I, I'm used to this people a skill that I'm going to give you 518 00:23:50,100 --> 00:23:52,700 four crisis mode. Is something called riding the 519 00:23:52,700 --> 00:23:54,500 wave. This is one of my favorite 520 00:23:54,500 --> 00:23:56,700 skills and I use this. Now, actually, for migraines, 521 00:23:56,700 --> 00:23:59,500 which sounds kind of odd, but it's super effective and the 522 00:23:59,700 --> 00:24:01,700 Idea that nothing in life is impermanent. 523 00:24:01,700 --> 00:24:04,100 This is a quote that was actually set on she persisted 524 00:24:04,100 --> 00:24:06,200 and I'm obsessed with it. I say it all the time. 525 00:24:06,400 --> 00:24:09,800 I'm mentally say to myself constantly life is impermanent 526 00:24:09,800 --> 00:24:12,000 and then impermanence will be on your side. 527 00:24:12,300 --> 00:24:16,200 No emotion, no thought no urge, no physiological distress will 528 00:24:16,200 --> 00:24:18,900 last forever. That's just not how life Works. 529 00:24:18,900 --> 00:24:21,800 Our bodies and capable of it, our mind is incapable of it. 530 00:24:21,800 --> 00:24:25,300 Our distress will decrease at some point, something has to 531 00:24:25,300 --> 00:24:28,100 give something has to shift. And so when you're in crisis 532 00:24:28,100 --> 00:24:30,700 mode and you're really Whelmed with energy. 533 00:24:30,700 --> 00:24:33,800 Like I just think that I'm going to engage in this Behavior at. 534 00:24:33,800 --> 00:24:36,400 Can't stop having the surge circle in my head. 535 00:24:36,700 --> 00:24:40,200 What you're going to do is pay 100% attention to those salts. 536 00:24:40,200 --> 00:24:43,100 You're having and you're going to notice that the intensity of 537 00:24:43,100 --> 00:24:46,300 the urge comes in a wave certain promises drones like physics or 538 00:24:46,300 --> 00:24:48,900 something, but I promise this works, you're like wow these are 539 00:24:48,908 --> 00:24:50,300 just really strong. Like I don't even know if I'm 540 00:24:50,308 --> 00:24:53,100 gonna be able to resist it and then it gets a little bit lesser 541 00:24:53,400 --> 00:24:55,600 and then it lessens and then it's going to be more intense 542 00:24:55,600 --> 00:24:58,600 again and then it lessens same thing for anger or anxiety like 543 00:24:58,600 --> 00:25:01,300 oh my God, I can't breathe. With okay, my mind is a little 544 00:25:01,300 --> 00:25:03,300 bit quieter now but then it's a tense again and then it's 545 00:25:03,300 --> 00:25:07,200 lesser, it works in a wave. And so what you're doing rather 546 00:25:07,200 --> 00:25:10,900 than trying to avoid the emotion or force, it to go away, you're 547 00:25:10,900 --> 00:25:13,600 just sitting with the emotion and you're riding the wave. 548 00:25:13,600 --> 00:25:16,800 And you're really leaning into those moments where it lessons 549 00:25:16,800 --> 00:25:20,300 and intensity and being like, see it's getting less intense 550 00:25:20,600 --> 00:25:24,000 and this too will pass. And so when I use this for 551 00:25:24,000 --> 00:25:25,900 migraines, if you've ever had a headache, you're like this is 552 00:25:25,900 --> 00:25:27,900 comparable. And what I try to do is sleep 553 00:25:27,900 --> 00:25:29,500 them off. So like a lot of times, I get 554 00:25:29,500 --> 00:25:31,200 ahead. At the end of the day and I'm 555 00:25:31,200 --> 00:25:33,700 like, I've tried shower, I've tried drinking a lot of water of 556 00:25:33,700 --> 00:25:35,100 taking Advil, nothing is working. 557 00:25:35,100 --> 00:25:37,800 I just need to fall asleep and I can't fall asleep because my 558 00:25:37,800 --> 00:25:40,700 head hurts so bad. So rather than having thoughts 559 00:25:40,700 --> 00:25:43,000 going crazy in my mind. And also having this like 560 00:25:43,000 --> 00:25:47,300 throbbing going on in my head, I focus all of my energy on the 561 00:25:47,300 --> 00:25:50,500 pain itself and you notice that it's more intense, you like oh 562 00:25:50,500 --> 00:25:53,100 this is terrible and then it lessens you like oh my gosh, 563 00:25:53,100 --> 00:25:57,000 there's that sense of relief and so as you really, lean into 564 00:25:57,000 --> 00:25:59,500 those moments of relief or like, okay, I got this I can do. 565 00:25:59,700 --> 00:26:02,200 This, I can push through and then it's also really effective 566 00:26:02,200 --> 00:26:04,100 to be mindful and then I just go to sleep. 567 00:26:04,200 --> 00:26:05,500 It's great. That's the ride. 568 00:26:05,500 --> 00:26:07,800 The wave skill. I'm going to give you three more 569 00:26:07,800 --> 00:26:11,500 skills that you can use not in crisis mode, that will help you 570 00:26:11,500 --> 00:26:13,300 keep things at a net neutral point. 571 00:26:13,300 --> 00:26:16,000 We're not making things worse, we're not necessarily focusing 572 00:26:16,000 --> 00:26:19,600 on re shifting our entire life but we're just going to focus on 573 00:26:19,600 --> 00:26:21,700 coping with the right now. Not adding more things to our 574 00:26:21,700 --> 00:26:23,000 plate. So the first one that I'm going 575 00:26:23,000 --> 00:26:25,100 to tell you about is radical acceptance. 576 00:26:25,400 --> 00:26:30,400 We talked about how in DBT accepting loan wasn't Active and 577 00:26:30,400 --> 00:26:34,500 changing alone wasn't effective, because it doesn't satisfy all 578 00:26:34,500 --> 00:26:37,000 the emotional needs and it leads to more distress. 579 00:26:37,200 --> 00:26:40,400 So, the idea with radical acceptance at that, you are 580 00:26:40,400 --> 00:26:43,800 accepting Life On Life's terms. And if you can do this, keeping 581 00:26:43,800 --> 00:26:46,200 things, net neutral, choosing not to engage in those 582 00:26:46,200 --> 00:26:49,400 maladaptive coping skills. In my experience is a bit 583 00:26:49,400 --> 00:26:51,900 easier. So reading straight from the DBT 584 00:26:51,900 --> 00:26:54,100 worksheet here. What is radical acceptance? 585 00:26:54,100 --> 00:26:56,700 It's when you cannot keep painful events and emotions from 586 00:26:56,700 --> 00:26:58,100 coming your way. You're still going to have the 587 00:26:58,100 --> 00:26:59,200 urges. You're still going to have the 588 00:26:59,200 --> 00:27:01,900 stressor. As you're experiencing, but you 589 00:27:01,900 --> 00:27:04,300 can do some radical acceptance. So what does that mean? 590 00:27:04,300 --> 00:27:08,600 It means radically accepting all the way completely, totally, 591 00:27:08,600 --> 00:27:10,800 you're accepting with your mind, your heart and your body. 592 00:27:11,500 --> 00:27:14,400 And when you stop fighting reality, when you stop 593 00:27:14,400 --> 00:27:17,500 resisting, when you stop throwing a tantrum, when things 594 00:27:17,500 --> 00:27:20,500 are, not the way you want it, and let go of bitterness that is 595 00:27:20,500 --> 00:27:23,500 radical acceptance. And so there are a couple of 596 00:27:23,500 --> 00:27:26,400 things that need to be accepted and you can use radical 597 00:27:26,400 --> 00:27:28,700 acceptance for any situation whenever I get news that I'm not 598 00:27:28,700 --> 00:27:30,200 excited about or I will. Things were different. 599 00:27:30,200 --> 00:27:33,300 I'm not accepting. But in DB T, we are radically 600 00:27:33,300 --> 00:27:35,200 accepting. These four pillars across the 601 00:27:35,200 --> 00:27:36,800 board. Just to accept that. 602 00:27:36,800 --> 00:27:39,800 This is how life works and that we can't prevent painful things 603 00:27:39,800 --> 00:27:42,100 from happening. So we're accepting that reality 604 00:27:42,100 --> 00:27:45,900 is as it is the facts about the past the facts about the 605 00:27:45,900 --> 00:27:47,800 present. And even if you don't like the 606 00:27:47,800 --> 00:27:49,500 situation, the cards you've been dealt. 607 00:27:49,500 --> 00:27:53,000 Those are The Facts of Life. The second one is that there are 608 00:27:53,000 --> 00:27:56,800 limitations on the future for everyone, but only realistic 609 00:27:56,800 --> 00:28:00,300 limitations need to be accepted. So one example of this Is when I 610 00:28:00,300 --> 00:28:02,900 was starting treatment, I had this core belief that I would 611 00:28:02,900 --> 00:28:06,200 never be capable of recovering, that didn't need to be radically 612 00:28:06,200 --> 00:28:08,900 accept it because it wasn't a realistic limitation. 613 00:28:09,200 --> 00:28:12,000 I was capable of getting support and shifting my behaviors and 614 00:28:12,000 --> 00:28:14,400 asking for help. So, that's example of like, what 615 00:28:14,400 --> 00:28:15,900 are we radically accepting? What are we? 616 00:28:15,900 --> 00:28:19,500 Not radically accepting third is that everything has a cause 617 00:28:19,700 --> 00:28:22,200 including events and situations that cause you pain and 618 00:28:22,200 --> 00:28:24,500 suffering. So this is again, we're almost 619 00:28:24,500 --> 00:28:27,600 addressing this with this net neutral plan where when were 620 00:28:27,600 --> 00:28:30,300 engaging in negative coping skills, the Is us. 621 00:28:30,300 --> 00:28:31,900 We have to take accountability there. 622 00:28:31,900 --> 00:28:35,100 And so if we can even avoid that from happening in the first 623 00:28:35,100 --> 00:28:38,300 place, saves his pain and suffering and then the last 624 00:28:38,300 --> 00:28:41,200 pillar that were accepting is that life can be worth living 625 00:28:41,400 --> 00:28:44,700 even with painful events in it and this is hard. 626 00:28:44,800 --> 00:28:47,800 This is a tough pill to swallow when you are in so much 627 00:28:47,800 --> 00:28:50,900 distress. But as your emotional intensity 628 00:28:50,900 --> 00:28:53,400 lessons, with time, as you regulate your emotions more 629 00:28:53,400 --> 00:28:57,200 effectively, the painful events, you're experiencing become less 630 00:28:57,200 --> 00:28:59,500 intense and life really can be worth living. 631 00:28:59,600 --> 00:29:02,200 Being so that is what we are accepting and why we're 632 00:29:02,200 --> 00:29:05,500 accepting it is that rejecting reality does not change it. 633 00:29:05,500 --> 00:29:09,100 If we are resisting the truth of life it's not going to change 634 00:29:09,100 --> 00:29:10,500 it. It just makes things worse for 635 00:29:10,500 --> 00:29:13,200 ourselves. Second is that changing reality 636 00:29:13,200 --> 00:29:15,200 first requires accepting reality. 637 00:29:15,200 --> 00:29:17,900 So again we are accepting and changing but to change we first 638 00:29:17,900 --> 00:29:21,000 have to accept three pain. Can't be avoided. 639 00:29:21,000 --> 00:29:24,000 It's Nature's Way of signaling that something is wrong telling 640 00:29:24,000 --> 00:29:26,400 us to some extent effective the way that we're coping with life, 641 00:29:26,400 --> 00:29:29,100 the relationships were engaged in, aren't working for us 642 00:29:29,100 --> 00:29:32,600 something new. Chef, so pain is a signal for 643 00:29:32,600 --> 00:29:35,200 rejecting reality, turns pain into suffering. 644 00:29:35,200 --> 00:29:38,100 There's a difference between pain and suffering and when we 645 00:29:38,100 --> 00:29:42,300 reject reality, we suffer more and I almost sometimes see those 646 00:29:42,300 --> 00:29:46,900 maladaptive coping mechanisms as a way of rejecting reality and 647 00:29:46,900 --> 00:29:49,200 increasing that suffering. So that's why we're nipping it 648 00:29:49,200 --> 00:29:52,400 in the bud and trying to avoid that 5 refusing to accept 649 00:29:52,400 --> 00:29:56,100 reality can keep you stuck in unhappiness, bitterness anger 650 00:29:56,100 --> 00:29:58,800 sadness, shame and other painful emotions. 651 00:29:59,600 --> 00:30:02,400 It's acceptance may lead to sadness, but deep calmness. 652 00:30:02,400 --> 00:30:05,000 Usually follows, again nothing is permanent and that 653 00:30:05,000 --> 00:30:08,600 impermanence will be on your side and 7 the path out of hell 654 00:30:08,600 --> 00:30:11,200 is through misery, but refusing to accept the misery. 655 00:30:11,200 --> 00:30:12,700 That is part of climbing out of hell. 656 00:30:12,700 --> 00:30:14,900 You fall back into hell and we picture house. 657 00:30:14,900 --> 00:30:17,700 The bottom floors on fire and burning and overwhelming. 658 00:30:18,000 --> 00:30:22,700 But unless we climb up that and get through that stage 1, we can 659 00:30:22,700 --> 00:30:25,700 address anything else. And so one little Mantra that is 660 00:30:25,700 --> 00:30:28,200 used for radical acceptance. Is that everything is as it 661 00:30:28,200 --> 00:30:31,200 should be and everything. This is a test so to just 662 00:30:31,200 --> 00:30:33,300 reiterate the points we just talked about in slightly 663 00:30:33,300 --> 00:30:35,700 different language on a different DBT, work shape, 664 00:30:35,800 --> 00:30:38,700 freedom from suffering requires acceptance from deep within of 665 00:30:38,700 --> 00:30:41,900 what is Let Yourself Go. Completely with what is and let 666 00:30:41,900 --> 00:30:44,800 go of fighting reality. Acceptance is the only way out 667 00:30:44,800 --> 00:30:48,300 of how pain create suffering. Only when you refused to accept 668 00:30:48,300 --> 00:30:51,600 the pain deciding to tolerate and under the moment is 669 00:30:51,600 --> 00:30:54,000 acceptance, acceptance is acknowledging. 670 00:30:54,000 --> 00:30:56,300 What is to accept? Something is not the same as 671 00:30:56,300 --> 00:30:58,200 judging it is good or approving of it. 672 00:30:58,200 --> 00:30:59,800 You're just saying. This is the Cards. 673 00:30:59,800 --> 00:31:01,600 I'm being dealt, even if I don't like them. 674 00:31:01,900 --> 00:31:05,200 And lastly acceptance is turning suffering into pain that I can 675 00:31:05,200 --> 00:31:07,300 endure. So that's radical acceptance. 676 00:31:07,300 --> 00:31:09,400 We love radical acceptance. I want to do like a whole 677 00:31:09,400 --> 00:31:11,500 episode on that at some point because it's such a freaking 678 00:31:11,500 --> 00:31:13,600 good scale. It's hard, but it's amazing. 679 00:31:13,600 --> 00:31:16,200 It's like mind-altering paradigm-shifting. 680 00:31:16,200 --> 00:31:18,900 And then the second Alaska, I'm going to teach you is Copa had. 681 00:31:18,900 --> 00:31:20,800 We want to set ourselves up for success. 682 00:31:21,000 --> 00:31:23,300 And if we know that we are emotionally vulnerable to 683 00:31:23,300 --> 00:31:26,000 experiencing urges, to wanting to engage in a maladaptive 684 00:31:26,000 --> 00:31:29,500 coping mechanism, we want to set ourselves up for success and 685 00:31:29,600 --> 00:31:32,500 This one, we're using, the Copa had skull, so we're mentally 686 00:31:32,500 --> 00:31:34,100 walking through like, what's the situation? 687 00:31:34,100 --> 00:31:36,700 Like, I know that when I'm sitting in bed at night and just 688 00:31:36,700 --> 00:31:39,300 laying there, and I'm alone with my thoughts, I am more likely to 689 00:31:39,300 --> 00:31:41,800 have like a negative urge pop into my head or I know that when 690 00:31:41,800 --> 00:31:44,500 I am alone for a really long time, those negative thoughts 691 00:31:44,500 --> 00:31:48,500 pop up, or when I have lots of a routine, I'm more likely to 692 00:31:48,500 --> 00:31:51,900 engage in this Behavior because I feel really hopeless, whatever 693 00:31:51,900 --> 00:31:54,100 it is be aware of what those triggers are with. 694 00:31:54,100 --> 00:31:57,000 Those vulnerabilities are. And then we're going to set up a 695 00:31:57,000 --> 00:31:59,400 plan for how you're going to deal with the urges one. 696 00:31:59,600 --> 00:32:02,200 They arise in that situation. So again we're going to pull 697 00:32:02,200 --> 00:32:04,300 from those crises skills. We just talked about I'm going 698 00:32:04,300 --> 00:32:07,600 to use this stops go first. Then I'm going right into tip, 699 00:32:07,700 --> 00:32:09,800 then we're doing some distraction and then once I loop 700 00:32:09,800 --> 00:32:11,800 back to the original thought, we're going to ride the wave and 701 00:32:11,800 --> 00:32:13,500 we're going to work through it and we're going to accept it. 702 00:32:13,600 --> 00:32:15,800 So give yourself a plan. What thoughts are going to come 703 00:32:15,800 --> 00:32:17,200 up? What you're just going to come 704 00:32:17,200 --> 00:32:19,500 up. What skill am going to use and 705 00:32:19,500 --> 00:32:21,900 how am I going to deal with it? Right it out make it super 706 00:32:21,900 --> 00:32:25,500 detailed and give yourself a plan to follow the last going to 707 00:32:25,500 --> 00:32:26,900 teach you. Is accumulating positives. 708 00:32:26,900 --> 00:32:29,300 This one simple and it's one of my favorite skill of DBT because 709 00:32:29,300 --> 00:32:33,000 your Things that you like and the idea here is that when 710 00:32:33,000 --> 00:32:35,400 you're accumulating positive, you're not only increasing Joe 711 00:32:35,400 --> 00:32:38,400 and making your life, more worth living but you're improving your 712 00:32:38,400 --> 00:32:40,600 Baseline of functioning. So when we look at like a chart 713 00:32:40,600 --> 00:32:43,200 and we're like okay, sometimes I my mood is really high, 714 00:32:43,200 --> 00:32:46,200 sometimes it's really low and there's a big gap between that 715 00:32:46,400 --> 00:32:48,200 emotional high in that emotional low. 716 00:32:48,500 --> 00:32:51,500 We're sprinkling in accumulating positives throughout our day 717 00:32:51,500 --> 00:32:53,400 throughout a routine throughout our life. 718 00:32:53,800 --> 00:32:56,600 We become more neutral and emotions were experiencing. 719 00:32:56,600 --> 00:32:59,900 So again, having pain in life can be worth living and it's 720 00:32:59,900 --> 00:33:02,400 more worth living when the emotions are less intense and 721 00:33:02,400 --> 00:33:04,500 there is not that Whiplash from like, oh my God, I just had a 722 00:33:04,508 --> 00:33:06,500 great day and then I'm like at an absolute low. 723 00:33:06,700 --> 00:33:09,500 So sprinkle in the accumulating positives and the key here is 724 00:33:09,500 --> 00:33:11,700 you have to plan them. They have to be intentional. 725 00:33:12,000 --> 00:33:14,200 So plan your cup of coffee plan. The book you're going to read 726 00:33:14,200 --> 00:33:15,900 plan the TV show, you're going to watch the friend, you're 727 00:33:15,908 --> 00:33:19,000 going to see whatever it is. That brings you Joy plan those 728 00:33:19,000 --> 00:33:21,200 moments and accumulate them throughout your day. 729 00:33:21,900 --> 00:33:24,800 So we're reducing suffering, we're not rejecting reality. 730 00:33:24,800 --> 00:33:27,800 We are staying neutral. We're not overwhelming ourselves 731 00:33:27,800 --> 00:33:30,400 to try to make things better. We're just not Things worse, 732 00:33:30,700 --> 00:33:33,800 taking accountability over the fact that we have a choice when 733 00:33:33,800 --> 00:33:36,800 we engage in maladaptive coping mechanisms and then we have a 734 00:33:36,800 --> 00:33:39,200 really comprehensive plan of how to deal with those. 735 00:33:39,400 --> 00:33:41,900 So that's today's episode. I really hope you enjoy this. 736 00:33:42,000 --> 00:33:44,400 If you do share with a friend or family member, if you shout 737 00:33:44,400 --> 00:33:46,900 social media, tag me that she persisted podcast. 738 00:33:46,900 --> 00:33:49,100 I was repost and give you a little shout out. 739 00:33:49,100 --> 00:33:52,400 And thank you for listening and I'll see you next week. 740 00:33:52,700 --> 00:33:55,300 Thank you so much for listening to this week's episode of she 741 00:33:55,300 --> 00:33:57,200 persisted. If you enjoyed, make sure to 742 00:33:57,200 --> 00:33:58,800 share with a friend or family member. 743 00:33:58,800 --> 00:34:01,000 It really helps. Out the podcast and if you 744 00:34:01,000 --> 00:34:04,600 haven't already leave a review on Apple podcast or Spotify, you 745 00:34:04,600 --> 00:34:07,300 can also make sure to follow along at at she persisted 746 00:34:07,300 --> 00:34:10,600 podcast on both Instagram and Tick-Tock and check out all the 747 00:34:10,600 --> 00:34:13,900 bonus resources content and information on my website. 748 00:34:13,900 --> 00:34:17,300 She persisted podcast.com, thanks for supporting, keep 749 00:34:17,300 --> 00:34:19,100 persisting and I'll see you next week.