Category: Wellbeing

How to Conquer Difficult Emotions with Dialectical Behavior Therapy

By Aliza Dinerstein, LMSW

Throughout life individuals encounter a kaleidoscope of experiences,
each one eliciting a specific emotional reaction ranging from joy,
love and hope, to anxiety, anger, or fear. Although one instinctively
strives to increase positive feelings and decrease negative ones, it
is important to remember that, at times, encountering painful emotions
is an inevitable part of life. Dialectical Behavior Therapy (DBT), a
composite of therapeutic interventions geared toward helping
individuals build a life worth living, focuses on the science of
‘emotion regulation,’ i.e., one’s capacity to work through difficult
emotions in an effective way. DBT provides concrete, empirically based
practices such as building awareness, mindfulness skills, and specific
behavioral change that can be utilized in day to day life, helping
individuals approach challenging emotions in constructive and
rewarding ways.

The first step is to increase emotional awareness. Oftentimes, strong
emotional reactions occur and individuals are unable to identify their
own emotions or recognize their impact on thoughts and actions.
Therefore, one of the most fundamental tools in responding effectively
to difficult feelings is learning to identify and label present
emotions as they arise, while gaining an understanding of how those
feelings work in conjunction with one’s thoughts and behaviors.
Emotional awareness is developed through monitoring five specific
elements: 1) events that trigger emotional responses, 2) one’s
thoughts and cognitive interpretations of these event, 3)
physiological reactions and bodily sensations, 4) behavioral response
(i.e., actions), and 5) most important, the outcome of one’s
emotional, cognitive and behavioral responses – also known as
“effectiveness”. Building emotional awareness is a skill that takes
time and practice to acquire through the use of daily monitoring. But
this is the foundation of DBT, as it enables us to develop emotional
mastery and regulation.

Another core concept in DBT is to grant yourself the freedom to feel.
Usually, people try to avoid painful feelings such as anger, sadness,
fear and anxiety. However, inhibiting these emotions does not make
them disappear and in fact it usually makes them worse. Thus, DBT
emphasizes the importance of “mindfulness” which involves truly
experiencing emotions instead of blocking, suppressing, or avoiding
them. In mindfulness practice, emotions are understood as waves that
naturally rise and fall. When we allow our emotions to operate
naturally, the intensity of the feelings are minimized and we can move
through strong emotional responses in a more healthy and integrative
way. A related DBT concept is that one should aim to radically accept
each emotion without judgement. Mindful awareness is a key element for
truly allowing one’s self to feel, and mindfulness practice enables
us to work through emotions with mindfulness, presence, and
acceptance.

A third key DBT principal is learning to take care of the body in
order to take of the mind. Our capacity to cope with challenges in
moments of adversity is impacted not only by one’s emotional health,
but also by the condition of one’s physical wellbeing. DBT’s  emotion
regulation ‘PLEASE’ skill encapsulates these very dimensions of
physiology, which include 1) treating any existing Physical iLlness,
2) maintaining balanced Eating, 3) avoiding mood Altering drugs, 4)
creating healthy Sleep habits, and 5) engaging in regular Exercise.
Although these targets may seem simplistic, research shows that the
more one decreases physical and environmental stressors, the less
prone to emotional reactivity one becomes.

Although experiencing painful emotions is unavoidable over the course
of life, it does not mean that anyone must suffer through them. These
and other principals of DBT explain that one can change maladaptive
behavioral, emotional, and cognitive responses while mindfully
experiencing life in the present and accepting reality as it is. This
understanding, coupled with the skills that DBT provides, can help us
cultivate awareness, acceptance, resilience, and growth.

Four Strategies to Get Some Zzzzzzz’s

By Ariel Campbell

Most adults have experienced symptoms of insomnia at some point in their lives. In fact, according to the National Sleep Foundation between 30-50% of adults have occasional difficulties falling or staying asleep, waking up early, or waking up not feeling rested. Lack of adequate sleep can negatively influence our daily functioning by leading to impairments in attention and concentration, increased irritability, and overall poorer mental health. However, for those of us who suffer from occasional insomnia there are a number of healthy habits we can incorporate into our daily routines to improve our quality of sleep.

In order to understand how and why these habits can be useful in promoting restful sleep, knowing some basics about sleep is helpful. Our sleep is regulated by our body’s natural circadian rhythm. This circadian rhythm is responsible for our feelings of sleepiness and wakefulness throughout the day and is controlled by light and dark signals that occur naturally in our environments. For adults, sleep proceeds in a predictable pattern that involves 4-5 repetitions of a 90-minute sleep cycle, with each sleep cycle including 5 sleep stages. During sleep, a number of changes happen in our bodies – our heart rate and breathing slow down, our blood pressure and body temperature drop, our bodies produce and regulate a number of important hormones including those that impact growth and hunger, and our brains cycle through varying levels of activity.

Now onto some of the daily habits that can promote and improve sleep…

First, developing a bedtime routine can be an effective strategy for helping our minds and bodies transition into a state of relaxation after a busy day. Having a structured pre-sleep routine that includes a relaxing activity, like reading or listening to music, can promote sleep by helping us to form habits that actually function to cue sleep. Stimulating activities and screens, on the other hand, should be avoided during the 30-60 minutes before bedtime and as a general rule of thumb the only activities that should be carried out in bed are those related to sleep and intimacy. Additionally, an essential part of any good sleep routine involves keeping regular sleep and wake times, even over the weekend, insofar as this helps to maintain a consistent circadian rhythm.

Second, attending to certain factors within our sleeping environment can help to ensure high-quality sleep. Since light is a powerful cue for our body’s internal clock, keeping the bedroom as dark as possible while sleeping and dimming the lights one hour before bedtime are helpful sleep habits. If fully avoiding screens before bedtime isn’t possible, switching your cell phone or computer screen into nighttime mode is advisable because the blue light of daytime mode (as opposed to the red light of nighttime mode) will actually delay the release of melatonin making it harder to fall asleep. Keeping the bedroom temperature between 60-70 degrees while sleeping is another useful strategy that works by helping our bodies to maintain the drop in body temperature that accompanies sleep. And lastly, since our brains are still active and responsive during sleep a final consideration when it comes to structuring our sleeping environment is to limit noise as much as possible. Noise tends to be most disruptive during the first and second stages of sleep and during the second half of the night. Additionally “peak” sounds, for example busy street noises, are more damaging to sleep than ambient background sounds. If it’s difficult to eliminate noise while sleeping, white noise can help to reduce disruptions in sleep due to sound. Today, there are many apps for white noise but a fan or air conditioner that produces a consistent sound will also do the trick.

Third, certain exercise and dietary habits have also been shown to impact sleep. Aerobic exercise, like walking, swimming, or biking, can aid in sleep by increasing the amount of time our body spends in the deeper and most restorative stages of sleep. 20 minutes or more of daily aerobic exercise engaged in 4-5 hours before bed is recommended. While your morning coffee can help energize you for the day ahead, drinking a second cup of coffee during the afternoon or evening hours can disrupt sleep. Additionally, alcohol has been shown to cause impairments in sleep – although it may initially cause drowsiness and induce sleep, consuming alcohol before bed is associated with significantly more sleep disruptions during the second half of the night.

And finally, the timing, size, and content of meals can play a role in getting a good night’s sleep. For improved sleep, it is generally recommended that your largest meals be eaten earlier in the day and that snacks consumed before bedtime include complex carbohydrates and avoid sugar. Complex carbohydrates like whole-wheat breads, vegetables, fruit, and nuts break down slowly and help to prevent sudden spikes and crashes in blood sugar that can interfere with sleep.

While occasional symptoms of insomnia are common and not a significant cause for concern, they can nonetheless be disruptive to our daily routines. By using the above strategies for managing bedtime routines and environments as well as diet and exercise, you can develop healthy sleep habits that will promote a full night’s sleep and help you to wake up feeling rested and refreshed.

Making New Years Resolutions Work

Written by Ariel Campbell

For many of us, entering into the New Year can bring about thoughts of change. It can be a time of retrospection when we reflect on our life choices and consider improvements we would like to make. It’s probably the case that most of us, at one time or another, have set a New Year’s resolution aimed at bettering ourselves in some way. However, it’s probably also the case that most of us have experienced that initial sense of eager excitement and commitment gradually fizzle out into something more like a faint suggestion.

Despite our best intentions, making lasting changes in behavior can be hard. Luckily there are a number of strategies that can help us increase the likelihood of staying on track and achieving our goals. Whether it’s losing weight, improving an important relationship, or finally getting around to writing that novel these tips can help you make positive changes that last through 2017 and beyond.

The first step towards change is choosing appropriate goals. While we likely all have various areas of self-improvement that we could target, attempting to work on multiple areas simultaneously can be an overly ambitious undertaking. Focusing all of your energy for change towards one goal at a time will boost the odds in your favor. Additionally, aim to choose positive rather than negative goals. Positive goals are new patterns that you would like to see whereas negative goals involve current habits that you want to stop. It’s much easier to learn new habits than to unlearn old ones.

When setting goals, remember the acronym SMART to increase your chances of meeting your objectives. Setting Specific goals means being very clear and precise about what you want to achieve. If you’re working towards a long-term goal, breaking it down into smaller, clearly defined steps will help you to get started and stay on track more easily. Choose Measurable goals in order to track your progress. For example, if you want to find a new job choose to send out five applications per week. Make sure to set goals that are Achievable, or in other words goals that are in line with your abilities. Additionally, it is important to be sure that your goals are Realistic. Select a goal that is not only in line with your resources, but also with your larger life priorities and obligations. And finally, set Timely goals, meaning goals with a clear time frame and end date.

Now that you’ve set attainable goals, you’re ready to start working towards them. Making real changes in behavior is hard but following a few principles can help tip the scales in your direction. As you set out on each new step, consider any obstacles that may get in the way of reaching your goal. It’s impossible to anticipate all possible challenges, but predicting the most likely obstacles you might face and making a plan for how to manage them ahead of time will help to keep you on track. Repeating new behaviors is also key to achieving lasting change. With repetition, new patterns will begin to feel habitual. Once they do, you can tack on the next step in your plan and promote continued progress.

Another important tip to keep you moving in the right direction is to approach setbacks with the right mindset. It’s inevitable that old habits will creep in from time throughout the change process. Therefore, expecting setbacks and being kind to yourself when they do occur will help you to reflect on the things you could have done differently so that you’re better equipped to deal with future challenges. While being armed with the tools discussed so far will maximize your chances of making meaningful and sustainable changes, incorporating a few additional strategies that target your environment should make you unstoppable on the path towards achieving your goals.

One of the main reasons that it’s so hard to change our behavior is the fact that our surroundings are filled with cues that signal old habits. Embedding environmental cues that prompt new behaviors, like visible reminders or attention-drawing changes, can be extremely helpful in promoting change. Including significant others in efforts to change is also a valuable tool. Involving others can mean sharing your goals and progress with friends and family, paring up with someone who’s pursuing similar goals and can help to keep you motivated and on track, or joining a support group where you can share your struggles and successes and find encouragement. Whatever your goals may be, these strategies can help you to achieve them. Equipping yourself with these powerful tools will help you to effect and maintain the positive changes you want to see.