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.

Inspirational Message

The Way of Mastery is to break all the rules—but you have to know them perfectly before you can do this; otherwise you are not in a position to transcend them.

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Calmer in the Face of Hardship
I came to the Center for Anxiety for help in dealing with a family member who suffered from extreme anxiety. But I ended up getting a serious illness two months later and started having my own sessions. With the help of my therapist I got through my illness, learned to understand my habits that were making my major life stresses worse, learned to communicate better, taper my anger, and surprisingly I became more calmer even though my hardships in life worsened. Therapy is a lot of work and not easy, but nothing in life comes easy! I became a better and softer mom and (when I practice what I learned) and my kids and home are calmer and happier. I am still a work in progress and have more to work on, but I know I am on the right path. I wish I knew before how my communication style and anger were really impacting my life, how being softer you can accomplish way more then being harsh. I have been to other therapists in the past and I can hands down say that the Center for Anxiety’s approach is really effective. I have even referred a bunch of people to the Center and they have been really happy with the therapists and how much they really care for their patients.
I Tackled a Long List of Fears
When I first came to the Center for Anxiety, my list of anxieties/fears was long! I was scared of getting sick, getting stranded, driving, flying and more. With the help of my therapist, I immediately got to work and tackled every one of my fears. Now the world is open to me and I feel free! I can dream big and accomplish whatever I set my mind to! I am especially grateful that I was able to do all this without having to rely on medication. It was hard work – grueling at times! – but now I have the coping tools within me for life. In fact a family member recently said to me “You are awesome. You can accomplish anything you set your mind to because you don’t let fear stop you! ” Thank you Dr. Rosmarin and the Center for Anxiety staff for helping me get here. My fears no longer limit me and I love my life. Try it, it might turn your life around too!
Highly Skilled and Professional Treatment
When I sought treatment at the Center for Anxiety, the clinic was is in its incipient stages. However, by the time I successfully finished treatment, the Center for Anxiety grew and flourished into a world-class treatment center, offering cutting-edge, evidence-based treatment to countless individuals. The continued success of the Center for Anxiety comes as no surprise to me, with a team that contains such highly skilled professionals who display clinical acumen, empathy, and compassion. When I first entered treatment I was concerned that therapy would be similar to the experiences with past psychologists: a seemingly bottomless pit with no reductions in my anxiety symptoms, but was so relieved when I started to feel less anxious after only a handful of sessions. My therapist created a treatment plan that was tailored exactly to my needs and taught me practical skills to help me work through my anxiety that I still use and practice to this very day.
No More Panic
When I first came in, I was struggling with panic disorder and didn’t even know it, which only made dealing with it that much more difficult. After my first time sitting down with my therapist, however, I instantly started to gain perspective and look at the difficult situation in a different light. Our meetings helped me conquer the issue step by step and get my life back on track. I’d strongly recommend that anyone dealing with anxiety in a way that impacts their day to day life should visit the Center for Anxiety! I know it helped me tremendously.
Free of Obsessions
When I woke up one morning last June and didn’t want to get out of bed, I knew I needed help. The thought of getting through another day with all my anxieties, obsessions and rituals was just too overwhelming. After feeling stuck for years, I just couldn’t anymore. Thankfully, that’s when I found the Center for Anxiety. Dr. Rosmarin and his staff are experts at what they do, kind and professional. After just several weeks I accomplished my initial targets. The change I experienced in such a short amount of time was astounding that I stayed on for a while longer to work on more complex goals. I soon achieved those too. Now, I am free of my obsessions, know how to manage my anxiety, and love my life. My only regret: not having done this sooner. I wish I had known that you don’t have to wait to hit rock bottom to get help.
Depression Lifted
I’m 26 years old and I’ve been suffering from terrible depression for 7 years. In the throws of my sadness I literally wanted to die. Soon after starting therapy at the Center for Anxiety, my depression lifted. My suicidal thoughts began to dissipate. I remember the feeling that came over me as soon as the dark cloud above me left. It was the most liberating feeling I have ever experienced. I actually shouted to my friends, family and anyone nearby me “I’m Happy! I am Happy!” I felt free.
From EXISTING to LIVING
Over the course of four years I developed anxiety-like symptoms (tightness in chest, gut, back) that slowly but surely increased in duration and severity. The EXTREMELY uncomfortable nature of the symptoms notwithstanding, I still continued and managed to function. The effort required to do so, however, left me utterly drained. Having always been a very spiritual person I strongly felt that a course of therapy incorporating a spiritual component could potentially work well for me and decided to give the Center for Anxiety a try. Happily, I have achieved significant symptom reduction, tremendously improved emotional/mental health, and above all, Connection. Medication free. I’m no longer just existing, I’m LIVING. I’ve been given a second chance to become the unique human being that I was meant to be.
No More worries
I have wormed in healthcare for 36 years in many different settings, and I have been overwhelmingly satisfied with the Center for Anxiety. When staff says they are going to call, I get a call. From the first contact, I have been very impressed with the professionalism and efficiency. I had a situation and needed to have sessions more than once per week, and my clinicians worked out a schedule to accommodate my needs. I was astounded that they attended to me so quickly and effectively - they made my priority their priority. My clinicians were also excellent at what they do - they have a plan for me each session, and it's clear that they have thought in advance about each session, and that they are listening to what I say and observing what I do, even though our sessions have been conducted via Telehealth. Compassion is a quality that I have all too often found to be lacking in my experiences as a healthcare professional and patient, and this is not the case with the Center for Anxiety. Of all the websites I found on Google, I am so thankful that God guided my hand to yours.
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