Mindful New Years Resolutions

As we turn towards 2014 and close the book on 2013, some of us find it helpful to take stock of our lives and make resolutions for the upcoming year.  This is certainly nothing new. As a DBT therapist, I can't help but wonder, what are some ways in which we can resolve to be more mindful in 2014?

1. Daily Activities - We can practice mindfulness while doing ANYTHING (by itself).  We can mindfully drive a car (no music, no talking on bluetooth, no eating, just focusing on the road), brush our teeth (focus on the taste of the toothpaste, the feel of the bristles on your tongue, etc), do the dishes, and take a shower (focus on the smells, the feel of the soap, etc).  We can mindfully change diapers, prepare dinner, and even type emails.  We can resolve to practice one daily activity mindfully each day; by doing so, we are fully participating in that activity alone and exercising our mindfulness muscle for other times when we may need it.

2. Relationships - We can practice mindfulness while talking on the phone or talking in person to anyone.  We all have had conversations with others while driving, doing the dishes, cleaing up around the house, etc; when we multitask in this way, we always miss out on something.  When we are mindful with others, we give them the gift of our attention which can help to improve the quality of our relationships.

3. Daily Formal Practice - A daily mindfulness practice could entail sitting for 5 minutes each morning and focusing on your breath.  It could also mean walking mindfully to the train station or doing a body scan every evening after dinner. Regardless of which formal practice you choose, we find that people tend to stick with the practice if they schedule it in (even a few minutes is sufficient) and commit to doing it every day. 

We wish everyone a happy and healthy 2014!

Article on Gratitude in Children

Click here to read an article in the Wall Street Journal about the many benefits of raising kids with gratitute.  The article cites research stating that teenagers with high levels of gratitude had higher GPAs, less depression, and less envy than less grateful teenagers.

Article on Happiness in NY Times

Click here to read an article from this week's NY Times about research on happiness.  The article discusses factors that contribute to our happiness, including those which we can and cannot control.

Mindfulness Explained!

Click here to see a very user-friendly site with great animated videos to explain the abstact concepts of mindfulness.  You can watch the short videos and try out the site for 10 days for free. 

Drinking Tea Mindfully

Click here to read a great post on taking time for yourself by being mindful during the holiday season.  The writer suggests several different mindfulness practices, including drinking tea, brushing your teeth, and walking mindfully.

Post-Doctoral Fellowship Position at CCDBT

POST-DOCTORAL FELLOWSHIP IN DIALECTICAL AND COGNITIVE BEHAVIOR THERAPY

The Center for Cognitive & Dialectical Behavior Therapy (CCDBT) PLLC  invites applications for a year long post-doctoral fellowship beginning Summer/Fall 2014 FOR OUR NYC & LONG ISLAND OFFICES

Professional activities will include: Providing individual and group Dialectical Behavior Therapy for adolescents, adults, & families; providing cognitive therapies for depression & anxiety;
providing skills training for parental management of childhood
behavior disorders, and providing Mindfulness-Based Stress Reduction
to medically referred clients.  Postdoctoral fellows will participate
in program development and administration, monitoring client outcomes,
and conducting research. Specific activities will be determined with
the fellow to match his/her career goals.

The Center for Cognitive & Dialectical Behavior Therapy (CCDBT) PLLC,
is: a privately-owned therapy center made up of licensed psychologists
and social workers. The mission of CCDBT is to provide effective and
specialized treatment to people of all ages who are experiencing
difficulties in their lives.  The goal of CCDBT is to help people meet
the challenges in their lives and develop the skills needed to deal
with such challenges. For more information, see http://www.ccdbt.com.

Applicants will be considered who: Complete a clinical psychology
doctorate by the start date: demonstrate strong potential for a career
in programmatic implementation of DBT, have substantial experience in
CBT and with adolescents and families. Experience with Dialectical
Behavior Therapy is highly preferable. Applications are reviewed and interviews are granted on a rolling admissions basis.

Please email or fax letter of interest, CV, & 3 letters of reference to:   

Jennifer Byrnes, Ph.D.

Director of Research & Training, CCDBT

jbyrnes@ccdbt.com

fax: 516-396-2195

NY Times Article on Insomnia Treatment and Depression

Click here to read and article in today's NY Times about how treating insomnia can also lead to significant improvements in depression.

Ny Times Article on Mindfulness

Click here to read an article about how celebrities, corporations, and even the military are using mindfulness and meditation to improve quality of life and disconnect from technology.

Article in NY Times about Mental Health Parity

Click here to read an article in last week's NY Times about the new Mental Health Parity and Addiction Equity Act.  According to the Obama administration, individuals may be entitled broader mental health coverage than before.

Graduate Group at CCDBT

We are excited to announce that CCDBT has started a DBT Graduate Group for young adults. Participants must have completed DBT Skills Group and have an individual therapist. The purpose of this group is to help young adults continue to practice DBT skills as well as to provide ongoing peer consultation. The group will be held Thursday afternoons from 2:15-3:15pm. The group is an open format, and we would love to have new members join as they are ready.  If you are interested, please contact Dr. Rachel Gerstein (516-390-3525 x17) or Dr. Liz Gellman (516-390-3525 x 24), or talk to your individual therapist.

Mindfulness Exercise from BTech

I came across this interesting mindfulness exercise from Marsha Linehan and Behavioral Tech and thought I'd pass it along:

"Radical acceptance requires turning the mind. Turning the mind is where you simply say, 'Yes. I will. OK.' It means you find within yourself the ability to say 'Every moment is perfect. Every day is a good day. Everything is as it should be.'' It may not be what you want, and it may not be what you like, but it’s what it should be. It’s turning the mind.

Now the fact that you turn back around again 30 seconds later is not important. You probably will turn back around and say, ‘No! Everything is not perfect!’ The minute you see that happening, just gently turn your mind again. ‘Every day is a good day. Everything is as it should be.’

In this mindfulness exercise, I'd like you to practice just that - turning the mind. Turning the mind is going within, following your breath within, and allowing yourself to accept the moment of the breath – just this one moment of this one breath.

You might find it useful, as you breathe in, to say, ‘Everything is perfect,’ and as you breathe out to say, ‘…as it is.’ Everything is perfect… as it is. So sit down. Get yourself comfortable. Get into a posture that is somewhat willing, sitting up straight, feet flat on the floor, and nothing on your lap.

Everything is perfect… as it is."

Article on Brandon Marshall and BPD

Click here to read an article about Brandon Marshall wearing green shoes in the Bears v Giants game to support Mental Health Awareness Week.  Marshall was reportedly diagnosed with Borderline Personality Disorder in 2011.

This Week in Adolescent and Family DBT Group

This week in Adolescent and Family DBT Group we are reviewing the FAST skill and the Interpersonal Effectiveness module as a whole.  The Interpersonal Effectiveness module deals with how to improve our relationships; specifically, how to ask for what we want (DEAR MAN), how to keep a good relationship (GIVE) and how to keep respect for yourself in relationships (FAST).

This Week in Adult DBT Group

This Week in Adult DBT Group we are beginning the Mindfulness module.  The first skill in this module is the States of Mind.  The three States of Mind are Emotion mind (acting impulsively based on our emotions), Reasonable mind (acting just based on the facts, no emotion), and Wise mind (acting based on some emotion and some facts, making decisions we feel good about for years to come). 

Article in the NY Times about Mindfulness

Click here to read an article in this week's NY Times about training doctors in mindfulness techniques.  They reported that doctors trained in mindfulness had decreased levels of burnout, anxiety, depression, and distress.

This Week in Adult DBT Group...

This week in Adult DBT group we are reviewing the Interpersonal Effectiveness module and conducting graduations for those that have finished one or two cycles of DBT.  The interpersonal effectiveness module deals with how to improve our relationships; specifically, how to ask for what we want (DEAR MAN), how to keep a good relationship (GIVE) and how to keep respect for yourself in relationships (FAST).

This Week in Adolescent and Family DBT...

This week in Adolescent and Family DBT we are reviewing the GIVE skill and teaching the FAST skill.  The FAST skill is used as a way to keep respect for yourself in relationships; for example, when you are using the GIVE skill over and over and the relationship is not improving.  FAST stands for: (be) FAIR, (no) APOLOGIES, STICK TO VALUES, and (be) TRUTHFUL.

Article in NY Times about OCD and CBT

Click here to read an article in this week's NY Times about how Cognitive Behavior Therapy can be more effective at treating Obsessive Compulsive Disorder than antipsychotic medications.

This Week in Adult DBT Group

This week in Adult DBT Group we reviewed the inventory for interpersonal relationships and taught the Cheerleading skill.  Cheerleading statements are used to help overcome our worry thoughts and get/maintain good relationships.  Examples include "It is ok to want or need something from somebody else" and "The fact that I say no to someone does not make me a selfish person." As a reminder, there will be NO Adult DBT Groups next week due to Labor Day and Rosh Hashannah.

This Week in Adolscent and Family DBT Group

This week in Adolescent and Family DBT Group, we are reviewing the TIPP skill and the whole Emotion Regulation module.  The Emotion Regulation module teaches us how to change emotions that we want to change.  The TIP skill specifically has to do with reducing painful emotions right now.  The four ways to do this include: changing your body temperature, intensely exercising, progressively relaxing your muscles, and using paced breathing.

NY Times Article on Sleep and Exercise

Click here to read an article from this week's NY Times about the relationship between exercise and insomnia.  Research suggests that a regular exercise program can significantly improve insomnia.

This Week in Adolescent and Family DBT Group

This week in A & F DBT Group, we reviewed the interactions between emotions, thoughts, and behaviors and taught the skill of Problem Solving.  Problem Solving is called for when you are experiencing a justified emotion (the emotion fits the facts) and you want to change that emotion.  If the emotion is not justified, Opposite Action should be used instead. 

This Week in Adult DBT Group

This week in Adult DBT Group we reviewed ABC Please and taught the TIP skills.  The TIP skills stand for ways you can change your emotions by changing your body chemistry.  T is for changing your body Temperature (dunking your face in ice water), I is for Intensely Exercise, and P is for Progressive Muscle Relaxation.  This concludes the Emotion Regulation module. 

DBT Graduate Group at CCDBT

We are excited to announce that CCDBT is starting a DBT Graduate Group for young adults, ages 18-25.  Participants must have completed DBT Skills Group and have an individual therapist at CCDBT.  The purpose of this group is to help young adults continue to practice DBT skills as well as to provide ongoing peer consultation.  If you or your child is interested, please contact Dr. Rachel Gerstein (516-390-3525 x17) or Dr. Liz Gellman (516-390-3525 x 24), or talk to your individual therapist. 

NY Times Article on Exercise and Anxiety

Click here to read a recent article in the NY Times about how exercise can reduce anxiety.  DBT skills such as Intensely exercise (TIP) and PLEASE also are ways in which you can reduce negative emotions by either intensely exercising or by exercising on a regular basis.

Announcing CCDBT Manhattan!

CCDBT is pleased to announce the opening of a second office in Manhattan, located at 

303 Fifth Avenue, Suite 1003, New York, NY 10016, ph: 212-532-2467. 

The Manhattan location will offer the same treatment options as the Lake Success CCDBT office, including CBT, DBT, and Mindfulness Based Techniques.  We are very excited to begin this new endeavor with our staff and patients.  

-Tracy Kisner, Psy.D., and Rachel Gerstein, Ph.D. 

Dr. Silverman's Retirement

CCDBT would like to announce the retirement of Dr. Burt Silverman from our practice.  Dr. Silverman was instrumental in the creation of CCDBT and often liked to call himself the "oldest living DBT therapist."  He touched many lives in his numerous careers, including high school guidance counselor, teacher, and furrier.  Our staff and patients will have to radically accept his retirement, although we will miss him dearly.  Feel free to post a comment if you would like to leave a message for Dr. Silverman.

Heartfulness

by Perry Meltzer, Psy.D.

 

In many Asian languages the word for “mind” and the word for “heart” is the same word. So when you hear the word “mindfulness,” you have to hear the word “heartfulness” simultaneously to understand or feel what mindfulness really is. That is why mindfulness is sometimes described as an affectionate attention and why I encourage you to practice with a very light touch, bringing an attitude of gentleness and compassion to yourself at every turn.

- Jon Kabat-Zinn, “Mindfulness for Beginners”

Mindfulness can initially sound like a pretty nebulous concept. Because of its seemingly abstract nature, when learning the skill, its helpful to initially focus on the more practical aspects of mindfulness. At the same time, its important to maintain a connection to the essence of what mindfulness is all about.

What is mindfulness all about? Mindfulness has been described, simply, as focused awareness of the present moment. From a DBT perspective, the goal is to use this awareness of the present moment to get ourselves into Wise mind. By hitting the pause button and noticing the moment we are in we can acknowledge our emotions, identify our current state of mind, and take note of what is driving our actions. This process is referred to as taking hold of the mind, as we gain control over our mind by choosing where to focus our attention. Ultimately, this provides the opportunity to synthesize our Reasonable and Emotional Mind so we can take the wheel and drive our own actions with our Wise Mind.

As skills trainers, after facilitating an understanding of taking hold of the mind with the States of Mind, we teach the steps for what to do and how to do it with the What Skills and the How Skills. The emphasis here is on the doing. Facilitating trainee mastery of a skill requires this initial focus. As the skill of Mindfulness is cultivated, a broader concept of Mindfulness can be incorporated with the notion of heartfulness. Heartfulness, a beautiful embodiment of the spirit of mindfulness, encapsulates the affectionate and compassionate presence that comes with being mindful and being human. The How Skill of doing things Non-Judgmentally is the closest representation of heartfulness in the DBT skills manual. By engaging in judgmental thinking, we are fighting against reality by imposing our will on how we think things should be. When we fight against what is, we end up raising our emotions and we keep ourselves in a more emotional place. By removing judgment and focusing on the facts, it helps us accept reality and access our Wise Mind. Heartfulness takes non-judgment a step further. It goes beyond simply removing judgment and encourages we approach the world with a shared sense of humanity and kindness to ourselves. While subtle, I would liken this to the difference between noticing the moment and accepting the moment. Heartfulness is very much a way of being where the goal is not only getting into wise mind. The goal is being your wise mind.

As Jon Kabat-Zinn encourages, it would be helpful if we all approached our mindfulness practice with heartfulness. In the Distress Tolerance module, we learn to be kind to ourselves in moments of intense emotion by self-soothing. Heartfulness allows us to be gentle and compassionate to ourselves and those around us in every moment. Whatever the moment brings. If we approach our emotions, behaviors, and thoughts with heartfulness, we allow ourselves to gracefully accept all that enters our experience without judgment or acting on impulse. And in the moments that we do judge and act impulsively, which we all do, we once again access our heartfulness. We kindly accept ourselves for being human. And we continue to work on nurturing a focused awareness of what it is to be human and what it is to be wise. In this moment...and this moment...and the next.

 

This Week in Adult DBT Group

This Week in Adult DBT Group we are reviewing both the skill of Radical Acceptance and the Distress Tolerance module as a whole.  The other skills in the module include Distract, Self-Soothe, Improve the Moment, and Pros/Cons.

This Week in Adolescent and Family DBT Group

This week in Adolescent and Family DBT Group we are reviewing both the HOW skills and the mindfulness module as a whole.  The other skills in the module are the 3 States of Mind (Wise Mind, Emotion Mind, and Reasonable Mind) and the WHAT skills. 

Three Mindfulness Exercises from Behavioral Tech

Click here to see 3 examples of basic mindfulness practices from Behavioral Tech.

Article on Loneliness

Click here to read an article on loneliness from the NY Times this week.  The article points to research suggesting that loneliness can be damaging to our physical health as well as to our mental health.

This week in Adolescent and Family DBT Group

This week in Adolescent and Family DBT Group we are reviewing the Mindfulness States of Mind  and teaching the What skills.  The What skills are ways to achieve wise mind, including Observing, Describing, and Participating.  Observing involves noticing your experience, Describing involves putting words on the experience, and Participating involves fully experiencing your feelings/experience without being self-conscious.

This week in Adult DBT Group

This week in Adult DBT Group we are reviewing Pros/Cons and teaching the first part of Radical Acceptance.  Radical Acceptance is an incredibly powerful skill; it can help us let go of suffering and accept difficult realties in our lives.  Radical Acceptance is a process that takes time.  In fact, it involves turning the mind, over and over again, and choosing to accept a difficult reality. 

Self Care for Moms

Click here for a great article on why self-care is so important for mothers. With Mother's Day coming up this weekend, it can be easy to forget to take care of ourselves as we often get so caught up in taking care of others. 

This Week in Adult DBT Group

This week in Adult DBT Group we will cover Pros/Cons of acting on an impulse.  This skill can help us to get through an emotional crisis by slowing down our decision making and helping us to see the consequences of acting on an impulse.  It can also help us prepare in advance for a crisis by looking at the consequences of behaviors ahead of time.

This week in Adolescent and Family DBT Group

This week in Adolescent and Family DBT Group we are beginning the Mindfulness module. Mindfulness is often thought of as the most crucial DBT skill - without mindfulness we wouldn't be able to "hit the pause button" and use any of our other DBT skills.  This week we will cover the 3 states of mind - Reasonable mind, Emotion mind, and Wise mind.

This week in Adolescent and Family DBT Group

We are currently in the Middle Path module in Adolescent and Family DBT Group.  This week we reviewed the first part of Dialectics and taught Dialectical Dilemmas.  Dialectics involves thinking about something in a new way, instead of getting stuck in extreme views.  Dialectics teach us that there is more than one way to see a situation and to solve a problem.  The core dialectic in DBT is balancing acceptance and change.  Dialectic Dilemmas involve common dilemmas in families with adolescents, including balancing independence and dependence or being too loose versus being to strict.  For homework, family members will practice calling the dialectic when disagreements start to get hot, instead of escalating. Once someone calls the dialectic, family members can look to find a middle path between the two extremes. 

This Week in Adult DBT Group

We are currently in the Distress Tolerance module in the Adult DBT Group.  This week we reviewed the Distract skills (Distract with ACCEPTS) and taught the Self-Soothe skills.  Self-Soothing involves decreasing negative emotions by engaging our 5 senses.  For example, you could self soothe with vision (lighting a candle), hearing (listening to soothing music), smell (using a favorite lotion), taste (drinking hot tea), and touch (putting on a cozy sweater).  Group members were also asked to make a self-soothe kit to use during a crisis. 

Article on Mindfulness in the NY Times

Click here to read a recent article in the New York Times about mindfulness.

NY Times article on DBT and CBT

Click to here for a recent NY Times article on therapy.  The article points to evidence suggesting that many patients do not receive evidence-based treatment, such as DBT and CBT.

This Week in Adolescent and Adult DBT Group...

Both of our groups are still on the same topic. This week we will review the FAST skill and review the whole Interpersonal Effectiveness module.  The FAST skill is used as a way to keep respect for yourself in relationships; for example, when you are using the GIVE skill over and over and the relationship is not improving.  FAST stands for: (be) FAIR, (no) APOLOGIES, STICK TO VALUES, and (be) TRUTHFUL. 

This week in Adolescent and Adult DBT groups...

We are finally in the same place in both our Adolescent and Family and Adult DBT Groups!  This week we are reviewing the DEAR MAN skill in the Interpersonal Effectiveness module and teaching the GIVE skill.  DEAR MAN has to do with asking for something effectively or saying no.  To do this we Describe the situation, Express our feelings about the situation, Assert ourselves, and lastly, Reward the other person ahead of time.  We do all of this while at the same time taking hold of our Mind, Appearing confident, and Negotiating. 

The GIVE skill has to do with how to keep a good relationship.  To this we (act) Gentle, (act) Interested, Validate, and (use an) Easy Manner.  This skill takes practice, especially when you have negative emotions!

Article on Exercise and Stress

Click here to read an article from this week's NY Times about how exercise can help protect children and adolescents (and adults, too!) from stress.  This is similar to the PLEASE skills in DBT in which balanced levels of exercise can help reduce emotional vulnerability. 

Article on Anti-Depressants and Therapy

Click here to see an interesting article on how therapy may be a helpful treatment for people with depression who have not improved with medication. 

Article on Mindfulness in the Workplace

Click here to see a recent article in the Financial Times about how companies are using mindfulness in the workplace to increase productivity and focus.  I think this speaks to how important mindfulness (or "hitting the pause button") can be in all areas of our life - home, work/school, and play. 

This week in Adult DBT Group

This week in Adult group we are discussing the What skills in the mindfulness module.  The What skills have to do with what to do to get into wise mind.  They include observing (noticing your experience), describe (putting words on the experience), and participating (fully experience your feelings without being self-conscious).  Next week we will discuss the How skills. 

This week in Adolescent and Family DBT Group

This week we are finishing the Emotion Regulation module!  We are reviewing the TIP skill (changing your body Temperature, Intensely exercising, and Progressively relaxing your muscles) to reduce intensely painful emotions.  Many of our teenagers and parents got the opportunity to practice dunking their face into ice cold water in group last week - it was quite a site.  We are also reviewing the whole module, including ways to change emotions you want to change (problem solving and opposite action), reducing emotional vulnerability (ABC Please), and coping with painful emotions right now (TIP).  Next week we will welcome new families and begin the Interpersonal Effectiveness module. 

NY Magazine Cover Story on Adolescence

I found this article on the power of adolescence to be fascinating.  Check it out here.

This reminds me why I was so affected last week when I walked into Garden City High School to give a presentation - I was immediately flooded by my own memories of high school.  The article describes how our brains process information from ages 15-25 differently than from other time periods in our life.  Adolescence can be such an powerful time our lives that our thoughts, feelings, and even musical preferences during this time can influence the rest of our lives.

Mindfulness Quote of the Day

“Walk as if you are kissing the Earth with your feet.”-Thich Nhat Hanh

Mindful Eating for the New Year

I imagine many of you have eaten a raisin.  But how many of you have eaten a raisin mindfully?  A growing body of research shows that eating mindfully could help to make healthy food decisions and to lose weight.  Eating mindfully means eating slowly, without distractions, and focusing on the food with all of your senses.  So many of us, myself included, scarf down dinner while texting a friend, watching tv, and checking email all at the same time.  When doing so, we certainly don't concentrate on the taste or texture of our food.  We do this at the expense of really tasting our food and likely end up over-indulging.

The next time you sit down to a meal, I challenge you to taste at least one food mindfully and engage all of your senses. Turn off the tv, put the phone on vibrate, and try the following exercise, with a raisin or any other food:

Pick up a raisin and hold it in the palm of your hand. Look at it. Examine it. Describe the raisin. What does it look like? What color is it? How would you describe the texture? Now, feel the raisin in the palm of your hand. What does it feel like against your skin? Pick it up with your other hand. What does it feel like in your fingers? Is it slimy? Rough? Smooth? Soft? Hard? Squeeze it softly. What do you feel? Smell the raisin. Describe how it smells. Rub the raisin between your fingers next to your ear.  What does the raisin sound like?  Put the raisin in your mouth, but do not eat it. What does it feel like on your tongue? What does the texture feel like now? How does it taste? How does the taste compare to the way it smelled? Move it around in your mouth and notice every aspect of the raisin. Bite the raisin once and notice what you taste. Now how does the raisin feel in your mouth? Slowly finish chewing the raisin and notice its texture and how it tastes.  Does it taste like other raisins you have eaten? Or does it taste differently?  Before you swallow, see if you can become aware of the urge to swallow.  Then swallow.  Notice that you are now exactly one raisin heavier than you were before.

For further reading on mindful eating, check out the following:

NY Times Article on Mindful Eating
Harvard Health Newsletter Article