Recovery is a Process: When a Boulder Slams Into Our Recovery Path

Recovery is a Process

“Why try? I’m tired of trying. “Why change? Nothing ever changes?” Many folks in early recovery believe NOTHING will ever get better or they believe things will get better, but only temporarily! They expect that when things are going well, something will happen and ruin everything…the bottom will fall out again and they will end up in the same position or worse. They have trouble believing recovery will make a real difference in their life.

The truth, when we are living a recovery lifestyle things get better in our life. As recovery time increases, the big picture of our life begins to come together and many good things happen. At first, one or two good things happen. When we build on these improvements, several more good things happen…then several more…and several more. Soon, we go from experiencing relief to experiencing some life satisfaction. Over time, periods of joy occur…and meaning returns to our life! The truth, things get better when we get better. Things change when we change.

When a Boulder Lands on Our Recovery Path: Things rock along okay for a while…3 months, 6 months, sometimes longer. We’re dealing with stuff that comes our way…and we’re making gains day by day…and then, something happens. Boom! It’s like a boulder falls out of the sky and smashes right into the middle of our recovery path. We’re now faced with a huge stumbling block…something big…and something hard to get around.

The boulder that slams into our recovery path may be an old friend who shows up one day, maybe someone we’ve been in love with before. We’re feeling all the fun and excitement of the good ol’ times. We’re tempted to spend time with them to relive old times and cherished memories…however, their situation or lifestyle conflicts with our recovery plan. Maybe they still drink or use drugs, or cut, or shoplift…maybe they have a bad attitude or they don’t have steady work and want to stay with us for a while…maybe they’re moody and get very critical and ugly…maybe they’ve abused us before.

The truth…life is going to happen. Difficult things will come our way and boulders will land on our recovery path. The direction our life goes depends on the choice we make when we’re faced with difficult situations. It’s like we come to a fork in the road. We can keep on the right path or we can go down the wrong road. No matter what we do, WE ALWAYS HAVE A CHOICE…to stay on the Recovery Path or to go down Relapse Road.

At this point, we’re faced with a major decision…and we have two choices. We can fight to stay on the recovery path and work to deal with the situation productively, or we can relapse into old behaviors and habits to numb-out and white-out the pain and distress. If we choose to stay on the recovery path, we’ll probably have a tough time dealing with the situation. Getting around, through, and passed a boulder takes time and we’re impatient creatures…especially when we’re expected to tolerate discomfort, inconvenience, pain, and suffering without our preferred destructive coping behaviors! We don’t want to tolerate distress and it’s very tempting to give up…and give in to old ways…the ways of relapse. We don’t want to take the time it takes…to deal with the boulder. We want the pain and discomfort to go away…fast. We don’t want the stress. We don’t want the heartache. We just want to be happy. We want life to go smooth…and when it doesn’t, we get discouraged. We want to call it quits. If life has to be like this, we don’t want any part of it.

The truth is…to maintain recovery, we must have an attitude of willingness. We must be willing to do whatever we need to do to be okay and to maintain our recovery. If we don’t do what it takes to stay on the recovery path…if we don’t try hard enough for long enough…it’s likely that we’ll relapse into our former destructive ways. Then, many of the things that became good because of our recovery will once again go bad…and that’s when we’ll walk away saying, “Why did I even try? I always relapse and things get bad again.”

The truth is…when we try…and continue to try to deal with life and all the boulders that come our way, life will get better and better. If we keep on keeping on, we’ll finally get through…passed…over…and around the boulders and obstacles in our recovery. That’s how people recover. They don’t give up…or they don’t give up for long!

Recovery is not one action. It is not something that happens in a day. It is step-by-step, decision by decision, and day after day. It is a lifestyle…and a life-long endeavor!

Why try? Because life gets good when we try and even better when we keep trying and refuse to give up! The something that happens that destroys our life is our decision to relapse. The thing that really breaks us and causes us to bottom-out emotionally and spiritually is a broken promise to ourselves…the promise we make at the start of recovery. It’s the promise that, “I’ll do whatever it takes to be okay…because I’m tired of living this way. Come hail or high water, I’ll do whatever I have to do to be okay…because I refuse to live like this anymore.”

In our recovery, there will be times when we’re holding on by just a thread…but we’re holding on. It’s only when we let go, that we fall. It’s like the saying, “You never fail until you stop trying.”

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Adapted from Chapter 3 “The Pathways of Recovery” from the DBT-CBT recovery workbook “Out-of-Control: A Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook for Getting Control of Our Emotions and Emotion-Driven Behavior” – Copyright 2009 by Melanie Gordon Sheets, Ph.D.  (www.dbt-cbt-workbook.com)

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The Strength to Love Again

It certainly takes a lot to open our hearts to truly love again. It’s about the willingness to take the risk to love again…to trust that this love will bring us joy and not pain…or that it will bring us much more joy than pain…or that this love will enhance our lives in such a meaningful way that any pain experienced is well worth it and that in the long run, our lives will be much more beautiful and complete because we loved again.

A wise mind knows that when we truly love, we will also truly experience pain.  Pain is often a by-product of love…even the most perfect or true love. The deeper we love…the deeper our pain is likely to be. That’s why some who have been  been deeply hurt by love, have made a conscious decision to never love again. They “refuse” to love again. They guard against lowering their guard…they work very hard to maintain a closed heart, to be detached, and to not care too much. They are not willing to open their lives to love again.

So, in their efforts to protect themselves against future pain, they cause themselves ongoing pain and suffering. Their daily lives are marked with pain…loneliness, anger, resentment, bitterness, unresolved emotional issues and concerns…and the pain of unfulfilled needs for attachment and love.

It takes great strength to open our hearts to love again…because we know that loving someone will also bring pain. It’s the acceptance that nothing is perfect…and the knowing that our lives and the lives of those we love will be much better because we loved again.

Note:  The accompanying photo/poster was copied from a Facebook posting.  It is not an original work! 

A Modified DBT-CBT Recovery Program for a Forensic Population: A Presentation at the 2011 Texas Forensic Mental Health Conference

Texas Forensic Mental Health Services:
Issues in Treatment, Evaluation, and in the Court

October 25 – 27, 2011

Presented by North Texas State Hospital – Vernon Campus – Vernon, Texas
Wilbarger County Auditorium

Featuring:

Dr. Robert Morgan “Treating the Mentally Disordered Offender: A Model and Guide for Practice” 

Robert D. Morgan completed his Ph.D. in counseling psychology at Oklahoma State University and a postdoctoral fellowship in forensic psychology in the Department of Psychiatry at the University of Missouri-Kansas City School of Medicine and the Missouri Department of Mental Health. He is currently the John G. Skelton, Jr. Regents Endowed Professor in Psychology at Texas Tech University and the Director of forensic services at Lubbock Regional Mental Health Mental Retardation Services.  His research has been continuously funded for the past 8 years including by the National Institute of Mental Health and the National Institute of Justice. He is co-author of The clinician’s guide to violence risk assessment (2011) and co-authoring Treating the Mentally Disordered Offender: A Model and Guide for Empirically Supported Practice to be published by Oxford University Press. He is also the Series Editor-in-Chief for Correctional Interventions that Work also to be published by Oxford University Press. His research and scholarly activities include treatment and assessment of mentally disordered offenders, forensic assessment, and professional development and training.

Also Featuring:

Dr. Melanie Gordon Sheets“A Modified DBT-CBT Recovery Program for a Forensic Population: Treating Individuals with Highly Destructive Coping Behaviors”

Melanie Gordon Sheets, Ph.D. is the Chief Psychologist at Big Spring State Hospital, the Co-Director of the Lone Star Psychology Residency Consortium, and a Clinical Assistant Professor with Texas Tech University School of Medicine, Department of Psychiatry.  She earned a Ph.D. in Clinical Psychology from Texas A&M University in College Station, Texas. She has worked with psychiatric inpatients for 25 years and in Texas state mental health facilities since 1992. Specialty areas have included individual and group psychotherapy, psychological assessment (personality, neuropsychological, malingering, and trial competency evaluations) with forensic, VA, and general psychiatric inpatients. She has authored a therapy workbook entitled, “Out-of-Control: A Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook for Gaining Control of Our Emotions and Emotion-Driven Behavior” – 2009. Recovery Works Publications. She has conducted the DBT-CBT group at Big Spring State Hospital since 2004.

Dr. Stacey Shipley“Competency to Stand Trial: Forensic Evaluation, Report Writing, & Expert Testimony”

Stacey L. Shipley, Psy.D., completed her doctorate in forensic psychology from California School of Professional Psychology in Fresno, California and obtained her Bachelor’s Degree in Psychology from St. Edward’s University in Austin, Texas with a Minor in Criminal Justice.  Her clinical and forensic training has focused on both adults and adolescents, particularly in forensic settings. Dr. Shipley is a licensed psychologist in Texas, Iowa, and North Carolina and is the Director of Psychology at North Texas State Hospital.  She specializes in forensic evaluations (e.g., CST, fitness to proceed, insanity, risk assessments, psychopathy classification) and treating maternal filicide offenders. Her professional presentations have included those areas of forensic practice, as well as the relationship between mental illness and violent crime.  She has published articles in the International Journal of Offender Therapy and Comparative Criminology, regarding psychopathy and its clinical implications.  She has also published chapters on maternal filicide, serial rape and murder typologies, forensic case formulation for adult sex offenders, and co-authored Introduction to Forensic Psychology: Issues and Controversies in Crime and Justice (2nd Ed.) and the upcoming (3rd Ed.) published by Academic Press.  She co-authored The Female Homicide Offender: Serial Murder and the Case of Aileen Wuornos (2004) published by Prentice Hall’s Women in Criminal Justice Series.      

Additional features and workshops include:

Andrew W. Carruthers, J.D.; Brent A. Carr, J.D.; and Brian D. Shannon, J.D.“Interface Between the Courts and Forensic Hospitals Judges Panel”

Presentations by a legal scholar, felony and misdemeanor court judges, followed by a panel discussion of the legal experts.

Michele Borynski, Ph.D. & Jennifer Russell, Ph.D.“Violence Risk Assessment: An Overview for Community & Inpatient Evaluations”

Thomas R. Mareth, M.D. – Chair DSHS Dangerousness Review Board“Dangerous Review Board Training”

About North Texas State Hospital (excerpted from http://www.dshs.state.tx.us/mhhospitals/northtexassh/ntsh_about.shtm)
History of Wichita Falls State Hospital
“In 1917, the State of Texas created the Northwest Texas Insane Asylum. It was located on 940 acres seven miles south of Wichita Falls…In 1925, the name was changed to Wichita Falls State Hospital (WFSH). It had a modern surgical operating room, radiology, laboratory, electrotherapy apparatus, and hydrotherapy equipment. By 1930, the census was over 1500 patients with a staff of 235, including seven doctors and 93 attendants. During the height of the Depression, the hospital was virtually a self-sustaining community. It had an agricultural enterprise that included farming, hogs, chickens, and cattle. Most of the staff lived on the campus.

By World War II, the hospital consisted of 35 brick buildings and 60 frame structures. Due to wartime shortage of available employees, 234 staff members served approximately 2400 patients. Staff worked six days per week, 12 hours per day. Six nurses rotated coverage at night; three staff members offered occupational therapy. The end of the war saw the total number of employees rise to 503 by the early 1950’s. In 1951, Vernon State Home was activated as a branch of WFSH at the old Victory Field Army Air Corps training field. Vernon served about 400 patients “who do not require an active medical or psychiatric program,” while WFSH continued with a census of 2400. Volunteer programs and charitable donations made life more pleasant for the patients during this period.

In 1955, psychiatric treatment was revolutionized with the introduction of psychotropic medications. Major changes in mental health care continued to occur in the 1960’s. The Texas Department of Mental Health and Mental Retardation was created. New community MHMR centers and outreach programs were established through the state hospital system to better serve the citizens of Texas. The first volunteer services coordinator was hired in 1960, and the first social worker was hired in 1966. Vernon State Hospital (VSH) was established as a state hospital separate from WFSH in 1969. Child and adolescent services were added in the early 1970’s. With more effective medications, increased community services, and placement in nursing homes, the hospital census dropped below 900 by the middle of the decade…

The 1980’s saw the genesis of psychosocial programming and programs such as the client worker program, Fairweather Lodge, and Career Village. These programs profoundly affected the ability of patients to return to their communities. Vernon State Hospital was redefined as the state’s forensic psychiatric facility in 1987; as a result, WFSH’s catchment area grew from 23 counties to 53. By late in the decade, the average census at WFSH had fallen below 500, while the number of admissions and discharges increased. The hospital was more effectively and efficiently treating more people. The end of the decade also saw the introduction of the first atypical antipsychotic drug, Clozaril. Although extremely expensive and wrought with many side effects, it could effect profound improvement in some persons with mental illness.

Another change in Wichita Falls State Hospital’s operation came in 1993 when the responsibility for the substance abuse recovery program was removed from the state hospitals and given to the Texas Commission on Alcohol and Drug Abuse…Concern for healthcare costs and methods lead TDMHMR to explore new and more efficient ways of doing business. As a result of that initiative, TDMHMR initiated the merger of the administrations of Wichita Falls State Hospital and Vernon State Hospital in January 1996.”

History of Vernon State Hospital

The first state psychiatric facility in Vernon, TX, was a geriatric extension of Wichita Falls State Hospital called the Annex. It was first opened in 1951 at Victory Field, the former World War II Army Air Corp pilot training facility south of the city. It served about 400 “senile-type” patients. In 1967, construction of a new psychiatric rehabilitative facility began on 69 acres at the northwest edge of Vernon. In 1969, Vernon State Center began operation as a state hospital serving general psychiatric patients from 30 counties of northern Texas, independent of Wichita Falls State Hospital. It offered inpatient psychiatric services to a predominantly rural population and also operated seven rural-based outreach centers…

In 1971, the Texas Legislature created a statewide treatment facility for drug dependent youth. Because of Vernon’s remote location from the metropolitan drug scene, it was selected to be the site for this new service…Over the years, the adolescent population evolved: From the first years as a drug treatment facility, the need became one to serve teens with a dual diagnosis of drug dependency and a mental illness. The program – serving an average census of 75 patients — was eventually renamed the Adolescent Forensic Program (AFP) because approximately 90% of the patients had, in addition to a dual diagnosis, an involvement with the law enforcement/judicial system.

In 1983, Vernon State Center’s name was changed to Vernon State Hospital (VSH) to maintain continuity throughout the Texas Department of Mental Health and Mental Retardation (TDMHMR) system.

  • Persons with felony charges who have been found incompetent to stand trial;
  • Persons admitted for pre-trial evaluations for competency and issues of insanity;
    • Persons found not guilty by reason of insanity;
    • Persons from other state hospitals who have been found to be manifestly dangerous;
    • Mentally retarded persons who have been found incompetent to stand trial on misdemeanor or felony charges;
    • Persons from the Texas Department of Criminal Justice (TDCJ) and other jails who need inpatient psychiatric hospitalization. [The hospital has never been asked to fulfill this mandate as TDCJ developed its own psychiatric services.]…

The year 1995 also marked the birth of an initiative between TDMHMR, the Texas Youth Commission (TYC), Vernon State Hospital, the City of Vernon, and the Vernon Business Development Corporation to open a TYC youth boot camp facility at VSH’s South Campus. As a result of the cooperative efforts of all parties, the VSH South Campus (Victory Field facility) was leased to the Texas Youth Commission the following year. The VSH Adolescent Forensic Program transferred to the VSH North Campus in September 1996, moving into four renovated buildings on the south side of the Maximum Security Program. The move necessitated an $8.5 million construction project, resulting in the building of the Mooney Building, which houses the adult Behavior Management and Treatment Program, and the Heatly Building, a new adolescent activity building. It also necessitated additions to the administrative complex, new fencing, and other renovations. By the late fall of 1997, the adult maximum security and adolescent forensic programs were fully operational at one campus location.

In January 1996, TDMHMR combined the administrations of Vernon State Hospital and Wichita Falls State Hospital under the leadership of James E. Smith, Superintendent. This initiative was in answer to the ever-pressing need to provide the citizens of Texas with more effective and more cost-efficient mental health care. Consolidation of the two hospitals became official on September 1, 1998, under the temporary name Vernon-Wichita Falls State Hospital. Nine months later, the 76th Legislature formally renamed the organization North Texas State Hospital, retaining the location names – Vernon campus and Wichita Falls campus – to designate the individual sites.

The Vernon campus of North Texas State Hospital has a history of offering exceptional mental health care to the various groups of patients entrusted to its care and plans to continue to offer the best care available to the specialized populations of patients who are now in its charge. Throughout the years, it has maintained Joint Commission on Accreditation of Healthcare Organizations accreditation as well as a reputation for “country care.” It has become nationally recognized as a benchmark in the forensic mental health care field.

History of North Texas State Hospital

After two and a half years of intensive planning and incremental consolidation, Vernon and Wichita Falls State Hospitals officially became a single mental health care organization on September 1, 1998…the state legislature formally renamed the “new” organization North Texas State Hospital (NTSH).

Today North Texas State Hospital operates two sites 55 miles apart in north Texas. The Vernon campus provides forensic services for the entire state of Texas and offers both a 284-bed Maximum Security Program for adults and a 78-bed Adolescent Forensic Program for dually diagnosed youth ages 13-17. The Wichita Falls campus provides general psychiatric inpatient services for child, adolescent, adult, and geriatric patients with a bed capacity of 330.

Together, the two campuses of the organization comprise the largest state hospital in Texas.

Last updated April 08, 2011″

If our loved one truly loves us, but they are abusive towards us…should we forgive them…and continue to stay with them even though they are hurting us…and emotionally destroying us?

Some folks, because of their raising and emotional stuff, have a hard time saying, “I love you.” or showing their love physically through hugs n’ rubs. Their kids, spouses, and other intimates sometimes develop issues because they are not demonstrative of their love. Their intimates question their love for them because they do not show it. They sometimes feel a void or emptiness because of the absence of verbal and physical manifestations of their love. This can create a great deal of frustration and tension in the relationship. So, just like WE have issues and shortcomings…we have to recognize these folks have their own issues and shortcomings…and the lack of verbal and physical acknowledgement of their love for us…happens to be one of their shortcomings. So, instead of continually questioning whether or not our loved ones love us…we ought to look at the Big Picture of their behavior towards us…how they prove their love in other ways…like the things they do for us and the way they treat us. I believe that love is an action…that when people love us, it is apparent in their behavior towards us.

But this brings up another point. Some people because of their upbringing and trauma experiences, may act in VERY unloving ways towards us. For instance, they may be physically or emotionally abusive. I believe that many of these folks actually love their people, but their emotional issues result in very unloving actions towards us and other loved ones. They act that way…not because they don’t love us…but because of Emotional Mind dynamics…and being abusive is their destructive coping behavior…they yell n’ scream and cuss n’ fuss and they may hit us. Their behavior is not a manifestation of love or lack thereof, but a manifestation of the ugly inside them…all the pain and anger and ugliness from their past. It’s like they “throw up” or vomit that ugliness on those closest to them. Why? Because they have all this toxic stuff inside them…and when they get “Big-Time in Emotional Mind,” the poison is bubbling up inside them…and they blow up…and this stuff blows out…and all over those around them. Why the family and those they love? Well, we are the safe objects…the safest place for the emotional tension to be released. Because we’re safe, we stay with them…and they can “get away with it.” They can explode on us and around us. Point…it’s not about their love for us, it’s about their emotional baggage…their past relationship experiences…their history of trauma…and how they learned to cope with negative emotions. That’s what makes abuse intergenerational. That’s how it gets passed on from one generation to the other. It’s about social learning, trauma, emotional pain and intensity, and destructive coping behaviors.

So, this brings up another point. If our loved one truly loves us, but they are abusive towards us…should we have mercy…forgive them…and continue to stay with them even though they are hurting us…and emotionally destroying us? Should we practice “love is an action” and stay with them? I believe we should protect ourselves and others and get out of the situation…because we’ll never be okay IN this toxic relationship…and if we have kids, we have a responsibility to protect our children and not allow them to be victimized…and exposed to poison. If we remain in the situation, we are just enabling the perpetrator to continue their destructive coping behavior and we are setting the stage for this destructiveness to pass through the generations…to our children and grandchildren. If we have been victimized and have emotional issues because of this, we need to get therapy for ourselves and the other victims to work through this so we are not living our lives…living this out. We have to do something to stop this destruction both in the here-and-now…and in the future. We have to stop the cycle. It will be healing to know though…that the one who hurt us…probably really loved us…but their emotional stuff got in the way of demonstrating that love in all ways. We ought to understand that what they did, had less to do with love…and much more to do with how they cope with pain and stress. They were desperate for relief in the moment, the emotional moment…and they did what “came natural” to them. They did what was “bred into them”…what their role models did…what they learned to do…and what gives them immediate relief in the moment. It’s like their drug of choice.

We all have some undesirable ways of releasing the pressure of the emotional moment. I believe we all enact destructive coping behaviors…some more so than others…and some of these destructive coping behaviors are more destructive than others. Some people are abusive to others and some are abusive to themselves. Some smoke, drink, drug, or overeat. Some over-shop, over-golf, over-work, over-play, over-Facebook…over-sex…etc. Others may withdraw, isolate, under-work, under-eat…etc. We’ve all got “stuff” and our challenge is to find healthy ways of releasing stress and pressure and dealing with our emotional issues and concerns. We’ve got to find Life-Enhancing coping mechanisms and to refuse to do our “preferred” or overlearned destructive coping behaviors.

Introducing the Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook at the Houston Chapter of TAAP Spectrum 2011 Annual Conference

The Thirty-Eighth Annual Houston Chapter TAAP Conference on Addiction Studies
September 22 – 24, 2011

TAAP (Texas Association of Addiction Professionals)

Doubletree Hotel at Bush International Airport
15747 JFK Boulevard – Houston, Texas  77032

DBT-CBT for Co-Occurring Disorders and Destructive Coping Behaviors: A Workbook-Based Group Therapy Program Combining DBT, CBT, and AA Recovery Principles

This 1.5 CEU workshop will be presented by Melanie Gordon Sheets, Ph.D.

from 10:30 – 12:00 pm on Friday, Sept 23th, 2011.

This workshop will provide an introduction to the workbook based DBT-CBT recovery program, a modified DBT program for individuals with affective disorders, personality disorders, and destructive coping behaviors, such as substance abuse, self-injury, suicidal threats, verbal/physical aggression, eating disorders, overshopping, etc. Some key recovery concepts, skills, techniques, and understandings will be discussed and several program worksheets will be reviewed.

Training Objectives:

  • Participants will gain information about the structure of the DBT-CBT program, target populations, problems addressed, and utility in various treatment settings and by various providers including peer support specialists.    
  • Participants will understand the basic dynamics of Emotional Mind which drive emotional dyscontrol, relief-seeking destructive coping behaviors, and the Cycle of Suffering.
  • Participants will gain familiarity with the use of the Wise Mind Worksheet to work through destructive emotional states, thoughts, and impulses to facilitate constructive problem-solving and life-enhancing coping responses.
  • Participants will gain familiarity with the structure and use of a “Game Plan” (a client developed individualized recovery plan) including the use of Rational Mind and Wise Mind to challenge recovery sabotaging Emotional Mind “excuses” and Rational Mind “obstacles.”

Dr. Sheets is the Chief Psychologist at Big Spring State Hospital, the Co-Director of the Lone Star Psychology Residency Consortium internship program, a Clinical Assistant Professor at Texas Tech University School of Medicine, Department of Psychiatry, and the author of the DBT-CBT “Out-of-Control” recovery workbook. She began her career as a mental health technician at Richardson Medical Center in 1985 helping individuals with agoraphobia, substance abuse, depression, Bipolar Disorder, and Borderline Personality Disorder. She earned a doctorate in clinical psychology in 1992 from Texas A&M University where her training emphasized psychoanalytic and Jungian psychotherapy methods. She completed her pre-doctoral internship at the Dallas VA Medical Center in the PTSD Clinic, the Substance Abuse Unit, and Inpatient Psychiatry units. She has conducted the DBT-CBT Group since 2004 for forensic, VA, and general psychiatric inpatients.

The full title of the therapy workbook is “Out-of-Control: A Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook For Getting Control of Our Emotions and Emotion-Driven Behavior (targeting drug / alcohol abuse, bipolar disorder, borderline personality disorder, depression, anger, cutting, and codependency recovery)”published by Recovery Works Publications (2009).

Dr. Sheets will be presenting on the DBT-CBT Workbook program at the North Texas State Hospital Forensic Conference in October, 2011.  Details will follow.  

(click here to visit the Houston Chapter website)

TAAP is a state affiliate of the national organization, “The Association for Addiction Professionals” (NAADAC), formerly known as the National Association for Alcoholism and Drug Abuse Counselors.   The name change reflects the increasing variety of addiction services professionals: counselors, administrators, social workers and others, who are active in counseling, prevention, intervention, treatment, education and research.

For more information about TAAP, visit their website at:  http://www.taap.org

For more information about NAADAC, visit their website at:
http://www.naadac.org


Track Your Emotional Level Using “The Levels of Emotion Chart” from the DBT-CBT Workbook (with Estimates of Emotional Mind and Rational Mind)

The Levels of Emotion Chart provides descriptions of how we FEEL and FUNCTION when we’re experiencing different levels of negative emotion. The levels range from 0-10. At Level 0, we are at peace. At Level 10, we are desperately overwhelmed with negative emotion. Notice the far right columns.  They show how active Emotional Mind and Rational Mind are at each level (this is just a guess though!) This chart helps to gauge or measure our emotional intensity and to better understand the effect our emotional levels have on our ability to participate effectively in our life.

Use the link below to check out the chart and to read the text from the workbook related to the chart.  I don’t know why, but you’ll go to a page view that doesn’t open the file…BUT, if you click the link again when you get to that page…it’ll come up like it’s supposed to!  

The Levels of Emotion Chart – from the DBT-CBT Therapy Workbook by Melanie Gordon Sheets, Ph.D.

Review the levels of emotion in the chart and answer the following questions.

What level are you currently at?

What has been you lowest and highest level today?

What is the level of your best functioning over the past week? the last month?

At what level were you at when “Something Happened” and you ended up having to go into treatment?

At what level should you seek help so you can prevent going into treatment?

Most group members believe we should call our support person, sponsor, counselor, or crisis worker at level 5 or 6. Knowing what they know now, they want to get help BEFORE things begin to get out-of-control. At levels 5 and 6, we still have a fair amount of Rational Mind going on. This helps us to seek support…and to accept the Rational Mind and Wise Mind understandings and suggestions offered to us!

The Dynamics of Emotional Mind and It’s Role in Driving Destructive Coping Behavior: When Emotional Mind Drives…We Wreck Out…and Our Lives Become a Total Wreck

The Dynamics of Emotional Mind - hand-out  092010b

View the pdf file for a readable image – click the link below

The Dynamics of Emotional Mind – DBT-CBT Conference Handout – 072411

This hand-out addresses the dynamics of Emotional Mind and its role in driving destructive emotion-driven coping behaviors (e.g., substance abuse, aggression, eating disorders, etc.)

The “Cycle of Suffering”- when we respond to emotional pain and life problems in destructive, emotion-driven ways, we end up with new problems and increasingly severe old problems…and we feel worse than before.  If we respond to this new level of pain and problems in destructive ways, our pain and problems will continue to intensify and multiply.  Because we’re not working through our pain or resolving our problems, our emotional baggage piles up.  The trauma from the past weighs us down in the present and intensifies present misery.  What could have been temporary pain and problems has turned into long-term pain and suffering.  The only way to get the cycle of suffering to stop…is to stop it.  We can stop our suffering by stopping our destructive coping behavior.  We must turn on Rational Mind to “think through before we do” and we must “follow through” with Wise Mind problem-solving and life-enhancing coping behaviors.

Based on:  “Out-of-Control:  A Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook for Getting Control of Our Emotions and Emotion-Driven Behavior” copyright © 2010 by Melanie Gordon Sheets, Ph.D.   (www.dbt-cbt-workbook.com)

“I Really Don’t Think of You as a Fat Person”: How the Big Picture of the Whole Person Changes the View

I responded yesterday to a LinkedIn discussion started by William Anderson, MA, LMHC, psychotherapist and director at The Anderson Method Therapist Network, and the author of the book, “The Anderson Method:  The Secret to Permanent Weight Loss” which describes his weight loss therapy program.  The discussion topic was, “Do you think there is bias against obese people in the counseling professions?  This is the information I shared on the topic, slightly modified:  

I’m just thinking…and haven’t totally processed this.  I’m thinking that one reason obese folks receive such negative scrutiny along with negative character judgments is that their addiction is very obvious…thus, the judgments come…perhaps similar to the judgments people make of others with obvious addictions…if they recognize the signs of such severe addictions.  In my life, I have been slender and I have been morbidly obese and I’m very aware of the discrimination based on weight, both interpersonally and professionally…and, I was always hard on myself. 

It ALWAYS amazed me when close friends would say, “I really don’t think of you as a fat person.”  At that time, I was huge…and I would say, “C’mon man, I’m wide both ways!” as I gestured left to right and front to back.  Their follow-up responses led me to believe that this was because they knew me as a person, the whole person including my positive personal characteristics and they did not superficially judge me to be a “fat person” as they would others they didn’t know…the nasty generalizations of the stereotypes of a very heavy person.  They perceived me and responded to me based on my character and personality, not the way I looked.

Once I had lost a lot of weight, my obese sister once said…”Isn’t it nice that you are no longer invisible.”  She was referring to the positive acknowledgement that better looking people receive…people show you positive regard and treat you differently.  I then told her how a young man working at a grocery store stopped me in the parking lot as I was pushing my cart to the car and he actually asked me if I would like some help with my groceries.  That was a first.  Had I been heavy and for me, less attractive, would he have offered?  I think not.  Me, I make a point of being nice and acknowledging people who I perceive are not commonly acknowledged or the recipients of random acts of kindness and respect.  Was just thinking….

Link to the LinkedIn discussion

Link to William Anderson’s book on Amazon

Why We Relapse: Desperate for Peace in a World of Emotional Turmoil

I responded today to a LinkedIn discussion started by Elisabeth Davies, MC of Bright Alternatives, Inc.  and the author of “Good Things, Emotional Healing Journal: Addiction.”  The discussion topic was, “Is relapsing with unhealthy substances an attempt to get more peace of mind? Being so passionate about this recovery topic, here’s my long-winded response!

“For many, yes. Many use substances as a coping behavior to help bring their emotional level to a more tolerable or comfortable level. Also, returning to such a behavior reduces the extreme tension of wanting to do it and not allowing ourselves to…thus, the experience of immediate relief or peace in-the-moment. To help us to feel better about relapsing, we’ve probably come up with all types of reasons (emotion-driven lies) as to why it is okay to do and would help us…and how we can also quit again when life settles down, etc…unless of course, it is a major emotional reflex to an immediate stressor and we do it VERY impulsively…without giving it much thought.

Relapsing on substances is little different than wolfing down a big bag of cookies or scoops n’ scoops of ice cream, or starting to smoke again, a “forbidden” sexual encounter….whatever. I think these types of behaviors have to do with attempts to bring an “out-of-control” emotional mind into control…so that we feel better and more comfortable in the emotional moment. It is all about being desperate for relief and doing what brings us relief, often immediate relief. It’s a desperate way to experience a sense of emotional, psychological, and physical peace IN-THE-MOMENT…although we’ll have hell to pay when we come to (when the emotional moment passes and rational mind picks up strength).

When we come to and realize what just happened and are faced with the consequences of our behavior…and the unresolved problem…we feel bad again…and then we may continue destructive coping….chasing “peace in the moment”…When we use destructive coping behaviors to deal with our pain and problems, we enter the Cycle of Suffering. Our problems multiply and intensity and we go through a period of increased pain and suffering as a result.

I believe most people use destructive coping behaviors to some degree (e.g., overworking, oversleeping, physical aggression, yelling, throwing fits, being rude and ugly, ‘always speaking our mind”, lying, gambling, obsessive exercise, cheating, sleeping around, codependency, procrastination, smoking, prescription meds, alcohol, overeating or eating the desired “poison foods” for us, being hyperreligious, narcissistic….and the list goes on and on.) I actually tell my patients that it’s “normal” to be “abnormal” and entirely abnormal to be so perfectly normal and in control of ourselves. We all do some destructive coping behaviors and the healthier or more in recovery we are…the less we do these things…and the more we work VERY hard to stay in control of our emotions, behaviors, and our addictions of choice….and the more we choose life-enhancing coping behaviors instead.

I’m obviously very passionate about this…it’s one of those, “been there, done that, still doing that…having to fight for recovery at times to stay in control…and not to get too far out of control” type of things for me. I believe that when we are in recovery…we remain “works in progress.” Sometimes it’s a daily battle and sometimes, an occasional battle. We’re emotional critters and creatures of habit…and when we hurt or are feeling desperate and “out-of-control”…we tend to fall back into old patterns of relief-seeking behaviors…or to certainly think about doing them!

We’re emotional critters and creatures of habit…and when we hurt or are feeling desperate and “out-of-control”…we tend to fall back into old patterns of relief-seeking behavior…or to certainly think about doing them!”

And you know the more we think about doing them…the more likely we are to finally do them. That’s because the tension is building…we want…and we won’t allow ourselves to have…and we want…we tell ourselves “NO”…and we want…and we’re tired of the pain, problems, tension, and frustration…and we become desperate for relief and peace…that we finally do what we keep trying not to do…and we relapse. Have you “been there, done that?” Have you been through this struggle? It’s a battle of the minds, Emotional Mind vs. Rational Mind and Wise Mind. It’s a battle of wills…willingness vs. willfulness. Which recovery skills do you use to get through the “fixing to relapse” moment? Do you still have these moments?

I believe that one of our major recovery tasks is to learn ways to keep our Emotional Mind in control and to tame our Emotional Mind when it is getting out-of-control. That’s my biggest recovery task…and it’s always a battle of the mind states and a battle of will. Sometimes, I grow tired of the battle and dealing with my emotional, willful self. At those tired, weak moments, I remind myself….”Mel, what do you want…peace and stability or chaos and pain?” Isn’t it horrible that you have to parent yourself even when you’re a grown-up!?

Link to the LinkedIn discussion

Link to Elisabeth’s book:  “Good Things, Emotional Healing Journal: Addiction on Amazon

Link to Elisabeth’s blog

The DBT-CBT Workshop at the 2011 Texas State Conference on Addiction Studies

The Thirty-Seventh Annual TAAP State Conference on Addiction Studies
The Age of Recovery:  Let the Sunshine In!
July 28-30, 2011


Omni San Antonio Hotel at the Colonnade
9821 Colonnade Boulevard
San Antonio, Texas 78230

DBT-CBT for Co-Occurring Disorders and Destructive Coping Behaviors: A Workbook-Based Group Therapy Program Combining DBT, CBT, and AA Recovery Principles

This 3 CEU workshop will be presented by Melanie Gordon Sheets, Ph.D. from 1:30 – 5:00 pm on July 28th, 2011.

This workshop will provide an introduction to the workbook based DBT-CBT recovery program, a modified DBT program for individuals with affective disorders and destructive coping behaviors, such as substance abuse, self-injury, suicidal threats, verbal/physical aggression, eating disorders, overshopping, etc. Some key recovery concepts, skills, techniques, and understandings will be discussed and illustrated via the completion and review of several program worksheets.

Training Objectives:

  • Participants will gain information about the structure of the DBT-CBT program, target populations, problems addressed, and utility in various treatment settings and by various providers including peer support specialists.    
  • Participants will understand the basic dynamics of Emotional Mind which drive emotional dyscontrol, relief-seeking destructive coping behaviors, and the Cycle of Suffering.
  • Participants will gain familiarity with the use of the Wise Mind Worksheet to work through destructive emotional states, thoughts, and impulses to facilitate constructive problem-solving and life-enhancing coping responses.
  • Participants will gain familiarity with the structure and use of a “Game Plan” (a client developed individualized recovery plan) including the use of Rational Mind and Wise Mind to challenge recovery sabotaging Emotional Mind “excuses” and Rational Mind “obstacles.”

The opening of the workshop will be conducted in didactic fashion to provide a basic overview of the DBT-CBT program; however, the program will concentrate on modeling the psychotherapeutic / psychoeducational process of the DBT-CBT inpatient recovery group held at Big Spring State Hospital (BSSH). Twelve volunteers will be solicited from the audience to function as “group members” for this portion of the program. A question and answer period will be offered during the latter portion of the presentation.

Dr. Sheets is the Chief Psychologist at Big Spring State Hospital, the Co-Director of the Lone Star Psychology Residency Consortium internship program, a Clinical Assistant Professor at Texas Tech University School of Medicine, Department of Psychiatry, and the author of the DBT-CBT “Out-of-Control” recovery workbook. She began her career as a mental health technician at Richardson Medical Center in 1985 helping individuals with agoraphobia, substance abuse, depression, Bipolar Disorder, and Borderline Personality Disorder. She earned a doctorate in clinical psychology in 1992 from Texas A&M University where her training emphasized psychoanalytic and Jungian psychotherapy methods. She completed her pre-doctoral internship at the Dallas VA Medical Center in the PTSD Clinic, the Substance Abuse Unit, and Inpatient Psychiatry units. She has conducted the DBT-CBT Group since 2004 for forensic, VA, and general psychiatric inpatients.

The full title of the therapy workbook is “Out-of-Control: A Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook For Getting Control of Our Emotions and Emotion-Driven Behavior (targeting drug / alcohol abuse, bipolar disorder, borderline personality disorder, depression, anger, cutting, and codependency recovery)” – published by Recovery Works Publications (2009).

Dr. Sheets will be presenting on the DBT-CBT Workbook program at the Houston Chapter of TAAP Spectrum 2011 Conference in September 2011 and at the North Texas State Hospital Forensic Conference in October 2011.  Details will follow.  

TAAP is a state affiliate of NAADAC, The Association for Addiction Professionals

Join TAAP through the national association
NAADAC – The Association for Addiction Professionals

NAADAC

By joining NAADAC, you will automatically become a member of TAAP if you reside in Texas.

As a member of NAADAC, you will receive numerous benefits designed to help you grow and prosper as an addiction professional.

NAADAC has memberships available for professionals, students, and even organizations!

For more information about TAAP, visit their website at:
http://www.taap.org

The TAAP 2011 State Conference
July 28-30, 2011
Omni San Antonio Hotel At the Colonnade

Click here for Details

For a draft conference schedule http://www.taap.org/associations/3397/files/matrix%20for%20web.pdf

The information below is excerpted from the TAAP website.

TAAP is the Texas State Affiliate to NAADAC.  NAADAC, The Association for Addiction Professionals, is the largest national organization for addiction-focused health care professionals with 11,000 members.  NAADAC is dedicated to the professional growth and development of addiction specialists.

Our Mission

TAAP seeks to promote the advancement of Addiction Professionals by uniting alcoholism and other addiction counseling professionals throughout Texas.

TAAP organizes and charters local chapters in Texas, and assists in stabilizing and increasing their membership.

By means of legislative initiatives, promotional campaigns and professional networking opportunities, TAAP will promote awareness of the disease of chemical dependency and other addictions and compulsive behaviors.

TAAP will advocate for standards for licensure and certification of qualified counselors to ensure the competency basis of those who counsel alcoholics and other addicts and their families and assure a high order of professional standards and ethics among those in the addictions counseling profession.

Organization Profile

TAAP is a confederation of individual counselors, prevention specialists, and other persons who have a direct interest in the field of addiction.  While the bulk of our membership is comprised of those professionals dedicated to the recovery of alcoholics and drug abusers and their families from the devastating illness of alcoholism and drug abuse, many of our members serve a clientele that suffer from other addictions as well.

United, we have a voice in important and critical matters relating to our association and profession, as well as those we serve.  This unity enhances our capability as individuals and gives us strength in professional matters.  Through a united effort, we are more likely to be recognized in legislative arenas.  Together we can work in partnership with state and federal agencies that regulate our industry, and we can promote public policy that will help us meet our goals.

For more information about NAADAC, visit their website at:
http://www.naadac.org

The organization evolved and became known as the National Association for Alcoholism and Drug Abuse Counselors (NAADAC) in 1982, uniting professionals who worked for positive outcomes in alcohol and drug services. It’s new name is NAADAC, the Association for Addiction Professionals. The name change reflects the increasing variety of addiction services professionals: counselors, administrators, social workers and others, who are active in counseling, prevention, intervention, treatment, education and research.

Houston Chapter of TAAP Spectrum 2011 Conference – Sept 2011 (click here to visit the Houston Chapter website)


 


NAMI | Midland, Texas 2010 Mental Health Workshop – DBT – CBT for Co-Occurring Disorders

NAMI Midland, Permian Basin Community Centers, Midland College, and the Odessa College Psychology/Sociology Department proudly sponsors, “Tots, Teens, and Troops:  Mental Health in 2010” on September, 23rd, 2010.  This workshop will be held at the Midland College Advanced Technology Center located at 3200 West Cuthbert in Midland, Texas.  8 CEU’s will be offered to conference attendees. 

The workshop opens at 9 A.M. with a keynote speech by Dr. Virginia “Ginger” Hilley addressing professional well-being.   Dr. Hilley is a psychologist at Big Spring State Hospital. 

Breakout Session Topics:

  • Infant Mental Health
  • Adolescent Mental Health
  • Veteran’s Mental Health
  • DBT-CBT for Co-Occurring Disorders

Dr. Melanie Gordon Sheets will be presenting the co-occurring disorders training on treatment of individuals with mental illness and substance abuse problems.  Dr. Sheets is the Chief Psychologist at Big Spring State Hospital and has been a clinical psychologist in Texas since 1992.  She has published a workbook based on the DBT group therapy program at the hospital.  This group provides treatment for individuals with major mental illness (Major Depression, Bipolar Disorder, Schizoaffective Disorder, PTSD, Borderline Personality Disorder) and addiction type problems such as bulimia, drug and alcohol abuse, and cutting. 

Dr. Sheets will present 3 break-out sessions.

Part I: When Emotional Mind Drives, We Wreck-Out…and Our Lives Become a Total Wreck

Addresses the dynamics of Emotional Mind and its role in driving destructive emotion-driven coping behaviors (e.g., substance abuse).  Related concepts and worksheets will be discussed: emotion-driven thoughts, emotion-driven lies, the cycle of suffering, and the big picture of my life.

Training Objectives:

  • Participants will understand how Emotional Mind dynamics drive destructive behaviors.
  • Participants will recognize the similarities among various types of destructive/addictive behaviors.
  • Participants will gain familiarity with the use and application of “The Cycle of Suffering Worksheet” and “The Big Picture of My Life Worksheet.”

The Dynamics of Emotional Mind - hand-out  092010b

Part II: Using Rational Mind and Wise Mind to Get Control of an Out-of-Control Emotional Mind

Addresses the role of Rational Mind and Wise Mind in recovery and the choice to utilize life-enhancing coping behaviors to deal with upsetting Emotional Mind states despite impulses to respond in destructive ways. Related concepts and worksheets will be discussed: thinking through before we do, challenging emotion-driven thoughts, looking at the big picture of the situation and our life, and the Wise Mind Worksheet.

Training Objectives:

  • Participants will understand the role of Rational Mind and Wise Mind in recovery.
  • Participants will gain familiarity with the use of Rational Mind and Wise Mind to work through destructive thoughts and impulses and to facilitate constructive problem-solving and life-enhancing coping responses.
  • Participates will gain familiarity with the use and application of “The Wise Mind Worksheet.”

Part III: The Game Plan – An Individualized Recovery Plan Incorporating Rational Mind and Wise Mind to Counter Recovery Sabotaging Excuses and Obstacles

Discusses the development and use of a Game Plan for recovery.  Special plan features include the identification of Emotional Mind “Excuses” and Rational Mind “Obstacles” (true obstacles) that can sabotage follow through with recovery steps and the use of Rational Mind and Wise Mind to challenge excuses and to problem solve to get around the obstacles in our recovery path. A sample plan for “Have Bipolar, Must Quit Drugs and Alcohol” will be reviewed.

Training Objectives:

  • Participants will understand how the Game Plan differs from conventional treatment plans.
  • Participants will understand the format and use of a Game Plan and its application for a wide range of recovery goals.

Melanie Gordon Sheets, Ph.D. is the author of

Out-of-Control: A Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook for Getting Control of Our Emotions and Emotion-Driven Behavior” (2009)  Recovery Works Publications.

Please contact Jill Stephens at 432-570-3333 or Judy Craig at 432-683-3648 for more information about the conference.

The cost is $15 without CEU’s and $30 with 8.0 CEU’s.

NAMI Midland is located at 1204 Lawson, Midland, TX  79701.

The Two Versions of the DBT-CBT “Out-of-Control” Workbook by Melanie Gordon Sheets, Ph.D.

Folks are asking about the two versions of the workbook, the 2009 and the 2010 version.  They are nearly identical, so there is no need to purchase one of each.

One major difference is the title change.  The new title clarifies the struggles FOCUSED ON in the workbook.  Most certainly, the bulk of the material in the workbook focuses on the issues and struggles common to depression, anger, codependency, substance abuse, bipolar disorder, and borderline personality disorder as the new title reflects.

The cover of the workbook lists a variety of common destructive coping behaviors, “emotion-driven coping behaviors.”  Some are frequently addressed in the workbook (revenge, suicide threats/attempts, aggression, saying hurtful things, overeating, and sleeping around) and some are not, like road rage, gambling, and anorexia.  Given these are all driven by an out-of-control Emotional Mind, the skills, attitudes, and understandings taught in the workbook apply just the same.  The new title was added to emphasize what the actual workbook text targets rather than what it applies to!

Some changes were made to the back cover (design and text) and some minor text changes were made.  If you are completing this workbook with a support group (or anyone else!), it doesn’t matter if members have different versions.  The text reads much the same and the pages are consistent across versions.

Honestly, I’d buy the earlier version if the price was a lot cheaper!  Otherwise, I’d go with the updated version.

DBT – CBT Training Workshop – Midland, Texas – June 21, 2010 ~ ~ ~ River Crest Hospital presents “From Chaos and Conflict…to Peace and Stability” – a one-day workshop with Melanie Gordon Sheets, Ph.D.

The images in this posting are reproductions of the actual training brochure.

This workshop is based on the DBT-CBT Recovery Workbook authored by the presenter, Melanie Gordon Sheets, Ph.D. entitled,

“Out-of-Control:  A Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook for Getting Control of Our Emotions and Emotion-Driven Behavior”  Recovery Works Publications (2009).

Training Objectives:

Participants will gain familiarity with the DBT-CBT recovery program including the types of problems and issues it addresses, the treatment groups it best serves, and its use in a variety of treatment settings.

Participants will gain an understanding of the dynamics of the three mind states (Emotional Mind, Rational Mind, and Wise Mind) and their role in relapse and recovery.

Participants will gain familiarity with the use and application of key DBT-CBT worksheets (The Big Picture of My Life, Challenging Negative Judgments of Me, Mindfully Protecting My Peace and Stability, The Cycle of Suffering in My Life, The Well Analogy, The Wise Mind Worksheet, and The Game Plan).

Participants will gain skills for using Rational Mind to challenge the irrational thoughts of Emotional Mind (Emotion-Driven Thoughts) and to talk individuals through urges to respond to emotional situations in destructive ways (Emotion-Driven Behaviors) to facilitate Wise Mind problem-solving and life-enhancing coping behaviors.

Radical Acceptance: Accepting the Unacceptable – Coming to Terms With Our Destructive Behavior to Heal the Emotional Pain of Shame, Guilt, and Regret

I recently responded to a LinkedIn discussion regarding the negative consequences of an individual being found “Not Guilty by Reason of Insanity.”  It was spurred by a Wall Street Journal article entitled, “The Trouble With the Insanity Defense” written by D. J. Jaffe, a co-founder of the Treatment Advocacy Center.  It was printed in the 3-26-10 edition.

http://online.wsj.com/article/SB20001424052748704896104575139801575696436.html

The writer notes, “Not guilty by reason of insanity is an inadequate remedy to violence by individuals with mental illness.” He raised some valid points.

As I work for a state mental health institution which provides treatment for NGRI patients, I responded with the following comment.

Pros and cons. Time in a psychiatric hospital is generally “easier” time than in prison – so that is a definite benefit to the NGRI population. Further, many of our NGRI patients have stabilized to a degree that they are among the highest functioning patients in the hospital and have the highest level of privileges. Those are benefits.

In terms of cons, in general the NGRI population spends more time in a psychiatric facility than they would if they served Guilty sentences in prison. Also, like the article notes, they are often held in a psychiatric hospital long after stabilization and likely safe release to the community. In Texas, the superintendent (CEO) of the hospital has to approve the potential release before petitioning the court for placing the patient on an outpatient commitment. Both the judge and the hospital CEO are risking their careers and reputation if the released patient recommits a significantly violent crime.

The headline test – ‘Judge ordered release of criminally insane man who kills again

In addition, the community mental health officials also have to ‘sign off’ on the release and attest that they can ensure adequate monitoring and treatment to prevent reoffending. It’s a risky business. However, many of the NGRI individuals are truly honorable, caring, competent individuals who regret their actions and strive for a productive life. It is a great shame for patients and victims. Our facility works very hard on behalf of these patients, the courts, and the community to carefully evaluate individuals who appear ready for an outpatient commitment and to ensure a sound outpatient treatment program / support plan is in place for these individuals. It is a risky situation however as a state psychiatric facility, we are charged with providing this service and level of care.”

Marilyn Miller, MS., LPC., a psychotherapist in private practice in San Antonio, Texas, comments in this discussion that she works with individuals with bipolar disorder to help them “resolve enormous shame for their actions during manic phases (pre-medication and -treatment).”  She notes that even though their acts did not involve violence against others, their behavior was so “devastatingly self-destructive” and “so counter to their own ‘real’ values that the hurdle of getting over that shame is quite high.”  She states that she “can not imagine the further horror” for NGRI individuals “knowing that they have taken lives (or attempted to do so).http://www.marilynmillerpsychotherapy.com/

My follow-up response using the vernacular and understandings of the DBT-CBT “Out-of-Control” Workbook I wrote…includes,

As you say Marilyn, it is horribly sad to work with the NGRI’s (or other patients) who are non-psychopathic…and in a period of being out of touch with reality or otherwise ‘Big Time in Emotional Mind’…enacted state dependent destructive behavior…and when they ‘come to’ reality (Rational Mind) and recognize what they have done and the impact on others and their lives…they are in great emotional pain and are devastated by their behavior.  Just this week in group at the state hospital, this came up as we were discussing the consequences of ‘Emotion-Driven Behavior.’  A cloud of great remorse and sadness came over the group in that moment of insight and understanding relating to why things are the way they are in their lives…why their people are so upset with them….and why they have lost so many of the things that they value and cherish.

I teach them that it’s not WHAT happened (like a relationship break-up, conflict on the job, abuse, etc) that has led to such life losses…that it is HOW they responded to the life situation (drugs, alcohol, suicide attempts, physical violence, saying ugly things to people, etc) that has led to the deterioration of their life and the widespread losses of all the people, things, and activities they love and cherish.  This is a painful truth that leads to a major moment of reckoning.  From there, we talk about what we can do to prevent getting ‘Big-Time in Emotional Mind’…and learning ways to respond through Wise Mind when we do experience out-of-control emotional moments.

This past week, this moment in group was so heavy in sadness that I told them that this is exactly why I wrote the workbook and why I am so passionate about helping them in group…that it pains me greatly to be among such neat, wonderful individuals who truly care about their lives and their people…and how it is so sad to live, eat, breathe Emotional Mind…and to be stuck in a ‘Cycle of Suffering’…a cycle of being upset, enacting destructive Emotion-Driven Coping Mechanisms, suffering more losses, feeling worse, continuing destructive copings, consequences worsen, feeling even worse….and on and on and on.

The depth of their pain is what drives me to work so hard to help them to understand Emotional Mind dynamics and to find new ways to respond to life stressors, problems, situations, losses, etc., to STOP the cycle of suffering, and to live a recovery lifestyle so they can reap all the rewards of doing so…to end their pain and suffering and to live a life that provides meaning and satisfaction.

For many, this involves understanding why they have done the things they’ve done, self-acceptance and forgiveness, being committed to change the way they respond to life, developing a Game Plan for recovery, and FOLLOWING THROUGH with their recovery plan.  This process also involves understanding why others have acted in certain ways towards them, acceptance and forgiveness of others, etc.

Another major point I teach them is that their destructive behavior is not a product of WHO THEY ARE as a person…not their character, personality, or true self…but a product of HOW THEY ARE (or were) when they are ‘Big Time in Emotional Mind’…as a result of psychosis, mania, intoxication, great anger or upset, the result of an altered state of consciousness, the one in which they are Big Time in Emotional Mind without any significant levels of Rational Mind going on.  It is not WHO THEY ARE….because most of these individuals are good-hearted people who care about others…and truly care about living a productive life and being kind, loving, and helpful to others.”

For this blog, I’d like to add the following text from Chapter 12:  “ACCEPTANCE” from the DBT-CBT Workbook.  This is an example of applying “Radical Acceptance” to our lives.  Radical Acceptance is about “accepting the unacceptable”….and boy, when we’re in recovery…we’re going to have to do a lot of that!

ACCEPTANCE OF THE BAD, HORRIBLE, ROTTEN THINGS WE’VE DONE

We’re human.  We ALL make mistakes.  When we’ve LIVED IN Emotional Mind, we’ve made MANY mistakes.  We’ve acted impulsively and have made MANY regrettable decisions.  We’re NOT bad, horrible, rotten people.  We’ve just done some bad, horrible, rotten things.  These things happen when people are drinking, drugging, in a manic or psychotic state, or are desperately overwhelmed with painful emotion.  When we’re CLEAN N’ SOBER, on our MEDS, making HEALTHY LIFESTYLE CHOICES, and ACTING IN WAYS to Mindfully Protect Our Peace and Stability, we’re GOOD-HEARTED PEOPLE with good morals and values…and WE CARE ABOUT PEOPLE.

Think of the REALLY NEAT people we’ve met in rehabs, AA, support groups, and hospitals.  They’ve lived a past JUST LIKE US.  They’ve done hurtful things to the people they love WHEN they were in the middle of their addictions and Destructive Coping Behavior.  They’re NOT bad people.  They’re the WALKING WOUNDED and IN THEIR DAYS of PAIN and IMPULSIVITY, they did some painful and impulsive things.  TAKE AWAY the drugs, alcohol, mania, depression, pain, anger, and bitterness…and what’s left are some PRETTY NEAT PEOPLE!

We’re the walking wounded.
We’ve experienced a lot of pain.
Being desperate for relief,
we’ve done a lot of painful things
that have hurt ourselves and others.

Think of two people YOU KNOW that fit that description.  What sort of bad things did they do when they were in the middle of their addictions and destructive coping behavior?  Also describe their character when they’re living a Recovery Lifestyle.  _________________________________________________ _________________________________________________

Our Recovery Task is to ACCEPT whatever we’ve done.  Then, we must WISELY decide which things we CAN DO SOMETHING ABOUT and which ones we CAN’T.  We need to focus our efforts on the things we CAN do something about that are a PRIORITY in our life.  We need to DO WHATEVER WE NEED TO DO to improve these things.  The things we can change that AREN’T A PRIORITY…
we need to LET THOSE GO… FOR NOW.

The things we CAN’T CHANGE…
we MUST let them go.
Letting go is a CHOICE.
It’s a choice for FREEDOM from burden
and a choice for PEACE and SERENITY.
Remember, “God grant me the serenity
to ACCEPT the things I cannot change.”
ACCEPTANCE is what gives us serenity
EVEN WHEN our lives are in turmoil.
It’s how we CHOOSE to THINK about things
and RESPOND to things
that ultimately affects HOW WE FEEL about things.
We can CHOOSE to be AT PEACE with our situations
or we can CHOOSE to be in turmoil.
We CANNOT LIVE NEW LIFE if we live in the PAST.
CHOOSE to let some things go
so you can GO ON with life…
and LIVE NEW LIFE!

Extra margin text from this section of Chapter 12:

We weren’t born this way.
We became this way
because of an Out-of-Control lifestyle.

Our people want us ALIVE and WELL,
so we need to bury the guilt and pain that’s killing us.
We cannot be the person we were meant to be
or live the life we were meant to live
if we are carrying around what makes us wish we were dead.

The only way to start over
is to START OVER.
We do that by accepting

what needs to be acceptedand by moving on down the Recovery Path.

This text was adapted from the DBT-CBT Therapy Workbook – “Out-of-Control: A Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook for Getting Control of Our Emotions and Emotion-Driven Behavior” by Melanie Gordon Sheets, Ph.D. – copyright 2009 – Recovery Works Publications –

Question: Is Spirituality A Major Component Of Your Work – Response: The Role Of Spirituality In The Development Of The DBT-CBT Therapy Workbook

Spirituality IS a major component of my work because it is a major part of who I am as a person and a major driving force for how I live my life.  The DBT-CBT recovery workbook that I wrote was initially written as a Christian DBT-CBT workbook; however, due to the biblical focus, I was not able to use it in the therapy group I conduct at the state hospital.   At the hospital, I was using packets of information (handouts) that summarized the major DBT-CBT concepts without spiritual references.  The patients continually asked for more information to study outside of group, to work on at home when discharged, and to share with their families…while all my time and energy was being spent on developing the Christian workbook.   The pressure mounted and I felt I had to leave the Christian project and develop a secular workbook for use with my patients.  Believe it or not, I feel God blessed that endeavor and guided the writing of the secular workbook.

Here’s the brief story.  While working on the Christian workbook, I became pregnant at the ripe age of 43 and naturally lost the energy and focus on the workbook.  I ended up losing the baby and did not immediately resume work on the workbook after physically recovering.  Within months, the internal (and external) pressure to write a workbook for patient use was mounting and by the following January, I was absolutely tormented by it…I had no peace.  I was so burdened by my lack of focus on the workbook that I had to complete a Wise Mind Worksheet to deal with it!  Of course, the end result was to set a date to re-engage in the writing process, but to abandon the Christian workbook to focus on a secular one.  I finally said, “Okay God, I’ll do it…I’ll start on January…” and I specified the date.

Amazingly, at that moment of submission of my will, I lost that pressure…that tormenting burden…and I finally felt “at peace.”  Oddly enough, as I write this now, I realize the date set  was the time period when the baby was due…towards the end of January that year…pretty cool synchronicity!

When the agreed upon start date came, I got back into the workbook as I agreed to do.  I took out all the biblical references and began writing it for a secular audience.  I remained insanely focused on the project for the following 23 months…until I “got ‘er done!”  That was 23 months of near “24-7” focus on the workbook during non-hospital job waking hours!  Everywhere I went, the workbook went…kid sport practices, rodeos, traveling even 45 miles from home, “vacations,” and even to Six Flags!  I said it was an “insane” focus!

Once the book was in print, I’d flip through it…and would be stunned at the amount of work and time that went into it.  It is astounding.  I’ve often said of myself that “I was born to work” and I’ve recently decided that my degree of task energy and persistence is a God given quality…because it is soooo unnatural…and if I had it my way, I’d play and entertain myself instead!  I whole-heartedly believe that God is the driving force that has enabled me the capacity to pull off the projects I have pulled off in my life!  Without the hand of God in my life, I really don’t think I would have made it through all the life experiences I have been through…the good ones and the bad ones.

All in all, spirituality is a major driving force in my life…something that defines my life…and thus flows into all aspects of my work…and not just in the form of “works”…but also in how I choose to interact with the people that are a part of my life…including the patients I serve!

What about you?  How does your spirituality affect your work?

What Frees You To Be Yourself…And To Achieve To Your Potential: Acceptance Of Self And Others From A DBT-CBT Perspective

I came across a discussion item on LinkedIn a little while ago about “What frees you to achieve to your potential.”  The individual posting the question focused on “self-discipline”…well, that was not what I had in mind when I read the discussion headline in my email.  Here’s my response!

“I believe self-discipline is a must, but that hasn’t set me free…it burdens me because I am overly-driven. I believe that my tenacity, perseverance, and ability to stay at a task long after others would have left it is a God-given gift…yet sometimes, I think it is also a curse! I guess I haven’t incorporated the “balance” component yet!However, I also believe that I am able to step out of my comfort zone, put myself “out there” or extend myself, try things…and achieve some pretty awesome things now and then because I do not expect that I will be perfect and I recognize that foibles, errors, and imperfections are very human. I realize that not everyone will like me or my style…and that’s okay…because not everyone will! No matter how great someone is…there’s always critics in every corner!I believe acceptance of my humanity and acceptance of the varied temperments of others helps to free me to be myself…extend myself…and be who I was designed to be…and do what I was designed to do. That sure helps me to work through the neurotic self-doubt and shame that has haunted me over the years.”

As I considered that response, it reminded me of a section in the introduction of the DBT-CBT Workbook I wrote last year.   This section is entitled, “Saving Face: DBT-CBT in Action” and the text from this section is below.

You’ve heard the saying about “stepping in it.”  Well, I sometimes “step in it”…and the work of this book is no exception!  I spoke to a professor at Texas A&M, Dr. Brian Stagner, about reviewing this workbook.  He was my mentor during graduate school and he graciously agreed.  Although I’m proud of this work, at the same time, I’m a little embarrassed by it!  That’s a dialectical problem by the way!  I figured he’d be impressed by the content, but stunned by the language and grammar…so, I never sent it to him!

Part of DBT-CBT is Choosing Our Battles and Taking a Stand and Fighting for what’s MOST IMPORTANT to us…NOT EVERYTHING in life.  It’s also about being prepared for and accepting the consequences of our behavior and choices.  It’s also about being wise…and we’ll see if I made a wise choice!  I expect to take some hits on grammar, like dangling participles, commas instead of semicolons, overuse of contractions, pronoun and antecedent disagreement, Texas slang, and other informal language and grammar.  The truth, I wrote this for the average person and in a language many people speak…except for some southern slang!  It wasn’t written for a professional audience, though I hope many in that audience will read it.  I’m an informal, “down-home girl” and I wrote this for “down-home people.”  I CAN BE formal if I have to be, but I certainly PREFER NOT!

Another criticism I expect is repetition in the workbook.  I tried to write this as I would speak it and teach it in Group.  When I teach important principles and concepts, I often repeat myself by explaining the same thing in different words…one sentence right after another.  Sometimes, hearing something said in different ways helps us to understand and remember it better…and if our minds have wandered, maybe we’ll get it the second or third time around!  I’m very invested in the people I work with…and I’m passionate about doing my part to change lives.  I drill home some points because this is intended to be a learning AND recovery experience.  It’s NOT designed for casual reading or entertainment purposes!

You’ll notice some repetition across chapters. My belief, most people don’t have audiographic memories…like they hear something once and remember it. My goal is for people to understand and remember these life-changing principles, concepts, and skills…so they’ll be equipped to apply them in Real Life. Many of us are hard-headed and need this information drilled into our minds. We may not WANT to hear some things and we may not be ready to look at or process some things. We usually have to be emotionally MOVED before we DECIDE to make difficult life changes. Being MOVED often involves looking at the Big Picture of Reality until our eyes are opened and the truth sinks in. Further, to learn how to carry out these skills and to live these concepts…we need to live, eat, and breathe this information until we know it so well we can repeat it back to ourselves. We LEARN by repetition.

Also, everyone doesn’t read a book cover to cover in a few days.  When time goes by, a review of important principles and concepts helps us to get the most out of what we’re reading.  Further, when we’re stressed out by life, our brain is working full capacity to survive and meet here-and-now demands…and it isn’t always so able to fully process and learn new information.  On top of all this, some of us have used a lot of drugs and alcohol, are aging, on medications, or have had head injuries…and our attention, concentration, and memories aren’t like they used to be!  Also, some folks have had learning problems all their lives.  Others may have symptoms of mental illness which affect their ability to concentrate.  In my mind…REPETITION IS GOOD!

The last point of embarrassment is…there WILL BE errors and typos…and Lord, I hope not…lost lines…where they disappear when the document is printed.  I know I’m obsessive-compulsive…a perfectionist in many ways.  I could review this book for ANOTHER year…and continue to make changes.  However, if I don’t GET ‘ER DONE…it’ll be half of forever before it’s in print and can be helpful to people who are HURTING and SUFFERING.  Getting this in print is much more important than perfection and my ego.

Some folks don’t like how I’ve used CAPITAL LETTERS.  I took some out, but left many.  Again, I’m trying to drill home points.  The capital letters are intended to draw attention to important principles and concepts…things I really want folks TO GET and be aware of!  Sometimes, they’re for emphasis (like to say louder when we’re reading), but most often they’re there to highlight a point.  The capital letters may make reading a little difficult until you get used to the writing style.

So, I resolve my dialectical problem of being both proud of this work and embarrassed by it.  I realize I want to print the PERFECT book to please a professional audience…however, I also recognize this book is for the average person who desperately seeks recovery.  THAT IS its value and purpose.  I ACCEPT that no matter how obsessive-compulsive and perfectionistic I am, I’m not perfect and I’ll make errors despite my best efforts to avoid them.  I also understand that although I’m a highly educated professional, it’s not my spirit to interact with the world in a formal manner.  I’m different, I’m down-to-earth, I am ME…and I’m okay.  Some people will accept and embrace this work…others will criticize it.  I understand some people will find fault no matter what…but, I’ve “stepped in it” and have set myself up for criticism because I haven’t used proper grammar or writing rules.

I’ll take my hits, do Damage Control, fix things as I see appropriate, and I’ll move on down the Recovery Path…and on with life!  Perhaps our paths will cross as we journey through the Pathways of Recovery.  Hope to see you there.

And to that, I say, “AMEN!”

So, what frees you to be yourself…and to be who you were designed to be…and to do what you were designed to do?

This text was adapted from the DBT-CBT Therapy Workbook – “Out-of-Control:  A Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook for Getting Control of Our Emotions and Emotion-Driven Behavior”  by Melanie Gordon Sheets, Ph.D.  – copyright 2009 – Recovery Works Publications

Working Through Verbal and Emotional Abuse: Challenging the Lies We’ve Come to Believe Using DBT-CBT Therapy Techniques

The following is an amended excerpt from the DBT-CBT Workbook. It is from Chapter 8, “Challenging Extreme Judgments,” which focuses on the negative things we say to ourselves (and believe) and the negative things others have said of us that we come to believe as truths about us.

When we’re mad or hurt, we sometimes say very hurtful things to ourselves and others. This is Emotion-Driven Behavior. Our hurtful words are based on how we’re thinking and feeling in the Heat-of-the-Moment! They’re ANGRY WORDS. We’re not in Rational Mind and we’re not speaking truth. We’re expressing HOW WE FEEL about people and things WHEN WE’RE MAD OR HURT! Words driven by a heated Emotional Mind SHOULD NOT BE TRUSTED!

The purpose of this chapter is to recognize that these statements are borne from Emotional Mind…an angry, depressed, or discouraged state of mind. They are Emotion-Driven Lies…not Rational Mind truths. The worksheet for this chapter, “The Challenging Negative Judgments of Me Worksheet” leads us through the process of challenging these lies through Rational Mind. We identify a particularly hurtful statement that has negatively impacted our self-esteem and self-concept and we identify characteristics of ourselves that prove that we are not that way. Then, we are challenged to answer the question…”What is rational to believe…that statement that came out of the mouth of someone who was upset and irrational in the emotional moment…or all these facts about ourselves that prove otherwise and the hundreds of people that agree we really are this kind of person?”

THESE TRUTHS SHOW HOW MUCH OF A LIE the negative judgment is…and has been. The judgment was NOT based on truth. It was an EMOTION-DRIVEN LIE MADE UP about us…and WE HAVE LIVED SO MUCH OF OUR LIFE BASED ON THIS LIE. We have believed the lie. We have NOTICED EVERYTHING that supported the lie, and discounted, overlooked, and IGNORED ALL THE THINGS that challenged the lie…all the things that prove we’re NOT stupid, worthless, or undesirable. LET THAT SINK IN. What was said about you is A BOLD-FACED LIE. IT IS NOT TRUTH. We know that now because THE FACTS PROVE IT! Anytime those old feelings come up, be ever so Mindful of the facts and the TRUTH. TAKE A STAND and RATIONALLY CHALLENGE THE LIE…right then and there. Don’t EVER let yourself get away with believing that lie again. RATIONALLY CONFRONT IT and DEFEND YOURSELF!

The following is the text that follows this worksheet and discussion directly about it.

APPLICATION: The Origin of the Judgmental Lies

Most of the negative judgments made about us…were first said to us when we were young. They were NOT based on anything about us…not a character trait or a personality feature.

When someone tells a 3 or 4 year old child that they’re worthless, stupid, or will never amount to anything…or they’re too much of this or too little of that…or no one will ever love them…IT’S AN EMOTION-DRIVEN LIE. How in the world can someone know something like that about a very young child? This type of meanness, ugliness, and hurtfulness SPEAKS VOLUMES about the person making the statements…AND SAYS NOTHING ABOUT THE CHARACTER OF THE CHILD.

We know that when WE make ugly and insulting comments to others, we’re being verbally abusive. Oftentimes, we’re mad and we say these things in anger. Likewise, THE PERSON saying ugly things to us is UPSET, too. Often, THEY FEEL stupid, irresponsible, or worthless and THEY TAKE IT OUT ON US. Most of them were emotionally abused…and are just MINDLESSLY PASSING IT ON to the next generation. Also, they may suffer the moodiness and impulsivity that goes with drugs and alcohol, Bipolar Disorder, Borderline Personality Disorder, etc. For whatever reason, they’re BIG-TIME IN EMOTIONAL MIND and they’re being verbally and emotionally ABUSIVE to us. When we’re YOUNG or VULNERABLE, (22) WE TRUST THEIR OPINIONS and come to BELIEVE what they’re saying. However, WE’RE BELIEVING AN EMOTION-DRIVEN LIE.

When we did “The Challenging Negative Judgments About Me Worksheet,” we CHALLENGED the EMOTION-DRIVEN LIE by looking at the Big Picture of Our Life THROUGH THE EYES AND TRUTH OF RATIONAL MIND. When we review this worksheet and consider all the things about us that support we’re capable people with worth and value, we’re functioning in Rational Mind. When we make a DECISION that WE’LL NO LONGER JUDGE OURSELVES in a FALSE and HURTFUL manner, we’re functioning in WISE MIND. When we’re DETERMINED that ANY TIME those old thoughts or labels COME TO MIND, we’ll CHALLENGE THEM and REMIND OURSELVES of all the things about us that PROVE otherwise, then, we’ll be USING WISE MIND TO MINDFULLY PROTECT OUR PEACE AND STABILITY.

ANY TIME, ANY ONE of those NASTY JUDGMENTS comes into our thoughts and begins to hurt us, WE NEED TO CHALLENGE THEM…right then n’ there. (23) We need to STOMP THEM OUT and REFUSE to allow them to CONTROL US any longer. They are lies. WE HAVE BEEN LIVING A LIE. We have perceived ourselves based on a lie. DO NOT ALLOW THESE LIES TO CONTROL YOUR LIFE ANY LONGER! DO NOT ALLOW THEM TO TAKE AWAY your peace and stability! They’re things Coming At Us that have NO PLACE in our Inner Circle.  TAKE A STAND against these lies…and FIGHT FOR YOUR RECOVERY!

APPLICATION: Stupid Is as Stupid Does?

At this point, some folks say, “When they said that, I had done something stupid or irresponsible.” Remember, we’re human. We’re not perfect. Things WILL happen.  That’s our humanity! One stupid behavior or 10 or 12 of them means we did one stupid behavior or 10 or 12 of them. Those things describe our behavior in-the-moment or the month. They DO NOT define WHO WE ARE as a person or WHAT WE’RE CAPABLE OF. They DO NOT define our character or our make-up. THEY DEFINE AN event, action, or a behavior…NOT our WHOLE person. Just because the 8th grade educated shift team leader made a mistake, that doesn’t mean he’s stupid. That means HE MADE A MISTAKE…THAT DAY. That mistake and an 8th grade education DOESN’T describe what he’s capable of. Those things DO NOT define his character or describe everything he has ever accomplished in life. HE IS NOT STUPID. He simply made AN ERROR.(24) Stupid ISN’T as stupid does!

There may be times in our life when we make many errors…even when we totally mess things up for a year or two by making one bad decision after another. DOES THAT MEAN WE’RE STUPID? NOOOOOO. It means we’re DYSREGULATED (25) and LIVING Big-Time in Emotional Mind. It means we’re making a lot of Emotion-Driven decisions which ARE STUPID. That DOESN’T MEAN WE ARE STUPID…you know why?    Explain. _________________________________________________________________________
_________________________________________________________________________

We’re NOT stupid or clueless. In our gut, we usually know our behavior is going to cause problems BEFORE we do it! We have Wise Mind going on, but we’re NOT PAYING ATTENTION TO IT. We’re NOT Following Through With What We Know is in our best interests…because WE’RE BIG-TIME in Emotional Mind! WE’RE  DYSREGULATED… we’re LIVING IN-THE-MOMENT. We’re uncomfortable…we hurt…we’re not worrying about tomorrow. We’re living for TODAY…and if it feels good…we’re going to do it!

Are we STUPID because we do it?  Explain. ___________________________________
____________________________________________________________________

No, we’re NOT STUPID. We’re ACTING in poor judgment. We KNOW better.  We know right from wrong…and good from bad. We DO stupid things because EMOTIONAL MIND IS DRIVING. That’s why we SPIN-OUT and LOSE CONTROL.  That’s why we wreck-out and our life becomes a total wreck.

So, does that mean we have poor judgment?  Explain. __________________________________

____________________________________________________________________________

NO…because WE HAVE GOOD JUDGMENT! We KNEW it was stupid or of poor judgment…but we did it anyway! We KNEW it was going to end poorly, but we DIDN’T CARE AT THE TIME. We just did what we WANTED to do…
and no one or nothing was going to stop us. We were being VERY WILLFUL.

What we did was EMOTION-DRIVEN Behavior. We do all types of MINDLESS and IMPULSIVE things when we’re acting on Emotional Mind…ESPECIALLY WHEN WE’RE IN A DESPERATE STATE, like desperate for relief, desperate for comfort, or desperate to be held and loved on. It’s NOT STUPIDITY. It’s DESPERATION. You’ve heard the saying, “Desperate times call for desperate measures.” Well, desperate measures often involve risky things that are likely to have a bad outcome. So, BECAUSE WE’VE DONE SOMETHING STUPID or two years or ten years worth, that DOESN’T MEAN WE ARE STUPID. That’s because WE KNOW BETTER.

WE JUST DO IT ANYWAY! Gladly, this workbook is about GETTING CONTROL of our BEHAVIOR and our LIFE! And, we do that by Turning On RATIONAL MIND and WISE MIND to REGULATE and CONTROL our dysregulated and Out-of-Control emotions and Emotion-Driven Behavior.

Footnotes:

22- If we’re older when these lies were spoken, they usually came from an abusive spouse or romantic partner.  Over time, we’ll realize these people were angry, mean, harsh, moody, and unfair.  We KNOW their words were Emotion-Driven.  We KNOW they’re abusive, mean, and critical people, but for some reason, we believe their ugly opinions.  We believe they’re right and other people are wrong.  Go figure.  The truth, we were vulnerable and they took advantage of it.  Often, they were mean to “keep us in our place”…in a “downed position” with low self-esteem.  They wanted us to believe we ARE stupid, unworthy, and not capable…so we would never have the strength to leave them.

23- Whenever a negative judgment begins to bother you, either complete “The Challenging Negative Judgments of Me Worksheet” in your mind or on paper.  Use this RECOVERY TOOL to challenge those lies!

24- I’m pretty smart with a Ph.D…that just gives me a license to be  Piled Higher and Deeper in errors!  Lord knows if it’s 10AM and I haven’t made an error yet, I must still be asleep!

25- Dysregulated – (dis-reg-you-lated) – not in control of ourselves… we’re not able to regulate or control our behavior.

Extra margin text below:

No matter how smart we are or how much psychological stuff we know, we can get side-swiped and wrecked-out by a hurtful comment.

When we believe these lies and base our sense of self and identity on these lies, we’re viewing ourselves through Emotional Mind.  We’re not dealing with the facts and the truth.  We’re overlooking, ignoring, and denying all the things which tell us we aren’t that way…and we’re focusing on ALL the things which suggest we may be that way.  We’re ignoring what Rational Mind is telling us and we’re viewing ourselves through the distorted lenses of Emotional Mind.

We have thought poorly of ourselves and have treated ourselves poorly because of a lie.

We ARE going to do some stupid and thoughtless things now and then, but that doesn’t mean we’re a stupid and thoughtless person.  It means we DID SOMETHING that was stupid or thoughtless.

We ACTED in poor judgment.  We went against our good judgment.

“Then how do we describe this stupid, poor judgment behavior?!”   We describe it as DESPERATE behavior.  It’s not an issue of smarts.  It’s an issue of being desperate and dysregulated!  It’s an issue of being OUT-OF-CONTROL! We know better, but we do desperate, self-defeating things anyway.

This text was adapted from the DBT-CBT Therapy Workbook – “Out-of-Control:  A Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook for Getting Control of Our Emotions and Emotion-Driven Behavior”  by Melanie Gordon Sheets, Ph.D.  – copyright 2009 – Recovery Works Publications

Using Rational Mind to Challenge the Emotional Mind Lies We Tell Ourselves That Sabotage Our Self-Confidence and Recovery: A View of Addiction Recovery from a DBT-CBT Therapy Perspective

Here’s an “adapted” excerpt from the DBT-CBT “Out-of-Control” therapy workbook.  It’s from Chapter 7, the Rational Mind chapter.  This chapter discusses Rational Mind in detail and offers many Rational Mind challenges for the Emotional Driven Lies we tell ourselves AND WE BELIEVE…ones that often sabotage our self-esteem and our recovery.

The Self-Fulfilling Prophecy of Failure:
“I expect to fail so I don’t try very hard …so, I fail.”

SKILL BUILDER: Failing to Succeed…or Successful Failures

Consider the lies we tell ourselves about success and failure, like,

“I’ll NEVER be  able to do it.”

“Everything I try gets screwed-up somehow.”

What do you say about your failures?  ____________________________
________________________________________________________

The truth…we MAY HAVE failed at MANY tasks.  If so, we need to rationally understand why.  Quite often, we fail because we DON’T TRY to succeed.  We “KNOW” we can’t do it…so we DON’T TRY, or we DON’T TRY VERY HARD.

Despite USUALLY giving things ONLY A HALF-HEARTED EFFORT, we may recall some times WHEN WE REALLY TRIED, but failed anyway.  BUT, DON’T THINK we’re off the hook because of some FULL EFFORT failures.

WE DON’T GET TO STOP TRYING just because when we’ve REALLY TRIED, we’ve still failed!  Rational Mind would inform us that MOST PEOPLE WHO SUCCEED HAVE FAILED MANY TIMES.  There are many TRUE stories to support this TRUTH.

Which stories have you heard…about people who FINALLY SUCCEED AFTER A LONG STRING OF FAILURES? _____________________________
_____________________________________________________

Abraham Lincoln ran for MANY political positions and lost MANY TIMES before he ever WON an election.  The ONE he won was THE BIG ONE…the PRESIDENTIAL election!  There are MANY stories about business leaders who had MANY failed businesses before they hit it big!  Henry Ford went bankrupt 5-6 times because of failed businesses before he gained success in the automotive industry.  The Heinz company had the same kind of start.  Have you read that Oprah was fired from a reporter’s job because she wasn’t right for TV?  Somebody certainly misjudged her!

Some of our greatest leaders and wealthiest people failed many times
before they achieved great success.

When we fail, we need to SEEK AN UNDERSTANDING of WHY we failed.  We need to LEARN FROM IT and CORRECT WHAT WE’RE DOING.  We need to change or adjust our plan to deal with what went wrong.  Successful “failures” start with PLAN A and go to PLAN B, C, D, E…and so on until things work out!  Despite their failures, THEY KEEP ON KEEPING ON!

It’s also important to be Mindful of our successes and accomplishments and to note WE’VE ALL HAD SOME!  We also need to realize that WHEN WE’VE TRIED…when we’ve REALLY STUCK WITH IT, we’ve overcome challenges…and WE HAVE BEEN SUCCESSFUL. Consider the 8-18 attempts at recovery that it takes people ON AVERAGE to become clean n’ sober.  Through our recovery attempts, we learn about our triggers and relapse patterns.  We learn we REALLY HAVE TO change the things in our life that we DON’T WANT TO CHANGE…things that we’ve refused to change, like friendships, activities, and abusive or conflict-filled relationships.  Because of our repeated failures at recovery, we FINALLY SUCCEED!  That’s because we’ve revised our Recovery Plan SO MANY TIMES that we FINALLY GET ENOUGH OF THE NECESSARY CHANGES made!  We’re hard-headed and we’ve got to learn from OUR experiences…and in the world of recovery…these experiences ARE OFTEN RELAPSES.

Does this information change the way you think about your “failures”?  If so, explain.  ______________________________________________
___________________________________________________

Changing our LIFESTYLE and our LIFE IS VERY DIFFICULT.
We need to ACCEPT OUR FAILURES

and UNDERSTAND they’re a NATURAL part
of the LEARNING PROCESS…
IF we learn from them.

It’s clear that Emotion-Driven Thoughts like, “I can’t do it. Why try?” are lies we tell ourselves. What’s the truth? _______________________________
______________________________________________________

The truth is, WHEN WE KEEP TRYING, things FINALLY work out.  Sometimes, we don’t succeed because we aren’t going about it the right way.  Therefore, we need to get a NEW PLAN.  Sometimes, we try to do more than is do-able at one time.  We plunge head first when we’d be better off wading in and taking smaller steps!  There are many reasons why we haven’t reached our goals.  Fortunately, most of these problems can be overcome with PERSISTENCE and a REVISED GAME PLAN!

Footnote: This footnote is “margin text” from the workbook alike the dark red inserts in the text above…however, these weren’t so easily woven in!  This first one relates to the 8-18 tries at recovery it takes on average to recover from substance abuse.

“Some say, ‘Been there, done 14, I’ve got to be real close to making it!’ Folks who are new to recovery are discouraged, ‘I don’t want to do this that many times.’ Be Mindful that 8-18 is an average. Some make it on the 1st try (they need to write the book!), others on the 25th. Some make it in 3 tries, others in 20. Bear in mind though…these numbers don’t mean it’s okay to relapse 17 times and then work real hard on the 18th try!”

These are “sayings” in the margin that go along with the text:

“If we don’t put forth a FULL effort,
we’ll never REALLY KNOW if we can succeed.”

“We never fail until we quit trying.
Success comes to those who are determined
to overcome obstacles in their path.”

When we understand that our failures are part of the learning process,
then we can constructively accept our failures and learn from them.

We’re so willful and hard-headed about recovery…
we won’t take someone’s advice or learn from THEIR experiences.
We have to learn from OUR personal experiences…
which is often OUR failures!

A mistake is only a mistake
if we fail to learn from it!
When we learn from our experiences,
our failures become a stepping stone toward success!
Therefore, a recovery goal is to Turn On Rational Mind to challenge our “failure” lies…
and to Turn On Wise Mind to make some adjustments to our Game Plan!
That’s because WE haven’t failed, our plan has!

Hope you enjoyed this blog entry and that it helps to challenge destructive “failure” thoughts.  It took half of forever to format this…the format of the workbook doesn’t cut n’ paste very well…or at least I haven’t learned yet how to do it more efficiently!  Life is one big learning curve and I guess sometimes we’ve just got to hold on…persevere…and enjoy the ride!

How Could Someone Try to Kill Themselves: Suicide Attempts and Doing the Unthinkable – from a DBT-CBT Therapy Perspective

When Emotional Mind drives and Rational Mind is left on the side of the road…

When folks are moderately, even severely depressed (say up to an 8 or an 8.5 on a scale of 1-10), they are “Big-Time in Emotional Mind” but they still have some Rational Mind going on (say 85% Emotional Mind and 15% Rational Mind).  Through the small degree of Rational Mind, they maintain some contact with reality and have some mindfulness of the big picture of their life. For instance, they still recognize they have something to live for…they still have some holds on life…and although their grip is loosening and they may be barely holding on…with at least some Rational Mind going on, they recognize the basics…like they have kids to live for…or pets…or their dying parent (examples).  However, as the depression worsens, Emotional Mind intensifies, and Rational Mind further fades…and they lose awareness of these reasons to live.

Patients in various ways have explained how this happens.  They relate that when they made that final decision to kill themselves…to enact that near fatal behavior…they weren’t  thinking…that previously they thought about their kids, their spouse, or other holds on life and they struggled to stay alive…but then, something happened and they no longer thought about these things.

One patient so well described this to me, I haven’t forgotten it.  She said that as her depression deepened, it was like she was going further and further down a well…and the deeper she went, the less she could see out.  She related that she got so far down, she was surrounded by darkness…she could no longer see nor feel…and she lost touch with the love she had for her kids and concern about what would happen to them.  She cried intensely and said that when she did what she did, thoughts of her kids did not cross her mind.  It was utterly heartbreaking, and yes, as a therapist and despite trying to hold my tears back, they rolled out of my eyes.  I stood up and hugged her as she wept and gently rocked her to help soothe her through the pain. It was one of those heart-wrenching therapy moments when I had no words to comfort her and could only pray for her self-forgiveness and healing.  She so loved her babies and could not understand how she could have tried to end her life.  With Rational Mind going on, she realized she did the unthinkable.

I believe that she became 100% (or near 100%) Emotional Mind…and Rational Mind was essentially turned off.   Without Rational Mind, she was not connected or in contact with the reality of her life and what really mattered to her.  It was like a Rational Mind black-out.   She was no longer mindful of the big picture of her life and the reasons to continue the fight.  And we always ask, “God, how could she have done that, she has kids” or “How could he have done that knowing his family would find him.”  They weren’t thinking…that part of their brain was turned off.

Based on the recovery workbook by Melanie Gordon Sheets, Ph.D. -<span
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The DBT-CBT Workbook: Worksheets, Activities, Charts, Questions, Skill Builders, Tracking Sheets, and other Special Features

The Special Features of the DBT-CBT Out-of-Control Workbook

“Statements of Support and Encouragement” –  the first two pages have space for our support people to write statements of support and encouragement for our journey through the pathways of recovery.

“Table of Contents” – a detailed 7-page table of contents not only lists the chapter titles, but also the major topics or sections in each chapter.

“Introduction” – the book opens with a general introduction to the program.

“FAQs and More” – an opening section that answers several “frequently asked questions” about the program and workbook.

“An Overview of the Three Mind States” – a two-page chart describes Emotional Mind, Rational Mind, and Wise Mind so folks have a general idea of what these are before they begin reading the book.  In addition, various emotions are listed with examples of the types of emotional thoughts that go with them. Then, examples of how Rational Mind and Wise Mind might respond to these emotions and thoughts are listed.

“An Overview of the DBT-CBT Process and the Pathways of Recovery and Relapse” – a flowchart shows how we use Emotional Mind, Rational Mind, and Wise Mind to deal with difficult life events and emotions in a healthy, recovery-based way.  The chart also shows what happens when we act on our emotions without using Rational Mind or Wise Mind. A written description of this process is also provided. This also serves as a very good overview of the DBT-CBT program.

“How Bad Do I Really Want Recovery?” – an introductory worksheet to help us gauge our readiness for recovery…before we get started with the workbook.

There are 14 chapters in this workbook:

The Nature of the Problem

The Big Picture of My Life

The Pathways of Recovery

Mindfully Protecting My Peace and Stability

Mindfulness Is a Skill

Emotional Mind

Rational Mind

Challenging Negative Judgments of Me

Wise Mind

The Wise Mind Worksheet

Distress Tolerance

Acceptance

Life-Enhancing Coping Skills

The Game Plan

“Rest Stops” – the 14 chapters are divided into three sections.  After each section is a “Rest Stop” which provides a summary of each chapter in the section, “Where We’ve Been…What Ground We’ve Covered.” The Rest Stops also tell us “Where Do We Go from Here” or what we are getting ready to cover in the next section or sections.

“Applications” – the “general knowledge” information presented in the workbook is applied to situations that are familiar to us. The information is applied to Real Life…and often it’s our life that it’s applied to or the lives of people we know.

“Skill Builders” – these are activities and worksheets that help us to practice and apply the skills and concepts we’re learning.  Several are highly therapeutic and will lead us to major insight, self-understanding, and change.

Workbook Questions – the pages of the workbook are FILLED with “workbook” type questions. These help us to process the material and apply it to our life. “Answers” or comments can be found in the text following most questions.

“Chapter Reviews” – each chapter ends with a set of questions about the material and space for writing responses to these questions.

“For Reflection” – at the end of each chapter is a lined space to “journal” or write.  We’re encouraged to write about whatever comes to mind or heart.  Some ideas for what to write are listed in the margin…such as how the material relates to our life, how it affects us, motivates us, what we have learned, major insights, etc.

“The Concepts and Skills Tracking Sheets” – worksheets at the end of each chapter which list the major concepts, principles, understandings, and skills presented in the chapter. They are a tool to help us learn, practice, and apply the skills and information in each chapter. They help us to remember what we’ve read and they offer a way to TRACK our practice and Real Life use of the recovery skills and understandings.

Margin Text – the left side of each page has a 1-1/2 inch margin that provides the following information and features:

Definitions – easy to understand definitions of words used in the text.

“Phonetic” or “Sound-Out” Spellings – spellings of less common or hard to pronounce words.

“Footnote Style Numbering” – the margin items listed above are numbered and the section in the text that they go with are numbered (footnote style).  This is so we know how the margin information connects to the text…to know when it should be read.

Quotes and Sayings – the margins are also used for quotes and sayings that relate to the text.

“A List of Negative Emotions” – a fairly long list of unpleasant, upsetting emotions.  Similar types of emotions are grouped together.  This helps us to be aware of the emotions we experience and it gives us words to describe our feelings.

“Turning Point Worksheets” – listed below are SOME of the worksheets that have had the greatest impact on Group Members.

“The Cycle of Suffering in My Life Worksheet” – helps us to understand how the problems we’re having in life are greatly worsened by how we are trying to cope with them. It shows that the things we’re doing to try to feel better in-the-moment end up causing us long-term pain and suffering.

“The Big Picture of My Life Worksheet” – helps us to recognize the many things that bring meaning and satisfaction to life…and what happens to these things when we respond to life in self-destructive Emotion-Driven ways.  It helps us to understand the consequences of Emotion-Driven Behavior.  The worksheet provides many insights that help our Rational Mind to rationally challenge many Emotional Mind “desires.”

“The Mindfully Protecting My Peace and Stability Worksheet” – helps us to understand the number of stressors, pressures, demands, and difficult things “Coming Our Way” and the importance of being mindful of these things, maintaining boundaries, prioritizing, and coming up with a Game Plan for managing what’s “Coming at Us.” The purpose is to protect our peace and stability and the quality of our life…to minimize Emotional Mind flare-ups and crises and relapse into self-destructive coping behavior.

“The Challenging Negative Judgments of Me Worksheet” – provides us a structured way to rationally challenge the abusive, hurtful, destructive statements made about us. Members are often shocked at the results of this worksheet because it shows or “proves” how much of a lie those statements were…and how irritational we are to continue to believe.

“The Well Analogy Worksheet” – helps us to talk our way through an Emotional Mind crisis or situation…to go from impulsive coping responses to a Wise Mind response.

“The Wise Mind Worksheet” – walks us through the use of the three mind states so we can come up with a Wise Mind plan for dealing with a major issue or problem.

“The Game Plan” – this worksheet is for the development of a personalized recovery plan. The principles, concepts, skills, and understandings gained throughout this workbook are used to develop this recovery plan. The use of Rational Mind and Wise Mind are built into the plan as is a respect for our Emotional Mind issues and dynamics and who we are and how we are as a person.

“Step-by-Step Instructions” – detailed instructions are provided for the completion of the worksheets and tracking sheets.

“Samples of Completed Worksheets” – one or more completed samples are provided for each worksheet. These aid in understanding how to complete the worksheets. Oftentimes, seeing how a worksheet is done helps to better understand how to complete it!  Many of the completed samples are used for discussion in the workbook, too.

“Real Life Stories” – four stories that describe the life events and situations common to a recovery population are shared. Many Group Members feel as if these stories were written about them…sparing some details.

“Out-of-Control:  A Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook for Getting Control of Our Emotions and Emotion-Driven Behavior” by Melanie Gordon Sheets, Ph.D.  –  Copyright 2009  Recovery Works Publications



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