Tag Archives: CBT

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

Posted on September 10, 2011 | Leave a comment

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 23^th, 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

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Posted in DBT - CBT Workshops and Trainings

Tagged addictions recovery, CBT, chemical dependency CEU, co-occurring disorders, DBT, DBT - CBT Training, DBT-CBT, DBT-CBT seminars, dual diagnosis, out-of-control workbook, recovery, recovery program, substance abuse

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

Posted on March 27, 2010 | Leave a comment

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 –

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Posted in 1 - The DBT-CBT Workbook, 2 - From a DBT-CBT Therapy Perspective, Acceptance - Non-Acceptance, Aggression - Physical - Verbal, Depression and Suicidality, Emotional Mind, Rational Mind, and Wise Mind, Excerpts, Grief and Loss, Pain and Suffering, Relapse - Recovery Dynamics, Self-Destructive Behavior, Substance Abuse

Tagged altered state of consciousness, bad decisions, Big-Time in Emotional Mind, Bipolar Disorder, bottoming-out, CBT, cbt workbook, Cognitive-Behavioral Therapy, commitment to change, criminal insanity, DBT, DBT radical acceptance, dbt workbook, DBT-CBT, DBT-CBT “Out-of-Control” Workbook, desperate behavior, desperation, destructive coping mechanisms, Dialectical Behavior Therapy, Emotion-Driven Behavior, Emotional Mind, emotional pain, emotional suffering, excerpt from the DBT-CBT Workbook, forgiveness, group therapy, guilt, healing, hospitalization or prison, impulsive behavior, irrational behavior, linkedin, mental health treatment, NGRI, Not Guilty by Reason of Insanity, physical aggression, psychiatric patients, psychotherapy, psychotherapy with bipolar patients, radical acceptance, Rational Mind, recovery, regret, regretful behavior, relief-seeking behavior, remorse, self-acceptance, self-destructive behavior, self-esteem, self-forgiveness, self-understanding, shame, starting over, state dependent behavior, stress, The Cycle of Suffering, the insanity defensse, the serenity prayer, therapy, violence, violent crimes, Wise Mind

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

Posted on March 7, 2010 | Leave a comment

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?

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Posted in Acceptance - Non-Acceptance, Excerpts, Normal People

Tagged acceptance, acceptance of others, acceptance of self, achievements, achieving, CBT, Cognitive-Behavioral Therapy, compulsive behavior, DBT, DBT-CBT, determination, ego, freedom, humanity, obsessiveness, perfectionism, perseverance, personal faults, personal integrity, positive self-affirmations, self-determination, self-disciipline, self-growth, self-respect, self-understanding, success

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

Posted on February 21, 2010 | Leave a comment

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.

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Posted in 1 - The DBT-CBT Workbook, 2 - From a DBT-CBT Therapy Perspective, 3 - DBT-CBT in action, Aggression - Physical - Verbal, Anger, Emotional Abuse, Emotional Mind, Rational Mind, and Wise Mind, Excerpts, Relapse - Recovery Dynamics, Relationship Dynamics, Thinking - Destructive

Tagged abusive relationships, anger, CBT, cognitive-behaioral therapy, DBT, dbt judging, depression, Dialectical Behavior Therapy, Emotion-Driven Behavior, Emotion-Driven Lies, emotional abuse, Emotional Mind, emotional pain, irrational thinking, linkedin, negative thinking, Rational Mind, self-esteem, Verbal abuse, Wise Mind

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

Posted on January 18, 2010 | 2 comments

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!

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Posted in Acceptance - Non-Acceptance, Emotional Mind, Rational Mind, and Wise Mind, Excerpts, Relapse - Recovery Dynamics, Self-Destructive Behavior, Thinking - Destructive, Willingness - Willfulness

Tagged acceptance, addictions, breaking habits, CBT, challenging negative thoughts, Cognitive-Behavioral Therapy, DBT, DBT-CBT, determination, Dialectical Behavior Therapy, Emotion-Driven Lies, failure, fighting for recovery, full relapse, goal-driven behavior, hope, learning from our mistakes, learning from personal experience, linkedin, mindfulness, mistakes, negative thinking, optimism, overcoming failures, overcoming mistakes, partial relapse, perseverence, Rational Mind, rational thinking, recovery, relapse, relapses, sabotaging oneself, self-destructive behavior, self-help, self-understanding, struggling through addictions, success, successful leaders, therapy, Wise Mind, working through failures

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

Posted on December 25, 2009 | Leave a comment

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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Posted in Depression and Suicidality, Emotional Mind, Rational Mind, and Wise Mind, Mindfulness, Suicide and Suicidal Behavior

Tagged black-out, CBT, cognitive therapy, Cognitive-Behavioral Therapy, DBT, DBT-CBT, depression, Dialectical Behavior Therapy, Emotional Mind, emotions, fighting depression, grief, healing, hope, impulsive behavior, loss of reality, mindfulness, mindlessness, numbness, psychologist, psychotherapy, Rational Mind, recovery, self-destructive behavior, self-forgiveness, suicidal behavior, suicide, suicide attempt, therapy, therapy workbook

The DBT-CBT Workbook: Worksheets, Activities, Charts, Questions, Skill Builders, Tracking Sheets, and other Special Features

Posted on December 12, 2009 | Leave a comment

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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Posted in About the Workbook

Tagged addictions, CBT, cbt worksheets, Cognitive-Behavioral Therapy, coping skills, DBT, dbt activities, dbt worksheets, DBT-CBT, Dialectical Behavior Therapy, Wise Mind Worksheet

The DBT-CBT Recovery Workbook Focuses On Self-Destructive Behaviors

Posted on December 12, 2009 | 1 comment

DBT-CBT is a life-changing recovery program that inspires people
to make the life changes that will change their lives.
This program has turned many defeated hearts into empowered spirits
that are psychologically prepared to take on the challenges of
GETTING ON and STAYING ON the Recovery Path.
Come join us in our journey.

This is a workbook for recovery from a variety of Self-Destructive Coping Behaviors. The philosophy of DBT-CBT is that “Many of our “abnormal” behaviors are normal given our experiences. They once served as survival skills. However, their period of usefulness is long over. We’ve overused these coping behaviors…and now, they’re causing us great pain and they’re destroying our lives.”

This workbook explains why we do the things we do…and why we keep doing these things even though they cause us more pain and problems. It’s about what we do in the heat-of-the-moment…the emotional moment. It’s about what happens when EMOTIONAL MIND drives and RATIONAL MIND takes a backseat…and WISE MIND is left on the side of the road.

When we’re filled with upsetting emotions, we often do things for quick relief…like drugs and alcohol; suicide attempts; cutting and other forms of self-mutilation; aggression; temper tantrums; walking off and leaving the situation; withdrawal; overeating or not eating enough; overshopping; “sleeping around”; rebound relationships; gambling; and other risky and reckless behaviors. The Nature of the Problem is…the things we do to feel better end up multiplying and intensifying our problems. Our Destructive Coping Behaviors help us to cope in the Heat-of-the-Moment…but, they have many negative consequences. They make our current problems more severe…and they CREATE many new problems for us to struggle with. Over time, our lives spiral OUT-OF-CONTROL and into a CYCLE OF SUFFERING.

This workbook provides useful tools, attitudes, and plans for changing how we respond to life. Our goal is to GET CONTROL of our OUT-OF-CONTROL emotions, behaviors, and thinking. We do this by PARTICIPATING EFFECTIVELY in our lives and by using LIFE-ENHANCING COPING MECHANISMS to deal with our pain and problems. Our goal is to MINDFULLY PROTECT OUR PEACE AND STABILITY and the BIG PICTURE OF OUR LIFE. Our goal is to STOP the CYCLE OF SUFFERING.

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Posted in About the Workbook, Aggression - Physical - Verbal, Anger, Avoidance - Denial, Eating Disorders and Weight Issues, Emotional Mind, Rational Mind, and Wise Mind, Pain and Suffering, Relationship Dynamics, Self-Destructive Behavior, Self-Injurious Behavior - Cutting, Substance Abuse

Tagged addictions, bad habits, CBT, cbt workbook, Cognitive-Behavioral Therapy, coping mechanisms, DBT, dbt workbook, DBT-CBT, Dialectical Behavior Therapy, Emotional Mind, fighting for recovery, hope, Rational Mind, recovery, sabotaging oneself, self-defeating behavior, self-destructive behavior, self-destructive coping, self-destructive coping behaviors, self-help, self-understanding, struggling through addictions, therapy, therapy workbook, Wise Mind

What Causes People to Change? When It’s Painful To Change But More Painful Not To

Posted on December 12, 2009 | Leave a comment

Pain and Suffering and the Pain of Change

Pain is a type of distress. It’s a natural part of life. Pain is designed to be temporary. The purpose of pain is to PUSH US TO DO SOMETHING to end the pain…so we can return to a pain-free state. Pain is a call to action.

Alike most things in life, we have two choices when it comes to pain. We can either LEAN INTO the painful situation and change things or we can work hard to avoid dealing with it.

If all we do is work to avoid pain…if we don’t Lean Into it…if we don’t deal with it…if we refuse to accept it…if we refuse to do what’s needed to get through it …OUR PAIN WON’T GO AWAY. It’ll be with us for a long time.

Running from our problems just prolongs our agony and brings us to a chronic state of suffering… a long-term condition of being overwhelmed with despair and stuck in the same place and time… and we don’t move forward.

We want things to get better in our life, but we’re NOT WILLING to do the things that will make our life better. We want life to change, but we’re not in the mood to change.

We generally DON’T CHOOSE to make major life changes “out of the blue” or on our own. Change usually happens when we’re FORCED to make changes. And most often, we make changes when we have NO OTHER CHOICE but to change. We generally let things get SO BAD that the pain of living like we’re living is MUCH GREATER than the pain of change…and that’s when we begin to change.

If we really want our life to change, we have to make changes…despite the distress of change. Our life isn’t going to get better unless we do things that make life better. When people make major life changes, a strong commitment is made, like, “Come hail or high water, this is going to happen. I’m going to do what I have to do, no matter what. I’m so tired of living this way. I refuse to allow myself to live like this any longer.”

Excerpt from Chapter 11 “Distress Tolerance” of the DBT-CBT Therapy Workbook entitled: “Out-of-Control: A Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook for Getting Control of Our Emotions and Emotion-Driven Behavior” (Melanie Gordon Sheets, Ph.D. – 2009 – Recovery Works Publications)

http://www.dbt-cbt-workbook.com

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Posted in Avoidance - Denial, Depression and Suicidality, Excerpts, Pain and Suffering, Relapse - Recovery Dynamics, Willingness - Willfulness

Tagged acceptance, addictions, avoidance, being stuck, breaking habits, CBT, change, Cognitive-Behavioral Therapy, commitment, conviction, DBT, DBT-CBT, decision-making, depression, determination, Dialectical Behavior Therapy, distress tolerance, fighting for recovery, healing, life changes, making change, pain, pain and suffering, recovery, self-destructive behavior, self-help, struggling through addictions, suffering, Wise Mind

Six Major Problem Areas Addressed by the DBT-CBT Recovery Program

Posted on December 11, 2009 | Leave a comment

DBT-CBT Addresses Six Major Problem Areas

These six areas are listed below. Examples of the types of problems
we might have in each area are also noted.

This workbook is designed to meet the needs of people who suffer
from problems in SOME or ALL of the six areas.

1. RELATIONSHIP PROBLEMS

Conflict-Filled or Stormy Relationships   • Abusive Relationships
Relationship Disappointments or Frequent Ups and Downs
Unfulfilling Relationships   •   Short-Term Relations
Love – Hate Relationships   • Few or No Close Relations
Fear of Rejection / Actual Rejection / People Have Pulled Away
Co-Dependency / Dependency   •   Attention-Seeking Behavior
Fear of Abandonment / Actual Abandonment   •   Mistrust
Mad at Everyone   •   Loneliness / Can’t Tolerate Being Alone
Shyness / Fear / Major Discomfort in Social Situations

2. MOOD SWINGS – DEPRESSION – ANXIETY – ANGER

Moodiness / Major Mood Swings • Easily Angered • Rage
Guilt / Shame • Being a “High Drama” Person
Unbearable / Intense Emotions • Anxiety / Panic
Depression / Helplessness / Hopelessness / Worthlessness
Believe Things Won’t Get Better / Want to Give Up
Feel Out-of-Control / Overwhelmed / Suicidal

3. UNHEALTHY THINKING

Worrying / Overthinking / “Stewing” over Things
Dwelling on the Past • Preoccupied with Revenge
Pessimistic Thinking / Negative Expectations • Irrational Beliefs
Catastrophizing / Blowing Things Out of Proportion
Black and White / All-or-None Thinking
Putting Ourselves Down / Focusing on Our Worst Qualities

4. UNHEALTHY COPING BEHAVIORS

Please see the “List of Common Self-Destructive Coping Behaviors” above.

5. OTHER IMPULSIVE BEHAVIORS – BAD CHOICES

Doing Things on a Whim / Making “Snap Judgments”
Not Thinking Things Through and Having Negative Consequences as a Result

6. QUALITY OF LIFE PROBLEMS

Burnt-Out / Life Is a Chore   •   Nothing to Live For
Emptiness / Meaninglessness / Boredom
More Problems Than I Can Bear • Must Start Over
Financial Problems / Bankruptcy
Job Loss / Can’t Keep a Job Loss of Career or Professional License
Demotion / Probation at Work
Loss of Relationships   •    Family Pulled Away   •   Can’t See Children
Loss of Trust From Others   • Reputation Damaged
Loss of Self-Respect and Integrity •   Loss of Self-Confidence
Problems Getting an Education / Not Completing Semesters
Underachievement • Loss of Housing   •   Loss of Transportation
Loss of Possessions • Loss of Pets   • Loss of Freedom
Legal Problems / Probation or Imprisonment
Health Problems / New Medical Diagnosis

This list is an excerpt 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. – 2009 – Recovery Works Publications

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Posted in About the Workbook, Aggression - Physical - Verbal, Anger, Anxiety and Panic Attacks, Borderline Personality Disorder, Depression and Suicidality, Excerpts, Grief and Loss, Relationship Dynamics, Thinking - Destructive

Tagged addictions, behavioral problems, Borderline Personality Disorder, CBT, Cognitive-Behavioral Therapy, DBT, DBT-CBT, Dialectical Behavior Therapy, Emotional Mind, fighting for recovery, recovery, self-destructive behavior, struggling through addictions

Radical Acceptance – “Accepting the Unacceptable” – From a DBT-CBT Workbook Perspective

Posted on December 11, 2009 | Leave a comment

We have a choice to accept difficulties as they come our way…
To lean into them and to get a game plan for dealing with them
AND a choice to Follow Through until we can Get Through…
OR we can choose to avoid, ignore, and numb-out our pain and problems
And stagnate in our pain and suffering.

When we choose to confront things
With an attitude of acceptance
That gives us the serenity to change the things we can
And the wisdom to know our limits.

Acceptance of our life situation and what we need to do about it…is a way of turning suffering we cannot tolerate into pain we can tolerate. It’s a way of turning hopelessness into hope. Most of us have been suffering the pain of our lifestyle and choices for years…and somehow, we remain willing to experience ongoing pain and misery because of them. We’re somehow willing to suffer long-term pain, but we’re not willing to go through the temporary pain of change. We’re somehow willing to dwell in a painful past, to remain in painful situations, and to continue painful addictions and impulsive behavior. We do so because we’re unwilling to accept and undergo the changes that will bring peace and stability.

Radical Acceptance involves accepting what we’d normally consider unacceptable. When we LIVE BY Radical Acceptance, we CAN ACCEPT something whether or not we approve of it and whether or not it’s right or wrong, fair or unfair, or pleasant or unpleasant. Radical Acceptance is about CHOOSING TO ACCEPT whatever is in our best interests to accept.

We MUST ACCEPT whatever we HAVE TO accept because NON-ACCEPTANCE keeps us emotionally troubled and stuck in negativity. To have peace, we must accept many things whether or not they’re acceptable. We must accept things from the past and present. Anything in the past that’s unfixable, we need to LET IT GO. Anything in our current life that we CANNOT CHANGE, we need to accept that it MAY NOT change. Anything we CAN change, we must LEAN INTO…to MAKE THE CHANGES we CAN MAKE. Our Recovery Goal is to live a life that MAXIMIZES peace, stability, meaning, and productivity. To do that, we MUST ACCEPT what has happened HAS HAPPENED, what we’ve done, WE’VE DONE…then, we need to LET IT GO…so we can GO ON with life.

From pages 313 and 316 – Excerpt from “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. – 2009 – Recovery Works Publications

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Posted in Acceptance - Non-Acceptance, Avoidance - Denial, Excerpts, Pain and Suffering, Relapse - Recovery Dynamics, Willingness - Willfulness

Tagged acceptance, CBT, Cognitive-Behavioral Therapy, DBT, dbt workbook, Dialectical Behavior Therapy, distress tolerance, emotional healing, emotional pain, fighting for recovery, healing, hope, pain and suffering, peace, psychology, psychotherapy, recovery, self-help, serenity prayer, therapy, therapy workbook, tolerance

A Partial Relapse or a Full Relapse – Using Rational Mind and Wise Mind to Tame an Out-of-Control Emotional Mind (A DBT-CBT Workbook Perspective)

Posted on December 5, 2009 | Leave a comment

The following is “Pete’s Story” – an excerpt from the DBT-CBT Out-of-Control Workbook which highlights a “real life” relapse experience. This relapse is processed using principles and concepts from the DBT-CBT Recovery Program, especially the three mind states of DBT. It’s an example of DBT-CBT “In Action.” The content for this post is the opening for Chapter 7, the “Rational Mind” chapter of the workbook. As it is from Chapter 7, it refers to things discussed in Chapters 1-6. So, if you feel a little lost reading it…that’s why!

Chapter 7 – RATIONAL MIND

We’ve been working with Rational Mind (1) throughout this book, so you’re somewhat familiar with this mind state. Rational Mind is the part of us that processes life in a logical, legalistic, fact-driven, reality-oriented, and cut n’ dry manner. In other words, Rational Mind uses reasoning, it respects rules, it’s guided by truth, it deals with how things really are, and it’s the calm, cool, intellectual, and unemotional part of us!

Emotional Mind is driven by how WE SEE AND EXPERIENCE the world while Rational Mind is driven by how THE WORLD REALLY IS!

The Purpose of Rational Mind

A Recovery Goal is PREVENTION of Destructive Emotion-Driven Behavior. We need to STOP OURSELVES before we do what we really feel like doing!
Rational Mind helps us to gain control before things get Out-of-Control.

When we’re in a troubling Emotional Mind state, the first step for gaining control is Mindfulness. We need to be aware of what’s going on in Emotional Mind. We need to be Mindful of our Raw Emotions, Emotion-Driven Thoughts, and our desired Emotion-Driven Behavior. This includes awareness of our feelings, the thoughts racing through our mind, and what we’re thinking about doing! Once we become aware of what’s going on in Emotional Mind, we need to TURN ON RATIONAL MIND to look at our situation logically and realistically.

Rational Mind helps us to know what is true and factual.
It helps us to perceive the reality of our situations and our life.
The reality of Rational Mind is generally quite different from the picture Emotional Mind paints!

Rational Mind helps us to understand THE BIG PICTURE OF THE SITUATION and the TRUTH about what’s going on. This helps us to challenge our Emotion-Driven Thoughts and to get our emotions MORE IN LINE with the REALITY of the situation. This REDUCES our emotional distress because we FOCUS on the HERE-AND-NOW situation RATHER THAN EVERYTHING that has EVER HAPPENED to us.

Rational Mind also considers the Big Picture of Our Life and REMINDS us of the CONSEQUENCES we’ll SUFFER if we ACT ON destructive Emotion-Driven impulses. WHEN we’re USING Rational Mind to deal with what’s going on in Emotional Mind, WISE MIND TURNS ON and BRINGS US to a GAME PLAN for effectively dealing with our situation. Our Recovery Goal is to PARTICIPATE EFFECTIVELY in our life… so we’re MANAGING and DEALING WITH our problems RATHER THAN CAUSING OURSELVES MORE PROBLEMS!

APPLICATION: The Meeting of the Minds

The following story, “Pete’s Story,” is a good example of how the three Mind States work together in real life.

Pete’s Story

Pete has a lot of stress and family conflict caused by his responses to life. His family has allowed him to stay in their garage apartment “for the last time.” His probation requires him to be employed. He doesn’t have a good work history so it took a while to find a job. He just bought a used car and now has visitation with his kids because he’s paying child support. Things are pretty good in his life… though not the greatest. His boss accused him of doing something he didn’t do. He blew up and walked off the job. He went to an old hangout and started drinking again and snorted some coke. Thoughts began churning in his mind. He is very worried and is thinking the worst, “My family is going to kick me out and I’ll be homeless again. I’ll lose my car without income and I’ll lose visits with my kids. If I get called for a UA (2), it’ll be dirty and my probation will get revoked (3)…especially since I’m now unemployed. Then I won’t see my kids for a long time.” He’s very upset with himself and thinks, “I am such a failure. I screw everything up. My family will NEVER let me hear the end of this. I should just kill myself. I can’t handle all this crap again.” Thoughts are racing through his mind. His emotions intensify and he becomes more and more upset. He begins to panic. He is desperate for a way out and considers going back to live with his ex-girlfriend. He’s afraid of doing that because she still uses drugs. He panics even more and all he can think about is killing himself. He ruminates about this stuff for hours and hours. It’s now 3AM and he’s worried about going home…so late…so upset…and so messed up.

Does Pete’s story seem like Real Life or does it seem like an exaggeration to make a good story? _____________________________________________________________________________________
_____________________________________________________________________________________

Have you been in a state like this before about a lost job or some other major problem? If so, describe how your experience is similar to his. ________________________________________________________________ ______________________________________________________________________________________

The quality of our life comes down to two choices.
We can LIVE IN Emotional Mind and ALLOW our life to fall apart
OR we can TURN ON Rational Mind and Wise Mind
to get a Game Plan for dealing with our problems.
The choice is to stay on the life-enhancing Recovery Path
or to go the way of Relapse Route.

SKILL BUILDER: Pete’s State of Mind

Re-read Pete’s story and UNDERLINE the parts that describe what’s going on in his Emotional Mind. Put a BOX around the parts that are driven by Rational Mind.

You probably had no trouble identifying what was going on in Emotional Mind. You may have had some trouble deciding if his statements about getting kicked out of his apartment, being homeless…and losing his car, probation, and visits with his kids were Rational Mind or Emotional Mind.

What did you decide? Explain what you based your decision on? ________________________________________________________________________________________
________________________________________________________________________________________

When he went to the bar, he was upset.
then he began drinking and drugging,
then he became hopeless, desperate, and PANICKED.

Mindfulness of the consequences suggests he was in Rational Mind. Some think he was in Emotional Mind because it seemed like he was catastrophizing4 how bad things could get. However, given his life situation, his worries WERE based on truth and reality!

A reason to suspect he was Big-Time in Emotional Mind is…WISE MIND DIDN’T TURN ON and OFFER LIFE-ENHANCING SOLUTIONS. All he did was ruminate for hours about consequences and finding a way out…NOT A WAY THROUGH. He was panicking! All the COCAINE and ALCOHOL did was PUSH HIM DEEPER and DEEPER into Emotional Mind…and farther and farther away from Rational Mind and Wise Mind. He couldn’t think straight. The MORE he ruminated, drank, and snorted, the MORE DEPRESSED, ANXIOUS, WORRIED, and PARANOID he became.

In order to think straight,
we’ve got to be straight!

The Big Picture of Pete’s Story suggests he was Big-Time in Emotional Mind. He had SOME Rational Mind going on…but, not much. He was AWARE of the consequences of losing his job, he KNEW he should not return to his ex, and he KNEW his behavior would cause family problems. He was probably 80%-20% Emotional Mind – Rational Mind. Wise Mind flickered on and encouraged him NOT to call his ex. Not having that option…and having more time to drink and snort, he panicked even more…and came to believe that suicide was his best option.

Isn’t it odd how we can go from bad to worse…
and we begin to think the worst option is the best?

Given Pete’s story IS Real Life, how do you think this part of his story ends? _______________________________________________________________________________________
_______________________________________________________________________________________

He’ll either do something MORE DESTRUCTIVE, like a suicide attempt, driving drunk, or a full-blown relapse OR he’ll do something LIFE-ENHANCING like staying safe and sleeping it off in the car and TURNING ON Rational Mind WHEN HE COMES TO…TO GET HIS LIFE BACK IN ORDER.

Pete’s story tells about the “Something That Happens” on the Recovery Path and the two choices we have. Pete CHOSE the RELAPSE ROUTE in the Heat-of-the-Moment. HOWEVER, he DOESN’T HAVE TO stay on that path. He can call for help at 3AM or crawl into his car and sleep it off.

SKILL BUILDER: How to Get Control Once We’ve Lost Control

Let’s suppose he chose the Recovery Path at 3AM. When he comes to and is able to shake off the cobwebs later that day, what might Rational Mind say to him? ____________________________________________________________________________
____________________________________________________________________________

Rational Mind might lead him to think,

“I blew up and walked off the job and I drank and used coke last night. I was scared. I freaked out…but this DOESN’T HAVE TO BE the end of the world. It’s time for DAMAGE CONTROL. MY PRIORITY RIGHT NOW is to get a job. Whether it’s my old job back or a new one…I need to act fast! No doubt my folks know Something Happened because I didn’t come home last night and I’m home now when I’m supposed to be at work. I need a plan for dealing with them, too, so I don’t lose housing.”

At this point, Emotional Mind will probably rear up with all kinds of self-defeating thoughts and feelings. Pete MUST TURN ON Rational Mind to Fight for his peace and stability. He cannot ALLOW Emotional Mind to control the course of his life. When a destructive thought comes up, Pete needs to remind himself that HIS NUMBER ONE PRIORITY is to STAY ON the RECOVERY PATH and that HE CAN AND WILL HANDLE this situation. He needs to tell himself that he STRUCK OUT last night, but there’s still MORE INNINGS in the game. He’ll have to challenge the destructive Emotion-Driven Thoughts AS THEY COME UP and REMAIN FOCUSED on TRUTH, REALITY, DAMAGE CONTROL, and PROBLEM-SOLVING.

At this point, Wise Mind will kick in to help him with a plan of action. What might Wise Mind suggest? ______________________________________________________________________
______________________________________________________________________

Wise Mind might suggest he visit his boss to apologize for blowing up and to ask for his job back. Wise Mind might suggest he TRY to assure his boss he didn’t do what he was accused of doing. Wise Mind would likely remind him if “Plan A” doesn’t work, he could apply for dozens of other jobs until he gets one…and that IT’S NO TIME TO BE PICKY! Wise Mind might encourage him to explain the situation to his parents…to let them know HE SLIPPED…but was BACK ON the RECOVERY PATH. If needed, he could tell them he’ll have a job quickly, REGARDLESS OF WHAT HE HAD TO DO. Wise Mind would likely inform him that it’s unlikely he’ll get called for a UA over the next few days and to pray on that! If he did get called for one, Wise Mind might suggest telling his probation officer what happened and the POSITIVE WAY HE’S DEALING WITH IT. Wise Mind would have MANY DAMAGE CONTROL and PROBLEM-SOLVING IDEAS for GETTING RECOVERY BACK ON TRACK!

When we mess up, we don’t give up.
We STAY IN the game even if it’s our toughest inning ever.

If at the end of the next day, he didn’t get his job back and he didn’t get a new one, Emotional Mind could easily start the self-defeating rumination and worry process. What could he do to help himself if this starts up? ________________________________________________________________________________________
________________________________________________________________________________________

Rather than spending days worrying about a catastrophe happening, Wise Mind would inform him that he’d be BETTER OFF PREVENTING ONE by focusing on a Game Plan! Wise Mind would strongly encourage him to chill-out and focus on Damage Control, problem-solving, and the use of Life-Enhancing Coping Behaviors (5) to avoid destructive worry.

Through Rational Mind, he could TAKE NOTE of the PRODUCTIVE things he’s done the last two days INCLUDING his MAJOR SUCCESS with QUICKLY GETTING BACK ON THE RECOVERY PATH and preventing a full-blown relapse. He could LIST HIS GOALS for the next day and a PLAN OF ACTION for the rest of the week. Since money is tight, he could WORK OUT A PLAN for paying what HAS TO BE paid. He could DISTRACT himself with POSITIVE ACTIVITIES (support group meetings like AA, helping his family prepare a meal, visiting with a recovery friend, etc.). He could SEEK TEMPORARY WORK cleaning yards, painting his parents home, and whatever else he can come up with to earn money and to KEEP HIS MIND BUSY. He could even talk with businesses about hiring him for a day or two to do “odd jobs.”

This WORK-UP of Pete’s story shows how RATIONAL MIND helps to CONTROL the INTENSITY and NEGATIVITY of an UPSET EMOTIONAL MIND! Rational Mind DOESN’T BUY INTO a “I’m a total screw-up. This is going to ruin everything. I can’t deal with it. I should kill myself.” mentality. Rational Mind CHALLENGES panic and negativity by looking at the situation in a calm, NON-EMOTIONAL, realistic, logical, and truthful manner. In the upcoming sections, we’ll look at some common Emotional Mind experiences from the viewpoint of Rational Mind. We’ll see how Rational Mind TAKES the POWER and NEGATIVITY OUT OF a destructive emotional experience.

Rational Mind tames what comes out of Emotional Mind.
Rational Mind pulls on the reins and helps to get control
of what is going Out-of-Control.

Footnotes

1- Dr. Linehan calls this mind state “Reasonable Mind.” On page 65 of her Skills Training Manual, she states, “This is your rational, thinking, logical mind. It is the part of you that plans and evaluates things logically. It is your cool part.”
2- UA – urinalysis – a urine test to check for drugs or alcohol.
3- Probation revoked – to lose the privilege of being on probation. Folks have to serve their sentence in jail if their probation is revoked.
4- Catastrophizing – (cuh-tah-stro-fi-zing) –when we’re focusing on the very worst things that could happen. It’s a form of the word, catastrophe – (cuh-tah-stro-fee).
5- Being busy with problem-solving…and working towards the solution is a powerful coping tool. Getting a newspaper and a phone book and making a list of jobs to apply for and businesses to call and visit is solution-focused. Visiting the employment agency and ironing a decent set of clothes for job hunting is very constructive, too!

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Posted in Anger, Anxiety and Panic Attacks, Depression and Suicidality, Emotional Mind, Rational Mind, and Wise Mind, Excerpts, Mindfulness, Relapse - Recovery Dynamics, Self-Destructive Behavior, Substance Abuse, Suicide and Suicidal Behavior, Thinking - Destructive

Tagged addictions, alcoholism, bad choices, CBT, challenging negative thoughts, chemical dependency, Cognitive-Behavioral Therapy, DBT, DBT-CBT, desperation, Dialectical Behavior Therapy, Emotional Mind, fighting for recovery, full relapse, healing, hope, hopelessness, irrational thinking, mindfulness, negative thinking, partial relapse, Rational Mind, recovery, relapse, sabotaging oneself, sabotaging recovery, self-destructive behavior, self-help, self-understanding, starting over, struggling through addictions, substace abuse, substance abuse recovery, success, suicidal behavior, suicidal thinking, Wise Mind, worthlessness

How to Motivate People to Change – Some Keys to Recovery from a DBT (Dialectical Behavior Therapy) and CBT (Cognitive-Behavioral Therapy) Recovery Program

Posted on December 5, 2009 | Leave a comment

From the perspective of a psychologist in a state hospital treatment setting and a population of individuals who have struggled with recovery over time, I believe insight and understanding is a key to creating a desire to change. I believe it greatly helps people to see the big picture of their life and come to an understanding of why their life is like it is…that is, why they have lost “everything” or most everything they’ve ever loved or cherished…or why things always end up so bad…or why anything good never lasts. I believe folks need to grasp that this life outcome is a product of how they have tried to cope with upsetting life events over time…and the way their life is today…is because of the progressive and worsening consequences of their self-destructive coping mechanisms (drugs, alcohol, verbal and physical aggression, suicide threats and attempts, rebound relationships, and other emotion-driven coping choices). I believe that once they grasp that the quality of their life is based on how they attempt to cope with daily life and major life stressors…once they realize that how they cope with life is responsible for the current state of their life….once they really get this…motivation for behavioral change often follows. In the group I do, they are also taught that part of being wise (use of DBT’s Wise Mind) is not only knowing what to do (Wise Mind Game Plan), but it is about “following through with what we know to do”…because there is nothing wise about knowing what to do…and then not doing it! I believe insight and understanding is an initial part of behavioral change. I also believe that knowledge that change is possible is essential. I believe they need to really get it that other people have done it and have made it through. They have to have this knowledge…which breeds hope that the recovery process actually works…that people do recover and live satisfying and meaningful lives. I also believe personal empowerment is a key ingredient. They have to believe that they can do it…that they have the skills and understandings necessary to pull it off.

Thus, they have to understand why things are as they are..(insight and understanding), they have to recognize that change is attainable (knowledge and hope)…and they have to think they can do it (personal empowerment). Of course, they also need the knowledge, skills, and resources for getting through the tough times that are part of making and undergoing major life changes (life-enhancing coping skills, support system, hobbies and activities, busy-ness). They have to understand the concept of Distress Tolerance…that things will be hard, but they must Get Through It…that recovery is not easy…and in fact, it will be one of the hardest things they’ll ever do. They are also taught that change typically does not occur until we are sick n’ tired of being sick n’ tired…that we have to soooo hate the way things are…that we’re willing to do whatever we’ve got to do to change things…that we refuse to live like this any longer. I believe that people need to be filled with recovery attitudes…or rehab-itudes…and they need to be prepared for the fight of their life…which for many is the fight FOR a life (a decent life) and for others, it is a fight for life itself…because the severity of their consequences has escalated into things being so bad…that it comes down to “life or death”…

When the pain of living like we’re living is greater than the pain of change…that’s when most people decide to change…and the question for the rest of us is…how bad do we have to let things get before we’re willing to make changes! It’s a shame that we’re such stubborn creatures, that we have to let things get so bad…before we’re willing to make changes! If only we knew then…what we know now…how we could have spared ourselves of such long-term pain and suffering.

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Posted in Acceptance - Non-Acceptance, Aggression - Physical - Verbal, Emotional Mind, Rational Mind, and Wise Mind, Pain and Suffering, Relapse - Recovery Dynamics, Relationship Dynamics, Self-Destructive Behavior, Substance Abuse, Suicide and Suicidal Behavior, Willingness - Willfulness

Tagged addictions, breaking habits, CBT, changing bad habits, Cognitive-Behavioral Therapy, coping behaviors, DBT, DBT-CBT, destructive coping behaviors, determination, Dialectical Behavior Therapy, distress tolerance, emotional behavior, Emotional Mind, fighting for recovery, hope, insight, introspection, loss, mindfulness, motivation, motivation to change, pain, pain and suffering, recovery, recovery program, self-destructive behavior, self-understanding, struggling through addictions, willingness, wisdom, Wise Mind

The Best Crash Diets are Crash n’ Burn Diets – An Excerpt from the DBT CBT Therapy Workbook

Posted on October 19, 2009 | Leave a comment

Crash n’ Burn Dieting

Why do you think a “crash diet” ¹ is an Emotional Mind behavior?
________________________________________________________________
________________________________________________________________

We’ve all heard of these diets and most of us have done them! We see many advertised on magazine covers, “Lose 10 pounds in 10 days with the Grapefruit Diet!” Some have strict menu plans. Many limit food choices. We may be able to eat as much as we want…but ONLY lean meat and vegetables…or boiled chicken and rice all day! Consider how limited a high protein – low carbohydrate diet is. One reason these diets fail is they don’t allow us to eat our favorite foods…and WE’RE NOT GOING TO STAY ON A DIET LIKE THAT…FOR VERY LONG!

Crash diets are driven by Emotional Mind because we’re WILLING to do something DESPERATE to lose weight QUICK. We’re IMPATIENT. We want IMMEDIATE RESULTS. We DON’T WANT TO WAIT to lose weight in a REASONABLE and HEALTHY way…even though WE KNOW it’s the only way to lose weight and keep it off! We’re being IRRATIONAL! We’ve deluded ² ourselves! We’re believing a LIE. SOMEHOW WE BELIEVE THIS CRAZY DIET WILL WORK…that we’ll suddenly develop skills to control our eating…that we’ll give up most or all of our favorite foods…and just eat certain foods. REALLY, IF WE HAD ALL THIS WILLPOWER, why would we need a crazy diet? Why wouldn’t we just do a “normal diet” and eat like a slender person? They eat all kinds of things…just smaller portions!

Just like other Destructive Coping Behaviors, we want IMMEDIATE RELIEF…for our long-term weight problem. So, we do something desperate to lose weight FAST!

The problem with a crash diet is it’s SO UNREASONABLE and STRICT we WON’T STAY ON IT the rest of our life! When we GET OFF the diet, we return to our old eating habits. We GAIN the weight back…AND THEN SOME! That’s because we’ve been starving our body and depriving it of what it needs to function. Our brain sends out “I’M STARVING TO DEATH” signals that tell our body to PROTECT ITSELF FROM DYING. So, our metabolism ³ slows, we BURN FEWER CALORIES, and fat stores up for future famines. ⁴ At the same time, our BRAIN POUNDS on us to EAT MORE to replenish ⁵ our body. Finally, we GIVE IN TO TEMPTATION and the demands of our brain and body and we do a ROYAL PIG-OUT! Then we FEEL HORRIBLE physically and emotionally. We’re bloated, sick, disappointed, and ashamed. WE FEEL LIKE A FAILURE. Weight loss seems hopeless, so, we GIVE UP on the diet. WE GAIN ALL OUR WEIGHT BACK…AND THEN SOME!

We’re willing TO TRY to defy ⁶ the laws of nature to lose a ton of weight fast! A friend once said, “I’ve given up on dieting. Every time I go on a diet, I end up gaining 10 pounds!” After we starve ourselves, our brain pushes us to gain extra weight so our body is prepared for the next famine!

What kind of diet would Rational Mind suggest? ________________
___________________________________________________
___________________________________________________

Rational Mind would encourage us to EAT THINGS WE LIKE, BUT LESS! Then our stomach will shrink and we’ll REDUCE CALORIES. We’ll get in the HABIT of eating “SKINNY PERSON PORTIONS” ⁷ and we’ll lose weight. Because we’re still getting our favorite foods, we’re less likely to get tired of this “eating plan!” It’ll become A WAY OF LIFE…that we can LIVE WITH for the rest of our life. We’ll STAY ON IT, LOSE WEIGHT, and KEEP IT OFF!

We’ve all heard THE BEST WAY to lose weight is to do it SLOWLY! If we’re not in a major weight gain cycle ⁸ and we cut our food intake by one-fourth, we may lose 2-3 pounds a month. That’s 24-36 pounds a year and 48-72 in two years! If we cut our intake in half, we may lose 4-5 pounds a month or 48-60 a year and 96-120 in two years! That’s a lot…and we can KEEP IT OFF if we KEEP IT UP! A “three-fourths” or “halves” diet will serve us MUCH BETTER over time than a “crash n’ burn” diet!

I’d rather lose 25 pounds a year by eating reasonably than gaining 10 pounds with a crash diet!

——————————
Notes:
1. A crash diet is very strict and is designed for FAST weight loss.
2. Deluded – (duh-lew-did) – talked ourselves or others into believing something that’s not true.
3. Metabolism – (met-tab-oh-liz-em) – the process of breaking down the food we eat.
4. Famines – (fah-men’s) – times when there’s little or no food in a country or region.
5. Replenish – (ree-plin-ish) – to restore and fill back up!
6. Defy – (dee-fi) – to go against or to challenge.
7. Ever notice how skinny people eat? They eat many of the same foods as an overweight person…just smaller portions. We had a store and I’d go there after my hospital job. I was always shocked to find half a bag of chips or half a candy bar left on the desk. I could never understand why the employee didn’t eat it ALL! Obviously, their eating habits were very different from mine! They’d eat half when I’d eat two!
8. If we‘re on a major weight gain cycle, we’ll have to cut down even more to get our daily calories in the range for losing weight. These numbers are estimates based on someone who’s maintaining their weight or is only gaining a few pounds a year.

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Posted in Eating Disorders and Weight Issues, Emotional Mind, Rational Mind, and Wise Mind, Excerpts, I've Lost 100 Pounds!, Relapse - Recovery Dynamics, Self-Destructive Behavior

Tagged addictions, Borderline Personality Disorder, breaking habits, CBT, Cognitive-Behavioral Therapy, compulsive eating, compulsive overeating, crash diets, DBT, DBT-CBT, Dialectical Behavior Therapy, diet failure, diet tips, dieting, eating disorder, Emotion-Driven Lies, Emotional Mind, fad diet, increase metabolism, lose weight, low metabolism, overeating, overeating disorder, Rational Mind, recovery, relapse, sabotaging oneself, self-help, struggling through addictions, weight gain, weight loss, yo-yo dieting

Using DBT CBT Workbook Recovery Skills To Get Control Of My Out-Of-Control Eating! Losing Weight Again!

Posted on October 18, 2009 | Leave a comment

I made it through the diet crisis. What a horrible time that was…to feel so out-of-control of my eating and knowing I was very close to relapse back into an EATING DISORDER! It’s kind of sad to think back to that…I was so desperate and struggling. Writing one of the blogs in that period, it occurred to me how much drama and chaos I was experiencing and allowing myself to go through. Because the theme of my life is “Peace and Stability,” I became sick n’ tired of the chaos and drama…and I took control of my out-of-control self! It was like “Ah, hell no” and I got very serious about getting my life under control.

So, I resolved to take advantage of my Wise Mind thinking and I got a Game Plan. I Followed Through with it and packed my food for my work day (planning, decided what to eat), stopped buying fruit (managed temptation), counted the calories throughout the day (Mindfulness), kept reminding myself of my goal to get control (All Day Daily Devotional), was Mindful of the two choices I had – to eat what I wanted and gain all my weight back or to control my eating and keep my weight down (Two Choices), put up tempting food that the family left out (more temptation management), and I Talked Myself Through impulses to eat something that would increase calories too much (Self-Talk, Talking Myself Through the Moment). I practiced what I preach. I wasn’t perfect though…but kept with it (Perseverance).

Just looked and the last entry was 10 days ago. In that time, I had 3 “bad days” in a row (1380 calories or more)– I pigged out on my husband’s home cooked beans and cornbread one day, another was a bunch of M&M’s, and another was chips. However, had many good days, too. Total calories this month is 1255, so, things have averaged out pretty good. Weight went up to 131 one day…and is now back to 124. 122 is my lowest during the last 4 years of dieting. Was often in the 124-125 range before things got out of control recently.

Other dynamics that have helped me over the past week have included…being overbusy and working long hours at work and having less time for food at home (I have been packing an insulated bag with food for work) , my husband hasn’t cooked since the beans and cornbread episode, I have been playing Zuma a lot when I’m home (pleasure and de-stressing time from overworking at work), and the kids have been VERY busy with school stuff in the evening and they haven’t been cooking much either!! So, the planets have lined up well…and all is well. Praise God. How can I forget…I also prayed and asked God to help me Get Control…because I was doing a horrible job of it on my own.

For some reason, I forgot that it was the 10 days after my period that my weight went up (like to 131 recently). Falling to 124 so fast caught my attention and I looked over my Excel spreadsheet and remembered that. So, I’m at a good time now when my weight should stay lower…for a few weeks. Would be fun to lose a new pound and get to 121.

It’s really unbelievable. I once thought that it would be impossible to hit 135…and that if I ever got to 165 it would be an amazing thing. I started out at 260 on my scale…(did I just put that in print) so, it is pretty unbelievable to be in the 120’s…or even under 200!

My goal is 112. I spent many years of my life in the teens…usually 115-118. If it’s do-able, I would like to hit 112 so I have a little room to move up and down and still stay below 118.

My kid was just reading this and asked why I wrote that I’ve lost 145 pounds if it’s only 136. I reminded her that I got pregnant during the last 4 years…gained weight during the pregnancy and when all was said and done after I lost the baby, I was 13 pounds higher. So, when I went back to my diet, I had to lose those 13 pounds again. So, in reality, I’ve lost 136 pounds + 13…so, I’m really at 149. I count those 13 because I had to lose them again…and regaining them wasn’t my fault…like going back up to 131!

Anyways, all’s well…for now. I guess that’s “for now in the diet world” because my life is entirely Out-of-Control at work…and I can’t stand the feeling. It’s not a wonder why I entitled the DBT-CBT Workbook, “Out-of-Control”!!! The way I’m dealing with that is by busting my butt to get caught up…or at least to get things well enough in control that I don’t feel so overwhelmed and desperately Out-of-Control! I’ll focus on that…work hard now…play later!

Balance is a big thing in the DBT-CBT recovery program and I noticed that I was achieving some semblance of balance by allowing myself to play Zuma for hours instead of working at home and making myself do things I didn’t feel like doing at home. I had to notice that because I felt guilty about playing so much Zuma!

I tell my Group folks that “normal” life isn’t a cakewalk…and “normal” folks aren’t so normal (ain’t I a good example! ) I tell them that “normal” life is stressful and it’s not easy…that “normal” people have many things to struggle with, too….and that’s it’s always something. Things are always “Coming At Us” that we have to struggle through and deal with…that the skills taught in the workbook not only apply to recovery from drugs and alcohol, or cutting and suicide attempts, or depression or Bipolar Disorder…that they are about how to deal with life in general.

I share with them glimpses of my struggles as examples now and then…and I let them know that even though I am years into recovery from my history of seriously self-destructive coping behaviors…I still have to deal with myself on a daily basis…and that I live, eat, and breathe the recovery principles in the workbook…and that I, too, get tired of having to deal with stuff ALL THE TIME!

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Posted in Eating Disorders and Weight Issues, I've Lost 100 Pounds!, Mindfulness, Normal People, Relapse - Recovery Dynamics

Tagged breaking habits, CBT, Cognitive-Behavioral Therapy, compulsive overeating, Counting Calories, DBT, DBT-CBT, desperation, determination, Dialectical Behavior Therapy, diet, diet tips, dieting, fighting for recovery, God, hope, Impulsive Eating, introspection, Losing Weight, mindfulness, recovery, recovery workbook, relapse, self-help, self-understanding, struggling through addictions, success, weight gain, weight loss, willfulness, Wise Mind

On Losing 145 Pounds and Using Dialectical Behavior Therapy (DBT) and Cognitive-Behavioral Therapy (CBT) to Regain Control Over My Over-Eating Eating Disorder!

Posted on October 7, 2009 | Leave a comment

Well, here’s another day of my recent fight to regain control of my eating and to continue to lose weight…and to prevent a full relapse into my over-eating Eating Disorder!

Felt great to weigh in at 127. One less than yesterday and a common weight for me over the past few months…and going in the right direction!

Started my day with Mindfulness of recovery being my #1 priority today. I thought about how I wanted to eat this day and I took note of what was coming at me today that could challenge my recovery. I thought about the Service Awards Celebration that would be held today at work. They’d serve cake, cookies, and other goodies. I wasn’t sure I wouldn’t eat anything there, so I was aware I needed to plan my food day to allow for that!

Started my work day by buying some time and drinking coffee first thing rather than settling into my 1-1/2 sandwiches of fat-free turkey and double fiber bread (230 cals!). Had that at about 11:30. That held me just fine until the Awards Celebration…I got a 20-year with the state of Texas award. Cool. I did good until the end when folks were chatting by the food tables…and I did it! I had a small piece of cake and would have had a chocolate chip cookie, but no chocolate cookies left of any sort and I wouldn’t waste calories on non-chocolate! Got out of there with only about 50 cals worth of cake! Oh yea! Awesome!

Well, just like I am…I get back to my work area…and there’s candy bars on the counter for sale for Relay For Life…and seeing them brings on the sweet munchies that were brought on by not getting the chocolate chip cookie! Mentioned to my friend that I had the sweet munchies now and she told me about all the treats she had stored in her desk! Oh boy! So had a Reese’s candy bar (270 cals), about a dozen M&M’s….and a good handful of cashews. Can’t imagine that to be more than about 130 calories. Delighted because 400 more calories satiated my sweet craving. Did so well that I skipped my afternoon black bean soup.

Worked late, came home at about 7 and enjoyed three yogurts (240 cals) and started on sunflower seeds. Betcha I won’t need to have the Snicker’s chocolate protein bar tonight after sweets earlier today. Really not craving anything except I’m enjoying the seeds! Think I’ll play Zuma for a while and then package up the books which have sold today. I feel so much better that my eating is better under control. Just need to continue what I’m doing and work through this “near disaster” in my recovery!

I kept track of calories all day…grand total of 1030. That’s a bit low (Rational Mind)…though I really like the number! (Emotional Mind) However, I want to re-experience peace and stability in my eating…and not the roller coaster of late. (Rational Mind) Too few calories for one to two days leads me into out-of-control eating while my body tries to replenish itself! (Rational Mind) I’m just not in the mood for more diet drama. Had my fill of that! (Rational Mind) May snack on something to bring it closer to about 1250 (Wise Mind)…but I really like the 1030 number! (Emotional Mind)

Oh boy, hubby just got home bearing Walmart grocery bags…and I get to put them up! My recovery supportive husband brought home three bags of chips…one of which I happen to really like…but, also a bag of apples. So, I was mindful of my recovery and my recovery goals and realized that if I cracked the bag of chips it would be 200 calories in seconds flat! (Rational Mind) Made a decision to put them up and out of my sight. (Wise Mind) Then, I found the bag of apples…ahhhhhh…had two. So, total calories now about 1160…and now he’s grilling hamburgers outside. Hopefully, I’ll just tear one in half and have that! (Wise Mind) That puts me right at that 1250 number! Boy, sure I love the food he cooks out there on the propane grill. Oh…man!

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Posted in Eating Disorders and Weight Issues, Emotional Mind, Rational Mind, and Wise Mind, I've Lost 100 Pounds!, Mindfulness, Relapse - Recovery Dynamics

Tagged addictions, anxiety, binge eating, binging, Borderline Personality Disorder, breaking habits, CBT, Cognitive-Behavioral Therapy, compulsive behavior, compulsive eating, compulsive overeating, coping skills, DBT, DBT-CBT, desperation, determination, Dialectical Behavior Therapy, diet tips, dieting, eating disorder, Emotion Mind, fighting for recovery, hope, mindfulness, out-of-control behavior, overcoming adversity, overeating, Rational Mind, recovery, recovery skills, relapse, relapse prevention, self-help, struggling through addictions, success, therapy, weight, weight control, weight loss, Wise Mind

Willfulness and Willingness…Fighting for Recovery…From My Overeating Disorder!

Posted on October 6, 2009 | Leave a comment

“You get skinnier every time I see you.” That’s what my friend said to me today…and I thought, “Fat chance of that!”

Weighed this morning – 128. Not horrible, better than 129 the other day…but lots worse than my monthly average the last few months (125 range) with lows at 122-123.

Getting dressed, I put on my size 10’s…my larger pants since I’m not in the 125 range. Oh my God, they were tight. I am not doing tight first thing in the morning, else by mid-afternoon seams will be a-bursting! Went up a half size bigger…ahhhhhh…and to think I was going to put those in storage just in case I started to get fat again. I shouldn’t need to wear those. I wore those at 135. But…if the pants fit, wear them!

I was feeling despondent, helpless, out-of-control…desperate…hopeless. Then, anxiety hit. I realized this could easily be a relapse point. Eating out-of-control…felt discouraged…was bloated…and having to wear “fat pants”…everything was just right for an Emotional Mind recovery sabotage.

My first panic thought was to strictly reduce my calories to 1100…to punish myself. (Emotional Mind thinking).

Rational Mind said, “That’s too low…and punishing yourself will backfire..it’s not a good thing for you.”

Wise Mind said, “Chill out Mel…work to maintain calories in the 1200 range…that’s very do-able for you…you can tighten up a bit.”

Thank God I’m into this DBT-CBT thing…and I live, eat, and breathe it. And thank God I caught myself in the middle of this serious Emotional Mind game. I thought, “You know, I’m not going there.” Then I thought, “I think I’ve just entered a fight for my recovery. It’s at that point now.”

I then recognized I felt a bit angry about this eating thing…frustrated, just tired of it. Then another thought flew through my mind, “I don’t get mad, I get even.” This is usually a negative, revenge type of Emotion-Driven thought, a self-destructive thought. However, for me…today…it was more like, “It’s time to kick this in the ass…I’m tired of it.” “It” being…”I’m tired of my crap”…it’s like “Shit or get off the pot”…or…”If you’re serious about this diet thing, then make it happen already…Get control or lose control. Game’s over. It’s time to get serious.”

I thought about DBT and “Willfulness vs. Willingness.” Well, one is usually bad – the stubborn, willfulness one…and willingness is usually good – the “I’ll do whatever I need to do to be okay”…it’s the “I surrender,” “I accept,”…the, ”I’m ready and willing” one.

Well, for me today, Willfulness was a positive thing. It was the stubborn and determined part of me…that fight from deep inside…being willful in a survivalist type of way…the, “I’ll be damned if this kicks my ass” type of fire from within!

Willingness was there, too. They stood side by side. I was willing to do what I needed to do to get this eating thing going on. I surrender my will to eat whatever I want to eat. I surrender to setting limits for my eating.

Well, I’ve done very well today with just a minimum of distress. Ended the food day at 6:30pm with 1185 cals. For breakfast I had 1-1/2 fat free turkey sandwiches (double fiber whole wheat bread) and drank coffee with about 25 calories of flavored coffee creamer. I had a can of green beans for lunch. That held me over until my mid-afternoon can of black bean soup which kept me from leaving work starving to death and ready to eat everything in sight when I got home from work. Upon arriving home, I had 3 black cherry yogurts (80 cals each and quite a treat) and a Snickers 290 calorie chocolate protein bar (quite a treat…like a candy bar!) I picked at leftovers and had a couple bites of chicken with green peppers. SUCCESS. Had to forego fruit and sunflower seeds today, but I’m fine. Started the sunflower seeds in the evening when I quit cigarettes a few months ago…and also added a lot of fruit then to deal with the nicotine withdrawal CONSTIPATION! Did just fine though without them tonight.

Now…today I went back to some of the dieting basics like I resolved to do a few days ago…yesterday…whenever it was. I kept a running tally of my calories through the day…and emailed them to my home! I was mindful of what I would eat (for the most part), planned my food day (for the most part) and I did the “think through before you do” thing. Now, tomorrow is a new day and I sure hope I experience that fire from within…and fight for my recovery all over again! I hope my battles help you in your fight.

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Posted in Eating Disorders and Weight Issues, Emotional Mind, Rational Mind, and Wise Mind, I've Lost 100 Pounds!, Mindfulness, Relapse - Recovery Dynamics, Willingness - Willfulness

Tagged acceptance, addictions, bloating, Borderline Personality Disorder, CBT, Cognitive-Behavioral Therapy, DBT, DBT-CBT, determination, Dialectical Behavior Therapy, diet, diet tips, dieting, eating disorder, Emotional Mind, fighting for recovery, hope, introspection, overeating, recovery, relapse, sabotaging oneself, self-help, self-understanding, struggling through addictions, success, weight gain, weight loss, willfulness, willingness, Wise Mind

DBT – CBT and dieting: Counting Calories…and They’re Adding Up!

Posted on October 5, 2009 | Leave a comment

I did good with my eating ALL day…until the bowl of Stouffer’s lasagna just a little while ago. Boy, it sure was good! Enjoyed every cheesy bite! Didn’t need it, just chose to have it. Put me about 200 calories higher than desirable for the day…makes for a “bad” day. Total calories today – 1465. Month average is now 1265 which is perfect for me…just where I want to be. Allows me to lose about a pound or two a month.

I’m bothered by eating more than desirable today. Did well with mindful eating ALL day…until the lasagna! However, I haven’t given up on me…yet. I’m determined to figure this out. A part of me says, “Maybe your body is just ready for maintenance eating” rather than losing weight. That’s probably Rational Mind! Emotional Mind says, “Well, I’m not ready for that. I still want to lose about 10-15 pounds” (Yes, I’ll still be within ideal body weight and more where I was most of my life before I got heavy in my late 20’s.)

The Wise Mind thought crossed my mind, “Just exercise some each day, that’ll take care of those extra calories.” My stubborn, Emotional Mind responded, “Nah, I’d just rather try to eat less.” In other words, I’m too lazy to exercise…I have other interests and things to do…I want to do the diet my way…not the way I know is best. So, I’ll persist in my stubborn ways and see how it goes.

Rational Mind says, “You can continue to try it your way, but if it isn’t working, you’ll have to try something else.” And, Wise Mind says…”See that bowflex and stepping machine behind you…” I think I’d rather give up that chocolate Snickers protein bar (290 cals) rather than exercise an hour! I’d much rather do that!

Touchdown Minnesota…Can’t help to favor Favre!

Tomorrow I’ll eat like I did today, but not allow myself to have the Snicker’s protein bar.

My God, what an awesome play by Green Bay…major pass from Rodgers…touchdown Green Bay. Score is tied. Exciting game!

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Posted in Eating Disorders and Weight Issues, Emotional Mind, Rational Mind, and Wise Mind, I've Lost 100 Pounds!, Relapse - Recovery Dynamics

Tagged acceptance, addictions, breaking habits, CBT, Cognitive-Behavioral Therapy, constipation, DBT, DBT-CBT, determination, Dialectical Behavior Therapy, dieting, Emotional Mind, fighting for recovery, hope, Rational Mind, recovery, self-help, struggling through addictions, weight gain, weight loss, Wise Mind

Using DBT and CBT to lose weight

Posted on October 4, 2009 | Leave a comment

I’ve lost 145 pounds and now I have to go on a diet! That’s where I’m at right now. I have steadily lost a ton of weight in 4 years and I find myself in need of going on a diet! September was a VERY bad month for me. I had many more bad days with very high calories than usual (in the 1800-2100 range with one day even higher!) Such high calorie days typically happen just a couple times a month…not many times! Last month (September), I ended up with almost 200 more calories per day than typical. May sound like nothing…but, that adds about 1-1/2 pounds to me over the month…and it kept me from losing any weight.

That may not sound bad…but, the problem is…I really struggled this past month. I was “out-of-control” with eating. I’d pig out some days…and then work hard other days to get my overall monthly calorie count lower…only to have more pig-out days…followed by major attempts to control my eating…which still very often resulted in more calories for me than usual. Overall, I did not have a natural eating pattern this month…it was a time of out-of-control eating.

I recognized that I was in a period of early relapse with my eating disorder (over-eating)…and that if I didn’t gain control, I would lose control, and end up “out-of-control” and back in a cycle of weight gain. I was mindful that I could end up gaining a bunch of weight and perhaps end up fatter than when I started. Scary. Don’t want to go there on purpose.

Because I live, eat, and breathe the teachings of the DBT-CBT “Out-of-Control” Therapy Workbook, I began dealing with this early relapse and my neurotic self. Towards the end of the month when I thought,

“Oh my God, I’m going to gain all my weight back”

and various other statements of an Emotional Mind panic, Rational Mind came to my rescue.

“If I don’t gain control, I will lose control, and gaining weight is certainly likely. I’ve done well with this diet thing for 4 years. I’ve been within ideal body weight for a year now. I’ve been losing weight up until this month. I’ve got the skills, willpower, and know-how to get control of myself. I’ve just gotta tighten up and get a Game Plan for getting through this.”

Wise Mind clicked on and I thought, “I’ll just go back to the early days of my diet and start over. I’ll do things like I did back then. I’ll just start from scratch.”

Emotional Mind clicked on, “I can just not eat much tomorrow and the next day, that’ll cut my calories down a lot for the month…and more in line with a normal month.”

Rational Mind and Wise Mind jumped me, “That’s a bad idea. You know better. You’ll just end up pigging out again. You can’t do that. It’s certainly tempting, but not the way to go. I just need to tighten up and do things like I did in the early days of my dieting.”

Emotional Mind reared up again, “Well, I can just starve myself tomorrow and the next day so my calories won’t be bad for the month and THEN I can start over. I don’t want to have such a bad month…and show a 4-pound weight gain this month. That’s awful”

Rational Mind said, “What’s done is done. It’s just numbers. You’ll show a gain this month, and then next month, you’ll go down again. It’s not real weight, well, just a pound or so. You don’t gain 4 pounds eating an extra 5000 calories a month, that’s just a pound and a half or so…and really instead of losing a pound n’ a half this month, you’re just breaking even. You’re on your period so the extra weight is probably just water.”
Wise Mind said, “Chill, you’ll be okay. This is just temporary. Let’s just get a plan.”

So, I began thinking of how I used to do things. It’s been a long time since I’ve had to be on a diet! I had developed such good eating habits that it became a natural part of living, more a lifestyle than a diet! I actually eat a very healthy diet…I’m just eating more…more yogurt, more fruit, more chocolate protein bars!

Part of my diet basics is to let the people I’m around know about my struggles and to solicit their help. So, I told the family I had a very bad September, that I need to tighten up…and that I don’t want to start the weight gain cycle. I asked them not to offer me food and to put their food up when they’re done. Of course, they’re not perfect in my recovery, so when I notice they’ve left something out that could be tempting to me, I put it up!

I’m also walking past temptation telling myself, “I can’t just eat that, I’m on a diet” instead of having a couple bites, a bowl, or a handful. I’m setting limits because my wants now are much greater than they’ve been for a long time…and I guess I’ve slacked off too much. I find myself eating because I feel like it, rather than eating when I’m hungry.

I’m also setting limits and making choices about when I’m going to eat…not just allowing myself to graze.
I also decided that I would count calories through the day instead of just doing it at night. This will increase my mindfulness of calorie intake throughout the day.

This morning as I was waking up and thinking about my day, I decided what I would eat. Since I slept late, I’d eat two meals and an evening snack.

I’ve also thought about the work week because my calories are higher during the week than on the weekends. I will bring a limited amount of food to work. For instance, instead of a huge bag of grapes that should last a few days, I’ll bring about 100 calories worth. I’m in the process of figuring out what my food day will be like at work and what I’ll have at home in the evening.

So, I’ve gone back to some of the basics, but, I’m not perfect in recovery. I’ve had one “bad day” this first four days of October, but three very good days. My overall calorie count is lower than desirable, but I have faith in myself, I’ll be able to get it up without any problem!

FYI: DBT-CBT (Dialectical Behavior Therapy – Cognitive-Behavioral Therapy)

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Posted in Eating Disorders and Weight Issues, Emotional Mind, Rational Mind, and Wise Mind, I've Lost 100 Pounds!, Relapse - Recovery Dynamics, Thinking - Destructive

Tagged addictions, breaking habits, CBT, Cognitive-Behavioral Therapy, DBT, DBT-CBT, determination, Dialectical Behavior Therapy, diet tips, dieting, Emotional Mind, fighting for recovery, hope, lose weight, Rational Mind, recovery, relapse, self-help, struggling through addictions, weight gain, weight loss, Wise Mind

A Quit Smoking Success Story…and I’m Even Losing Weight!

Posted on August 3, 2009 | Leave a comment

I thought I should write a follow-up to the “I Quit Smoking” blog entries over the past few months. So, here goes!

I’m pleased to say that I’ve successfully quit smoking! It’s been about 5-6 weeks now. No constipation…no bloating…and I’ve actually lost a couple pounds! Life is good. I’m still eating Activa type yogurt – about 2 a day and I’m chewing the nicotine gum – about 4-5 pieces a day. I have continued to have less soda per day (about 2 cans per day now) and have a protein bar about 5 times a week (the mega Snickers 21g protein ones!) instead of about 2 per day! Those are a treat and usually take care of chocolate or sweet cravings. I don’t think I’ve done a sweet binge in months since I’ve been eating them! I have been eating a ton of fruit though…that probably helps with the sweet binges! I have lost almost 150 pounds in the past four years so controlling the diet thing is very important to me. Yes, I was QUITE HEAVY, but part of that 150 was pregnancy weight – had an unexpected pregnancy during those four years! However, most of the 150 was part of a slow, insidious weight gain over 12 years! Do you know 100 extra calories a day adds about 1 pound of extra weight per month…and 12 per year! That’s probably how most of us end up so heavy…slow and steady! I’ve written the DBT-CBT Workbook (Dialectical Behavior Therapy – Cognitive Behavioral Therapy Workbook) which focuses on life-destroying addictions and behaviors like drugs and alcohol, self-injury (like cutting), verbal and physical aggression – but it only touches on eating disorders – like anorexia, bulimia, and overeating. I wish I had the energy to write a DBT-CBT Therapy Workbook for losing weight. Sure would be helpful to A LOT of people. I have certainly used the skills and understandings in the workbook to quit smoking and to get through this weight loss thing! I have to live, eat, and breathe DBT-CBT on a daily basis to deal with myself! I am a full-time job!

Oh, one other thing…I’ve been eating a lot of sunflower seeds in the evening, that helps to bind the hands and the mouth instead of smoking. I don’t have salt issues, so the seeds work for me! I’m at the point that I rarely think about smoking…can get into the car and take the 23-minute drive to work (or home) and it never crosses my mind. I did think about smoking last Saturday morning…that was a nice smoking time for me…get up, relax, have a few smokes…and start the day! However, got through the thoughts and urges to smoke by reminding myself how glad I am to not smoke…and to be free of that addiction. It also helped that I had lost a “new pound” that morning when I weighed…so that was certainly a positive!

I expect this will be my last “Quit Smoking” blog…and maybe I’ll make myself start writing a Diet Tips one!

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Posted in I Finally Quit Smoking!, I've Lost 100 Pounds!

Tagged addictions, bloating, breaking habits, CBT, cigarettes, constipation, DBT, DBT-CBT, Dialectical Behavior Therapy, dieting, quit smoking, quitting smoking, recovery, self-help, smoking, smoking cessation, struggling through addictions, success, weight gain, weight loss

Tag Archives: CBT

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

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APPLICATION: The Origin of the Judgmental Lies

APPLICATION: Stupid Is as Stupid Does?

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

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

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Pain and Suffering and the Pain of Change

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Chapter 7 – RATIONAL MIND

The Purpose of Rational Mind

APPLICATION: The Meeting of the Minds

Pete’s Story

SKILL BUILDER: Pete’s State of Mind

SKILL BUILDER: How to Get Control Once We’ve Lost Control

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