NAMI Cobb 2020 Leadership Team President – Peter Lyons [email protected]Secretary – Rebecca Forester [email protected]Treasurer – Jim Williams [email protected]CIT/Newsletter Editor – John Avery [email protected]Website Chair/Email - Allen Spetnagel [email protected]Outreach Co-Chair – Adrienne McGahee-Jackson [email protected]Outreach, Events Co-Chair - Tiffany Welch [email protected]Education Chair— Melissa Pike [email protected]Director of Programs - Neill Blake [email protected]Hospitality Chair – Debra Howard [email protected]Communications Co-Chair – Tiffany Conyers [email protected]Communications Co-Chair – Lawrence Forester [email protected]Membership/Advocacy Chair - Donna Hook [email protected]Helpline Volunteer/Phone – Sylvia Oliphant [email protected]Volunteer Coordinator – Paul Miner [email protected]NAMI Walks Cobb Co-Captains Linda Hicks John Hicks Website: www.namicobb.org Email: [email protected]Mailing address: NAMI-Cobb P.O. Box 999 Kennesaw, GA 30156 I NSIDE T HIS I SSUE 1 Monthly Meeting 2 President’s Newsletter 3 Education Speaker 4 NAMI Cobb News 5 PTSD is another lingering symptom of coronavirus 6 EMDR: the “hyperspace” of processing traumatic memories 9 What Is Imagery Rehearsal Therapy 13 What Is Dialectical Behavior Therapy 17 Ask the Psychiatrist: Everyday Tips for Better Mental Health 22 Meeting and Membership Information Newsletter Date Volume 1 Issue 1 MAY 2021 FRESH START Next Educational Meeting June 17, 2021 7 PM Our guest speaker this month will be: Michael C. McGovern, former Advertising Copywriter & Freelance Writer A candid conversation about anxiety disorder
5 PTSD is another lingering symptom of coronavirus
6 EMDR: the “hyperspace” of processing traumatic memories
9 What Is Imagery Rehearsal Therapy
13 What Is Dialectical Behavior Therapy
17 Ask the Psychiatrist: Everyday Tips for Better Mental Health
22 Meeting and Membership Information
Newsletter Date
Volume 1 Issue 1 MAY 2021 FRESH START
Next Educational Meeting June 17, 2021 7 PM
Our guest speaker this month will be:
Michael C. McGovern, former Advertising
Copywriter & Freelance Writer
A candid conversation about anxiety disorder
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President’s Letter
June President’s Letter Mental health month has come to an end. However, I believe that some of the Cobb County Public Library Mental Health Exhibits are still up. Our thanks go to the Cobb County Library System for helping us promote mental health in May. I also want to thank Dr. Hooper for a very informative presentation on anxiety during our May Educational Meeting. Dr. Hooper went through the various types of anxiety giving us a great overview of the subject. This was followed by a lively Q & A session. I am pleased to inform you that we will follow up Dr. Hooper’s talk with a personal presentation on overcoming anxiety. On Thursday, June 17th, at 7 PM our speaker will be a great friend of mine and fellow Trinity College graduate, Michael McGovern. He is a former advertising copywriter who developed an anxiety disorder while working on Madison Avenue. He will tell us what it’s like to have an anxiety disorder and what he did to overcome it. He will discuss the medications he took as well as the cognitive behavioral techniques he used to relieve his symptoms.
The link for the Zoom Meeting follows: https://zoom.us/j/96574692871
Meeting ID: 965 7469 2871 Passcode: 387287
We do not have an Educational Meeting in June, and if all goes as planned, we hope to be able to meet in person again for our August Educational Meeting. NAMI Cobb is an affiliate of NAMI Georgia, which is the state organization for NAMI (the National Alliance on Mental Illness). NAMI Cobb is an entirely volunteer run organization. NAMI Cobb seeks to create a community where all affected by mental illnesses find hope, help, and acceptance through support, education, and advocacy. NAMI Cobb provides several services to the community. These include monthly educational meetings, periodic classes, weekly support groups, and advocacy for mental health. Further information on these and other activities of NAMI Cobb can be found on our website, NAMICobb.org. Peter Lyons President, NAMI Cobb Affiliate
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Educational Meeting, Thursday, June 17, 2021 at 7 PM
Speaker: Michael McGovern Subject: Conquering Anxiety
Do you or a loved one suffer from anxiety? You’re not alone. 40 million Americans suffer from an anxiety disorder, a condition characterized by constant fear and anxiety. This month’s speaker will be Mike McGovern, a former advertising copywriter who developed an anxiety disorder while working on Madison Avenue. He will tell us what it’s like to have an anxiety disorder and what he did to overcome it. He will discuss the medication he took as well as the cognitive behavioral techniques he used to relieve his symptoms. Mike’s talk should be helpful to anyone experiencing an anxiety disorder or for those who have occasional bouts with anxiety.
This event is a FREE community service; all are welcome!
NAMI Cobb Affiliate completed a Family to Family class in May.
ONE COMMUNITY: A CELEBRATION OF UNITY
Join the Kennesaw community and your Kennesaw Police Department as we celebrate our community, our diversity and our unity. Be a part of this first annual outdoor event in the heart of downtown Kennesaw!
ONE COMMUNITY: A CELEBRATION OF UNITY
Saturday, June 19, 2021 Families are encouraged to attend this fun-filled event of games, activities, music, fun, and food celebrating Juneteenth and community unity.
GAMES & ACTIVITIES
────
BBQ
────
FREE TO THE PUBLIC!
────
A Celebration of Juneteenth
& Community Unity
────
Kennesaw First Baptist
Church
2958 N. Main St.
Sat., June 19, 2021
11 a.m. – 3 p.m.
Sponsored by:
Kennesaw Police
Kennesaw First Baptist Church
Fresh Start Page 5 PTSD is another lingering symptom of coronavirus,
affecting 30% of survivors, doctors find
BY KIM CHATELAIN MAY 25, 2021
Humankind has been experiencing traumatic events since we evolved as a species.
From our prehistoric ancestors’ encounters with saber-toothed tigers, to the bloodbaths on Civil War battlefields to the 9/11 terrorist attack, trauma has been an unwelcome and damaging intruder that can wreck our psyches. This emotional response not only inflicts immediate psychological distress, but it can leave markers in the mind that surface years later.
The term “shell shock” began appearing in medical literature of the early 1900s to describe the psychological corollary of World War I soldiers. During the second world war, “combat neurosis” was used to describe the aftereffects combatants carried home with them after harsh battle experiences.
In 1980, mounds of research and social efforts on behalf of Vietnam War veterans prompted the American Psychiatric Association to recognize these emotional scars in medical terms as post-traumatic stress disorder — PTSD.
Some 40 years later, PTSD has become a byproduct of COVID-19. The two acronyms have now intersected, leaving some mental health experts to lament what they fear will be the storm after the storm.
People with PTSD have an array of psychological symptoms, including hopelessness, anger, anxiety, depression, sleeplessness, memory problems, difficulty maintaining relationships and recurring visions of the trauma-causing event. Symptoms can occur anywhere from a few weeks to years after the trauma.
A study published in February in the American Medical Association Psychiatry found that 30% of COVID-19 survivors experienced PTSD. When you consider there are 30 million confirmed infections in the United States, the math becomes frightening.
Dr. Tamar Rodney is an assistant professor at Johns Hopkins School of Nursing who has done extensive research on trauma and PTSD biomarkers. In April, she presented a Zoom lecture called “Trauma — The Wounds You Cannot See,” which delved into the latent trauma of pandemic-related PTSD.
Because of COVID-19’s omnipresence, Rodney and other experts say treating those experiencing pandemic-related aftershocks could present a mental health challenge unlike any other we’ve faced in recent times. A lot of the research conducted on trauma focuses on a singular incident, such as an accident or a particular battle in a war zone. Conversely, the pandemic has been an escalating series of gut-churning events that lasted more than a year and impacted every aspect of our lives.
Post-pandemic PTSD is difficult to detect and treat, in part the ability to tolerate trauma can vary greatly among individuals. Moreover, the psychological damage from trauma often lies beneath the surface.
"If you have a cut, you put a Band-Aid on it, and everyone knows it is an area of tenderness and not to disturb it," Rodney said in the Zoom video. But with PTSD “scars still exist, but they are so deeply buried, and they are not acknowledged many times, and it's assumed that an individual might be OK."
Rodney said it will be important for us to look out for key PTSD indicators.
Page 6 Fresh Start They include negative moods, hyper arousal and avoidance of people or things that remind one of the traumatic event, or when memories of the trauma interrupt an unrelated flow of thoughts.
Dr. Gustave Sison, a New Orleans native licensed to practice psychology in Louisiana and Mississippi, said the breadth of the pandemic and its massive impact on large swaths of the population make the situation ominous.
“The pandemic has created the rare situation where, in a matter of a single year, a significantly larger percentage of the population has either directly experienced a life-threatening event or has had to cope with the sudden loss of loved one from COVID,” said Sison, noting that many health care workers faced the repeated trauma of dealing with severe illness and death over an extended period of time. “We can logically expect significantly more cases of COVID-19-related PTSD to emerge.”
Sison stressed it’s not unusual for people to experience anxiety, depression and sleeplessness for a period of time after a traumatic event. PTSD occurs when these and other severe symptoms persist for more than a month and significantly impact work and social life.
“It (PTSD) occurs when people cannot begin to move on, and symptoms do not subside or they worsen over time,” he said.
Experts say those struggling with PTSD should take action by seeking professional help and learning more about treatments for the disorder. Sison says south Louisiana residents can benefit from experts who are well-versed in PTSD.
“Think about it,” said Sison, who counseled victims of Hurricane Katrina in 2005. “Because of the stress caused by hurricanes that impact the entire area, therapists who have lived and worked in this area are some of the most experienced anywhere in the treatment of trauma-related disorders such as PTSD. So, get help.”
In her presentation, Rodney borrowed a line from romance writer Laurell K. Hamilton to stress the importance of confronting stealthy, pandemic-related PTSD: “There are wounds that never show on the body that are deeper and more hurtful than anything that bleeds.”
Learn more about PTSD and treatments for the disorder by going to the National Center for PTSD (ptsd.va.gov) or by downloading the free app PTSD Coach.
EMDR: the “hyperspace” of processing traumatic memories
Bryony Porteous-Sebouhian 27 May 2021
The word trauma has been at the forefront of many discussions surrounding mental health over the past year. Whether it’s high levels of post-traumatic stress disorder (PTSD) symptoms in NHS frontline workers, collective trauma as a widespread result of the pandemic or nuanced instances of racial trauma in the wake of George Floyd’s murder and the BLM protests. EMDR or Eye Movement Desensitisation and Reprocessing is one of the most successful therapies for trauma, but how does it work and why?
Content warning: this article contains brief mention of suicidality.
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To help us get to grips with EMDR, how it works and more importantly why it works so well with trauma we spoke to Dr Justin Havens who is an accredited EMDR consultant and board member of the EMDR UK Association.
What is EMDR and what do you think people should know about EMDR before considering undertaking it as a therapy?
“It stands for, a bit of a long acronym, eye movement desensitization and reprocessing, which the founder Francine Shapiro, later down the line, wished she'd made shorter, perhaps ‘accelerated processing therapy’ for example. But the essence of it, and the thing that makes it different to all the other forms of talking therapy is that it introduces eye movements, or tapping, or bilateral stimulation tones in the ears.”
“It's a bit like in Star Trek or Star Wars when they go into hyperspace, and things move on, it really does energize and speed up the processing of memories. The genesis of many mental health problems, whether it's depression, anxiety, addictions, behaviours, is actually rooted in trauma. And what EMDR is doing is really just accelerating that natural healing process where it's got stuck.”
“I sometimes say that EMDR is like a speedboat compared to CBT, which is a rowing boat. But with the power of the speedboat, comes responsibility on the part of the therapist. Good training. Experience and supervision is essential to ensure that EMDR is used appropriately and safely” In regards to the service user or practitioner point of view, is there anything people should specifically know about EMDR?
“It's a powerful therapy, and therefore, some of the issues that need to be understood are not so much client issues as therapist issues. You can't just start wiggling your finger around, cross your fingers and hope it will be alright. All trauma therapy is about accelerators and brakes. And, and the eye movements accelerate the process. So, you've got to know when to do it. And you've got to have an understanding of the client's history, because if they've got multiple traumatic events, it's possible to open up too many boxes.”
So, both clients and practitioners need to be really aware of these accelerators and breaks
“Yes. Certainly, if a client is finishing a session, and they're dysregulated, they're emotional… an EMDR therapist, even a relatively basically trained one should definitely not be letting them get to that state, that's a key message of the training. It’s all about safety. Obviously, when you get into more complicated service users and more complex PTSD, then it becomes may become harder and then you need that level of experience.”
We discussed the increased discourse around trauma as a result of the COVID-19 pandemic and how EMDR might play a part in responding to this, in response to this Dr Justin Havens noted the increase in EMDR trained therapists within IAPT services in the NHS saying “the NHS have just commissioned a competency framework, which is indicating that EMDR is going to be part of the future. That's quite exciting. So there'll be more accessibility of EMDR.”
Do you think you’ll see an increase in people accessing trauma therapy such as EMDR this year?
“I've not had a floodgate of new clients, and I don't think services are at this stage, I think there'll be a bit of a bow wave effect, a bit of a delayed reaction. If you think about lockdown being lifted, and people kind of getting back to normal, and then there'll be the people that haven't been able to get back to normal. It's never quite as dramatic as the media portrays in my experience. But that doesn't minimize that there is a probably going to be a major impact from COVID.
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We discussed specifically, those who have suffered during lockdowns due to underlying mental health problems or already existing and diagnosed mental health disorders, Dr Havens thought to bring up one example of a middle aged client who, at 16 was neglected and left alone to fend for herself. Dr Havens recalled this story acknowledging sympathetically, that the context of lockdowns really did retrigger those memories for that client.
Those who have been subtly affected by lockdown and the pandemic, due to traumatising memories resurfacing, or being triggered by too much time spent alone will likely be a part of this “bow wave effect” as Dr Havens puts it. As we come out of lockdown, the negative effects on mental health many of us have experienced over the past year will likely become muddied with enjoying the positives of more time with friends, loved ones, time outside, time spent enjoying our freedoms. It may only be once we have time to take stock of the past year that we realise the long-lasting impact.
While we’re all talking about trauma and the spotlight so to speak is on trauma therapies such as EMDR, what is your perspective on making mental health care more trauma informed?
“Treating the trauma and taking a trauma informed approach to assessment and diagnosis for me makes a lot more sense. You're trying to answer the question, how has person got to be this way. And when you do it from a trauma informed approach, it all makes sense, the story makes sense. And then you treat it and bringing it back to EMDR; EMDR is well researched, structured, powerful in the hands of the right therapist with the right environment, a game changer.”
For Dr Havens, understanding various diagnoses of mental illness or personality disorders even, in a trauma informed way, and thus giving patients and clients access to EMDR makes sense.
On its applicability to treat suicidality, Dr Havens said “research has been carried out using EMDR in crisis teams, working with people with suicidal ideation. Normal convention in therapy is to stabilise before treating trauma, but if the very reason for the instability is the trauma, it becomes a chicken and egg situation. Usually, if you resolve the trauma, the suicidal feelings can reduce and clients become more stable.” Similarly on alcoholism, bipolar and even psychosis Dr Havens explained “It can be similar with alcoholism. A lot of services will say, you've got to be sober before you could access services. But, if one of the reasons why they're drinking is a major trauma, then it makes sense to treat that first. OF course these approaches do require experienced EMDR therapist, to maintain safety.”
“I've worked with a lot of people with bipolar diagnosis or psychosis and these problems can be rooted in trauma. Now, of course, there are some that are not and I'm not saying, EMDR is a panacea for all trauma and trauma is a panacea for all mental health issues. But there's something to it, there's a lot more that can be done when you take a trauma informed perspective.”
Dr Justin Havens had one last comment to make, when discussing the many complexities of the traumas that lie at the heart of many people’s mental health problems.
“For me, EMDR offers a definite route to treat the complexity of trauma, when combined with a suitably skilled therapist.”
The introduction of EMDR into more IAPT services and the increased frequency in which we are seeing discussions around trauma informed care and trauma in general, points to something very hopeful and positive in our approach to mental health as a society. With all trauma informed care, as Dr Havens said “you’re trying to answer the question ‘how has the person got to be this way?” and EMDR, it seems will be an important, if not invaluable part of that answer.
What Is Imagery Rehearsal Therapy (IRT)? Nightmares can worsen sleep and affect all areas of your life. You can reduce bad dreams with this nightmare-focused therapy.
Disturbing dreams, or nightmares, can leave us feeling anxious, irritable, and unsettled long after we’ve woken up. Nightmares can even lead to insomnia and a fear of falling asleep.
This is especially true for people with conditions like post-traumatic stress disorder (PTSD). As many as 71% to 96% of people with PTSD may have nightmares, according to the National Center for PTSD. Having another condition in addition to PTSD, such as panic disorder, can also increase your chances of nightmares.
But whether you have PTSD, another condition, or frequent nightmares, you don’t have to live with disturbing dreams and sleep problems.
Imagery rehearsal therapy (IRT) is a brief, evidence-based cognitive behavioral therapy that can help you reduce nightmares and sleep better.
What can IRT help with?
First, what exactly is a nightmare? “Nightmares are vivid, realistic, and disturbing dreams typically involving threats to survival or security, which often evoke emotions of anxiety, fear or terror,” according to the American Academy of Sleep Medicine (AASM).
IRT can vary based on your needs and each therapist’s approach. But at its core, IRT directly targets nightmares to reduce bad dreams.
The AASM recommendsTrusted Source IRT to treat nightmares and nightmare disorder associated with PTSD.
Nightmare disorder affects about 4%Trusted Source of adults. Living with this condition means you experience recurrent disturbing dreams that cause distress and disrupt different areas of life — like work or school.
ResearchTrusted Source has shown that IRT:
• reduces how often nightmares happen • lessens distress caused by the nightmares • improves sleep quality
In addition, this study examined the effectiveness of imagery rescripting, a piece of IRT for people with nightmare disorder. Imagery rescripting helps you change the nightmare, so it turns out in a way that doesn’t lead to distress.
Similar to other studies, researchers found that imagery rescripting reduced how often the nightmares happened and the distress they caused for people with nightmare disorder — and these effects lasted 3 and 6 months later.
Imagery rescripting also reduced:
• nights with nightmares • insomnia • trauma symptoms • unhelpful beliefs about the nightmares
Page 10 Fresh Start Another study tested IRT in 20 people with difficult-to-treat co-occurring conditions in a psychiatric hospital. They received IRT in addition to other therapy. Overall, these people had fewer, less intense nightmares and better quality sleep.
And according to this review of treatmentsTrusted Source for nightmares in people with PTSD, IRT also reduced:
• disturbing dreams • PTSD symptoms • anxiety
In the same review, the researcher notes that results in veterans with PTSD have been mixed. But other factors — such as different versions of IRT — could explain these findings.
How does IRT work?
Although IRT is based on the idea that traumatic events cause nightmares, it doesn’t focus on exploring that trauma. Instead, IRT treats nightmares as a specific issue that you can address.
IRT also teaches that nightmares actually serve a “helpful” purpose. For example, nightmares might help you emotionally process a traumatic event. But over time, these bad dreams hurt more than they help.
So IRT might teach you to view nightmares as habits or learned behaviors — ones that you can alter and adjust so they no longer disturb you.
Another core belief of IRT is that working with dreams during the day can influence your nighttime dreams, and as an extension of that, your nightmares
The steps of IRT
You can use IRT in a one-on-one or group format. Each person’s situation, condition, nightmare complexity, and intensity are different, so the number of sessions and other IRT variables will differ.
There are also different versions of IRT, and they come with slightly different elements and instructions. For example, some versions include keeping a sleep diary and practicing relaxation techniques.
In general, IRT involves three stages:
• selecting a less intense nightmare (if possible, one that isn’t a replay of the traumatic event because the goal is not to trigger a strong emotional response)
• changing the nightmare — some versionsTrusted Source advise changing it however you want, while others suggest creating a positive ending
• rehearsing your new dream up to 20 minutes each day for about a week
What can I expect in IRT?
In an IRT session, you may be surprised (or relieved) to learn that you don’t discuss the details of your trauma or even the traumatic content of your nightmares. While an IRT therapist doesn’t discount your traumatic experiences, the focus is on addressing the nightmares.
Early sessions of IRT usually include discussing how the therapy works and responding to any of your questions or concerns. Your therapist can also teach you about nightmares and their connection to sleep quality.
For example, when you have nightmares, it’s natural to want to avoid them — and that’s how you might end up avoiding sleep or experiencing insomnia.
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In IRT, you begin by picking one less intense nightmare to work with. You also focus on practicing one new dream at a time.
One key to remember is that you don’t need to go through every single bad dream. After revising and rehearsing a few disturbing dreams, you’ll likely notice fewer other nightmares, too.
Like other forms of cognitive behavior therapy, IRT also includes homework: Outside of therapy, you might practice pleasant imagery exercises. Once you’ve created your new dream, you could also rehearse it for up to 20 minutes a day.
What are some common goals in IRT?
Goals of IRT can include:
Untying your identity from your nightmares
Because nightmares (and other symptoms) can impact your entire life, you might start to believe that having bad dreams is inevitable — or even that having them is linked to your identity. According to 2006 research, this is similar to when people don’t believe they can stop smoking because they’ve been doing it for such a long time.
Though not everyone who has nightmares holds this belief or identity, it’s common and understandable. But it can keep the nightmares going.
So one major goal of IRT is to realize your identity isn’t tied to your nightmares. Changing this learned belief can help you stop the nightmares.
Reducing nightmares
In IRT, you reduce nightmares by creating new dreams with positive, pleasant, or empowering images. These images will be different for every person, but the key is to pick what resonates with you.
Some people choose to change a few elements of a dream, while others create a completely new story.
For example, this might mean adding helpful characters or changing the setting to somewhere safe.
Sleeping better
In reducing disturbing dreams, IRT also aims to help you get a good night’s sleep. It could also help you manage:
• your fears about going to sleep • how often you wake up at night • restlessness during sleep
Better sleep can also produce other benefits, such as less anxiety and more daytime energy.
What’s next?
Having nightmares can make you feel helpless. But in imagery rehearsal therapy (IRT), you change those dreams and empower yourself with the techniques to manage them.
IRT isn’t widely available. To start your search, you can ask your doctor or a loved one to recommend therapists who specialize in trauma, nightmares, or sleep (or the mental health condition you might have).
Another option is to search online at the Association for Behavioral and Cognitive Therapies for a cognitive behavioral therapist.
After picking several therapists you like, you can interview them by asking these questions (and anything else you’d like to know):
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• Have you treated people using imagery rehearsal therapy? • What is your experience working with people with trauma? • What treatment approaches do you use for trauma? • What is your experience treating nightmares? • What is your perspective on nightmares and how to reduce them?
What Is Dialectical Behavior Therapy? by Margarita Tartakovsky, MS
If you’re looking to build skills like mindfulness and emotional regulation in therapy, DBT could be a good option for you.
Dialectical behavior therapy (DBT) is an effective, science-backed therapy that helps people — many of whom experience significant mental health challenges — build a life they find worthwhile.
In DBT, you identify what this kind of life looks like for you and learn the skills to make it happen.
While DBT can help regardless of whether you have a mental health diagnosis, it’s often used to support people who experience:
• borderline personality disorder (BPD) • eating disorders • substance use disorders • suicidal ideation and self-harm
If you’re feeling like mental health symptoms are negatively impacting your quality of life, health, or relationships, DBT might be a good choice for you.
What’s the theory behind DBT?
Psychologist Marsha Linehan, PhD, developed dialectical behavior therapy in the 1980s for people with suicidal thoughts who also often lived with BPD.
BPD is a mental health condition that involves:
• an unstable sense of self • intense emotions • impulsive actions • relationship difficulties • black and white thinking
The first word in DBT, “dialectical,” captures the treatment’s foundation. Dialectic philosophy features these core beliefs:
• All things are interconnected. • Change is constant and inevitable. • Opposites can be integrated to get closer to the truth.
In other words, two seemingly opposite things can actually be true at the same time. For example, it’s important to accept where you are and strive to grow. It’s important to recognize that you’re doing your best and keep trying.
At its root, DBT takes a biosocial approach to understanding how people’s symptoms arise and continue.
For example, many people with BPD grew up in an invalidating environment and tend to experience emotions intensely. Living in an environment where you don’t have support or acceptance of your needs can perpetuate or worsen those symptoms.
How does DBT work? Techniques and more
Dialectical behavior therapy is based on cognitive behavior therapy (CBT). CBT has a long track record of success, with hundreds of studies Trusted Source confirming its effectiveness.
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In CBT, you identify important-to-you goals and overcome obstacles that prevent you from achieving these goals. You learn skills to change unhelpful thoughts and behaviors.
The same is true for DBT, which is highly structured and teaches critical skills through these four modules:
Core mindfulness
Core mindfulness skills, adapted from Eastern meditation practices, teach you to become more aware of the present moment. You learn to focus on one thing at a time, without judging yourself or others.
Distress tolerance
When difficult situations arise, instead of getting stuck in thought patterns that don’t help you process the situation (like thinking “this isn’t fair!”), distress tolerance teaches acceptance. Accepting things you don’t have control over can help you solve problems and improve low moods.
To prevent impulsive or self-harming behavior, this module also teaches you constructive, in-the-moment alternatives. These include distraction and self-soothing techniques, like doing a deep breathing exercise, taking a walk, or listening to your favorite music.
Interpersonal effectiveness
In this module, you learn the skills to create healthy relationships while taking care of yourself. Interpersonal effectiveness includes working through conflict, listening well, and clearly asking for what you need.
Emotion regulation
Emotion regulation skills help you label your emotions without judging them. You learn how different emotions shape your behavior and what obstacles prevent you from managing your emotions.
Plus, you learn to avoid situations that typically trigger strong emotions and pursue events that boost positive emotions.
What are some common goals in DBT?
DBT’s ultimate goal is to help you live a life you feel good about. A meaningful, fulfilling life looks different for each person. This is why therapists help people hone in on what’s important to them.
Another critical goal of DBT is to address behaviors that pose a life-threatening risk, such as suicidal thoughts, suicide attempts, and self-harm.
It’s also important to address behaviors that interfere with therapy and prevent you from making progress. Therapy-hampering behaviors can include anything from missing appointments to arriving late or not completing homework.
As a team, you and your therapist will identify behaviors you’d like to decrease along with behaviors you’d like to increase. For example, someone might use DBT to address behaviors related to alcohol use or binge eating disorder.
What can I expect going in to DBT?
Dialectical behavior therapy consists of these key components:
One-on-one sessions
Once a week, you talk with your therapist to learn how to apply DBT skills to specific challenges and situations in your own life.
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To further help you practice these skills, you complete homework outside of your sessions. Homework typically includes filling out daily “diary cards,” which track your emotions, urges, behaviors, and thoughts. You also track the skills you’re using and how helpful they are.
Group skills training
This is often a 2-hour, weekly meeting that teaches you the above four modules. Because your training is done in a group setting, you have the opportunity to interact with others and role-play new skills.
Phone coaching
Unlike with most other therapies, with DBT your therapist is available by phone for in-the-moment support. So, if you’re going through a difficult situation and having a hard time using healthy coping techniques, you can call your therapist.
Consultation team
Because supporting people with life-threatening behaviors can be challenging, DBT therapists work with consultation teams. A consultation team is a group of DBT professionals who meet regularly to help one another navigate potential stressors, stay motivated, and deliver good therapy.
Is DBT right for me?
When figuring out whether DBT is right for you, considering these questions (and their answers) can help.
What conditions does DBT help with?
Research has found that beyond BPD, dialectical behavior therapy has been shown to help reduce suicidal behavior in adults. Studies show DBT also reduces self-harming behaviorTrusted Source and suicide attemptsTrusted Source in teens.
Experts have adapted DBT for other mental health conditions. According to research, DBT may be a promising treatment for:
• eating disorders, such as binge eating disorderTrusted Source • substance use disorder in adults and teens • co-occurring substance use and BPDTrusted Source • depressionTrusted Source • bipolar disorderTrusted Source
Who can benefit from DBT?
In addition to treating the above mental health conditions, DBT may be helpful if:
• you have a hard time dealing with your emotions • your emotions are intense or explosive • you regularly experience mood ups and downs • your relationships feel like a roller coaster • you feel empty or hopeless • you’ve tried other therapies that haven’t worked • your life feels out of control or isn’t fulfilling • you’re using outlets to cope with stress or overwhelming emotions that could pose health risks,
like substances or unprotected sex
Next steps
DBT is an evidence-based treatment for many mental health conditions. In DBT, you learn to manage intense emotions, cope with distress, and cultivate healthy relationships.
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To find a DBT therapist, you can use online tools like Behavioral Tech’s directory of therapists who specialize in DBT.
Asking around can also help. Checking with your primary care physician, other therapists, or your local college, university, or medical center could all be helpful options.
When looking for a therapist, you can also double-check that they specialize in DBT by asking questions like:
Ask the Psychiatrist: Everyday Tips for Better Mental Health
BY Muriel Sommers May 29, 2021
“When you treat a patient holistically, you not only treat the symptoms, you work with the patient on eating healthy, staying away from alcohol and drugs, and focusing on exercise as medicine,” says Rachel V.F. Rohaidy, M.D., a psychiatrist at Baptist Health Primary Care and medical director of The Recovery Village at Baptist Health.
“I’m a huge fan of holistic treatments which concentrate on the whole body because our body doesn’t function in separate boxes,” Dr. Rohaidy says. “Our thoughts and emotions affect the way we feel physically, just as the way we feel can affect our mental outlook.”
Rachel V.F. Rohaidy, M.D., psychiatrist at Baptist Health Primary Care and medical director of The Recovery Village at Baptist Health
The number of people struggling with anxiety, depression and stress today has increased since the onset of the Covid-19 pandemic, Dr. Rohaidy notes. “We’re seeing more people seeking help for those symptoms, along with an increase in patients presenting with substance abuse disorders,” she says.
According to the National Mental Health Association in 2019, 51.5 million adults in the U.S. were dealing with some type of mental illness. The U.S. Centers for Disease Control & Prevention (CDC) says 25 million American adults suffer from an anxiety disorder and, according to the World Health Organization, one in 13 adults globally battle anxiety.
“Psychiatrists are not the type of doctors anyone really wants to see,” acknowledges Dr. Rohaidy. “It’s sad that, for some people, seeking help is taboo. Most people who deal with anxiety and depression have had symptoms for 10 years or more.”
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We can all relate to that feeling when our anxiety level rises in response to a perceived threat or danger, Dr. Rohaidy says. “It’s when we have those ‘fight or flight’ moments that our body’s sympathetic nervous system kicks in and we get an adrenaline push which helps us during and after the incident, she says.
There are also times when we feel anxious, nervous, sad or depressed. “We’re human – those feelings are normal,” Dr. Rohaidy says. “But ‘normal’ can become a disorder when those feelings don’t go away, and when your sympathetic nervous system is constantly on and doesn’t switch off.”
When anxiety, depression or stress begins to affect your daily life, the way you feel and act, or your relationships with your family, friends or colleagues, that’s when she says it’s time to seek help.
Dr. Rohaidy offers specific and practical tips on how you can ease unwelcome feelings when they do occur, along with simple steps you can take every day to help ensure better mental and physical health. “All of these tips are good for you, even if you’re not experiencing anxiety or depression,” she says.
Everyday Steps to Better Mental Health
• Take a time-out. “When you’re feeling overwhelmed, it helps to find a healthy way to step back from the situation,” Dr. Rohaidy says.
o Take a moment for yourself, have a bath or a shower. Heat can reset the nervous system.
o Drink chamomile or green tea which can be restorative to your system and reset that stress response to your anxiety.
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o Green tea can be helpful but there are no studies. Tea tends to be more forgiving in the treatment of gastritis and on the GI system.
• Eat your way to better health. “Eating well is especially important because there is a clear gut-brain connection,” Dr. Rohaidy says.
o Issues with going to the bathroom can cause a backup in the gut which can lead to moodiness, irritability and anxiety.
o There are foods that have been shown to help with the treatment of Attention Deficit/Hyperactivity Disorder (ADHD) and other disorders. These foods help with anxiety and depression, and are also anti-inflammatory.
o Eat leafy greens, vegetables, nuts, seeds, (watch for allergies), fatty fish, halibut, salmon, and other foods rich in Omega 3.
o Omega 3 and other fatty acids are important for long-term health benefits for your health. You want about 1,000 milligrams in your system daily, which you can get from fatty fish, spinach and supplements.
o Eat a little turkey – it contains tryptophan which is said to produce healthy sleep patterns and boost your mood.
o An apple a day keeps the doctor away. There is a huge benefit to fresh fruits and vegetables.
o Ginger and turmeric are anti-inflammatory spices and can help with rheumatoid arthritis and other issues.
• Limit consumption of alcohol and caffeine. “Caffeine is a stimulant,” Dr. Rohaidy says. “When you increase your caffeine intake, you can also be increasing your anxiety levels.”
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o Caffeine can be sneaky– darker teas have caffeine in them, drink more on the light side.
o Limit energy drinks because they have caffeine. There is a condition known as Caffeine Use Disorder.
o If you can’t pronounce it, try to stay away from it. You only want to put things in your body that you can pronounce.
o Alcohol is toxic to every cell in your body. Drinking increases breast cancer risks in women and increased kidney cancer risks in men.
• Get more – and better – sleep. “We all need healthy, restorative sleep – ideally, 8 to 10 hours daily,” Dr. Rohaidy advises. “Sleeping more than 10 hours may be a sign of depression, however.”
o Have a sleep schedule. Try and go to bed and wake up at the same times every day.
o There is a reason why we sleep – our brains need to disconnect from the day and sleep is the way to convert our short-term memories into long-term memories.
o Alcohol ruins the sleep architecture and prevents you from going into deep REM sleep. Surface sleep means you’re not dreaming and not getting enough restorative sleep.
• Exercise! “It really is the best medicine,” says Dr. Rohaidy. o You don’t have to go to a gym – walking, washing your car, anything that gets
your heart rate up a little bit is good. o Just 10 minutes a day can bring the stress levels down and help you feel better.
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o Spend time in nature, go walking on a trail, ride a bike, just be outside. o Exercise helps build up some resiliency and the ability to bounce back after a
trying situation.
• Take a deep breath and count to 10. “When you feel overwhelmed and can’t take any more, count to 10 slowly and focus on your breathing,” Dr. Rohaidy advises.
o Doing a little meditation can help in stressful moments and, although it may feel silly, meditation can be practiced throughout the day.
o There are great apps like Headspace that can help you easily incorporate meditation into your daily life.
o Dim the lights, change the lighting close your eyes, breathe for three or four minutes.
o Sit, relax and restore, and that accelerated stress response will slow down.
The pandemic has been difficult for everyone, Dr. Rohaidy acknowledges. “It’s affected so many people in so many different ways – chief among them creating a sense of loss and isolation.” As more people get vaccinated, she predicts, things will begin to improve and “some of the isolation and anxiety people have felt over the last 15 months will begin to go away.”
To help fight feelings of isolation, Dr. Rohaidy recommends joining an online group with a shared interest, whether it’s gardening, cooking, photography or whatever activity you enjoy. “Make it a habit. Feeling a part of a community helps you feel connected and will improve your mood,” she says.
