Dr. Penati's Resources

This page will be evolving and changing over time. I hope you will find the information beneficial. For those of you that would rather listen to information, please note that audiofiles are provided for many of the written materials.

DBT

I am not exagerating when I say that learning and applying DBT concepts and skills has changed my life. DBT has opened the doors to the concepts of dialectical thinking, change and validation, and looking at situations with a "what is more effective" perspective rather than judgment. In general, learning to approach and look at situations and at ourselves from different perspectives.
Understanding the "D" in DBT

Understanding the "D" in DBT

"D" is for Dialectical. What does that mean? Well Dialectical thinking is where a person is able to examine or hold two opposing thoughts at the same time. In DBT, Dialectical is defined as a synthesis or integration of opposites (Marsha Linehan).

In simpler terms, Dialectical means two opposing things being true at once.

  • I can feel sad AND feel happy at the same time.
  • I can feel love AND anger for the same person.
  • I am fine as I am AND there is always room to grow.
  • I can tell someone that they have really improved (Validation) AND that they also need to learn more (Change).
  • Dialectical thinking is all about using "AND" to connect opposites.

"AND" Instead of "but"

"AND" Instead of "but"

WORDS have MEANING! When interacting with others, our words matter. A simple word that is very important in our communication with others is: AND.

The word AND connects two thoughts/statements. When we want both statements to be validated and paid attention to, we should use the word "AND." The use of AND can improve how we give feedback and tends to encourage dialogue when interacting with others. When giving feedback to others the use of the word "AND" allows both points/positions to be equally valid.

HOLD ON! There are times when the use of "but" is useful. We can use "but" when we want to dismiss (NEGATE) the first part of our sentence OR, looking at it from another perspective, when we want to emphasize the second part of our statement. Below is an example that uses both words "AND" and "BUT".

  • "I really messed up BUT I can learn from my mistakes AND do better next time" (Please note that the use of "BUT" places greater emphasis on "learning from mistakes" rather than the idea of "I messed up". Then the use of "AND" equally emphasizes and embraces the ideas of "I can learn" AND "I can do better"

Learn more about AND instead of BUT

The Four Basic Assumptions

The Four Basic Assumptions
 (Adapted from: DBT-Family Skills Training, Perry Hoffman)    

WAIT!

  • What is an Assumption?
  • How will these Four Assumptions help me?

An Assumption is a belief that cannot be proven. The way we think and the assumptions we make impact how we feel and how we interact with others. Embracing the Four Basic Assumptions can help us communicate more effectively with those we care about.

      1. There is no absolute truth or any one truth. Usually there are two or more truths
      2. All of us are doing the best we can
          AND
      3. We can do better, try harder (learn to be more skillful, gain more knowledge)
      4. Interpret situations in the most benign way possible (such as a kinder and gentler           interpretation, to give someone the benefit of the doubt)

Which of the Four Basic Assumptions do you find challenging?
Which are you willing to incorporate in your life?

Think of these Assumptions as guidelines. Perhaps, you will choose to experiment with each for a few weeks.

Learn more about The Four Basic Assumptions

Mindfulness

Do you ever function on "autopilot," such as not realizing how you got to your destination?
Do you multi-task?
Do you ever push away or cling to experiences?

If you answered "yes" to any of the above questions, then in that moment you were not practicing mindfulness.

Mindfulness is experiencing reality "As It Is" in the present moment. With mindfulness we develop an in-the-moment awareness of how we are doing mentally, emotionally, and physically.

Living in the present can have a profound impact in our lives.  Mindful living can help us more effectively  manage emotions.  Becoming aware of "what works" and "what does not work" allows us to start making changes in our ourselves and how we respond to and interact with others.

Learn more about Mindfulness and see what speaks to you.
States of Mind

The Four States of Mind

DBT talks about Three States of Mind: Emotion Mind, Reason Mind, and Wise Mind. The Body Mind has been included by some, as body sensations can be interconnected to our thoughts and feelings.

1. Emotion Mind: mood-dependent, irrational thinking, impulsivity, judgments, creativity, empathy
2. Reason Mind: cold, rational, just the facts, task focused
3. Body Mind: physical sensations
4. WISE MIND : intuitive knowing, gut instinct, what you know to be the truth deep in your heart                            when you are calm.

The goal is to get to wise mind and bring together the best of Reason and Emotion Mind.

What is your default Mind State?
Which Mind State would you like to strengthen?

Perhaps, throughout your day you can bring awareness to your current emotions, thoughts, and body sensations, so as to assess your current State of Mind.

Wise Mind

Wise Mind

The WISE Mind is more than the sum of its parts. When we are in a WISE Mind state:

  • the Reason Mind becomes a Doing Mind
  • the Emotion Mind becomes a Being Mind
  • and the Body Mind is connected to our thoughts and feelings

(Feel free to listen to the audio as you look at the diagram)  

wise mind

Nonjudgmental Stance (Just the Facts)

Taking a Nonjudgmental Stance

Let me begin by clarifying that we all judge. We may judge ourselves, others, and events that happen in our life. We can think of judgments as an abbreviated way of stating a preference, a way to organize our perceptions of a situation into categories such as "right," "wrong," "fair," "unfair," “good,” “bad.” If something is “good” then we know we can do more of it and if something is “bad” we know we may need to steer away from it.

When interacting with others and ourselves, judgments often elicit strong emotions. “Negative” judgments can elicit strong “negative” emotions. Perhaps surprisingly, “positive” judgments can also elicit “negative” emotions.

The idea of taking a nonjudgmental stance is learning to state opinions in terms of facts (who, what, where, when) rather than in the form of judgments. A nonjudgmental stance tends to be more emotionally neutral, while “negative” judgments tend to be experienced as harsh and critical in nature.

Being non-judgmental does not mean agreeing or ignoring behaviors and their consequences. It just means observing and describing behaviors and consequences using fact-based statements. With these facts, we can still choose to problem solve and/or make changes that will decrease pain and suffering. In fact, it is easier to make changes when we know what to change.

For example: if someone tells me, “I don’t like the way you treat me,” I really do not know what exactly I am doing that they don’t like. At the same time, I may also experience feelings of sadness, anger, and/or confusion.

On the other hand, if I someone tells me, “When you raise your voice, I feel scared and I would like you to talk in a quieter tone,” now I know exactly what the person is experiencing and the changes they would like me to make. In addition, I would experience more neutral emotions.

We don’t need to make judgments to create change. Actually, judgments often keep us in the emotion mind and away from the doing mind.

See if you can catch your judgments and gently, with kindness, allow yourself to stop and re-describe the situation based on "just the facts." Experiment and observe what happens.

Read more about taking a Nonjudgmental Stance.

Breathing

When applying breathing techniques, in-the-moment, we consciously control our inhalations and exhalations using different breathing patterns.  Mindful breathing helps us connect to the present moment; helps us move toward a relaxation response; and helps us send a message to the brain that everything is OK. Some breathing techniques are: Square Breathing (helpful during Panic Attacks), the 4-7-8 Breath, and Coherent Breathing.

When mindful breathing practices are incorporated in our day-to-day life,  we learn to stay in a relaxed response state, we become less reactive, and, over time, our brain's perception of stress changes.

We can use breathing APPS such as Calm App Breathing, the Heartmath APP, or Breathe APP to practice and learn new, more effective ways of breathing. The Ted talk about Breathing, Mindfulness, Heart Rate Variability clearly explains how the breath and mindful breathing practices are important to our physical and mental well-being.

Breathing Practices and Techniques

Emotional Regulation

It seems that many people think that therapy is all about learing to always be happy. Well, all emotions, including happiness, are like waves, they come and go. In addition, all emotions can be helpful, as they can give us information about our experience of the world and ourselves. AND at the same time, emotions can sometimes become Tsunamis and hijack us. This is when having some strategies to surf the emotional wave comes in handy.

The Function of Emotions

The Function of Emotions and Valdiation

Marsha Linehan, Ph.D. ABPP describing the Funtion of Emotions and why parent's validation of their child's emotions helps the child calm.

The Red Zone

The RED Zone

A time of intense emotional agitation when our emotions (such as anger, fear, sadness) are taking control. In DBT terms, emotional dysregulation happens when one is in the RED Zone.

In the RED Zone it is hard to self-soothe and redirect attention. In the RED Zone the THINKING part of our brain has shut down and so has our ability to problem solve.

In DBT, this is when we use DISTRESS TOLERANCE SKILLS to calm down enough (get out of the RED Zone) so that we can apply/use other coping skills.

Emotion Vulnerability

Emotion Vulnerability

(Adapted from the DBT Model of Emotion Regulation - Marsha Linehan, Ph.D.)

The three components of Emotion Vulnerability are: 1. Heightened Emotional Sensitivity, 2. Heightened Emotional Reactivity, and 3. Slow Return to Baseline.

1. EMOTIONAL SENSITIVITY

  • Being more sensitive to emotional stimuli
  • Being more likely to detect subtle emotional information in the environment that others don’t even notice
  • Experiencing emotions much more often than others

2. EMOTIONAL REACTIVITY

  • Having extreme emotional reactions
  • Having intense emotions. Emotions tend to hit like a ton of bricks
  • Experiencing disruption in the ability to think and the ability to self soothe

3. SLOW RETURN to BASELINE

  • having long lasting emotional reactions
  • having a hard time returning to baseline
  • contributes to high sensitivity to the next emotional stimulus

Read more about Emotion Vulnerability

Defusing Anger

Willing Hands

Body posture affects our emotions. Change your body posture to change your emotions.

Articles

My hope is to write brief Articles that will both validate and offer different ways of looking at life and ourselves. Please note that articles are provided in written and audio formats.

    Below are Breathing Techniques:

DBT

Breathing and Mindfulness

ADHD/ADD

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