Podcast appearances and mentions of marsha linehan

You can listen wherever you get your podcasts, OR— BRAND NEW: we've included a fully edited transcript of our interview at the bottom of this post.In this episode of The Peaceful Parenting Podcast, I speak with Shireen Rizvi, PhD and Jesse Finkelstein, PsyD, about their book Real Skills for Real Life: A DBT Guide to Navigating Stress, Emotions, and Relationships. We discuss what Dialectical Behavior Therapy (DBT) is, how it can help both ourselves and our kids with big feelings, and get into some of the skills it teaches including distress tolerance, check the facts, and mindfulness.**If you'd like an ad-free version of the podcast, consider becoming a supporter on Substack! > > If you already ARE a supporter, the ad-free version is waiting for you in the Substack app or you can enter the private feed URL in the podcast player of your choice.Know someone who might appreciate this post? Share it with them!We talk about:* 6:00 What is DBT?* 11:00 The importance of validation* 13:00 How do parents manage their own big feelings?* 16:00 How do you support a kid with big feelings, and where is the place for problem solving?* 23:00 Managing the urge to fix things for our kids!* 26:00 What is distress tolerance?* 28:50 “Check the facts” is a foundational skill* 34:00 Mindfulness is a foundation of DBT* 36:45 How the skills taught through DBT are universalResources mentioned in this episode:* Yoto Player-Screen Free Audio Book Player* The Peaceful Parenting Membership* Real Skills for Real Life: A DBT Guide to Navigating Stress, Emotions, and Relationships by Shireen Rizvi and Jesse Finkelstein * Shireen Rizvi's website * Jesse Finkelstein's websites axiscbt and therahive Connect with Sarah Rosensweet:* Instagram* Facebook Group* YouTube* Website* Join us on Substack* Newsletter* Book a short consult or coaching session callxx Sarah and CoreyYour peaceful parenting team- click here for a free short consult or a coaching sessionVisit our website for free resources, podcast, coaching, membership and more!>> Please support us!!! Please consider becoming a supporter to help support our free content, including The Peaceful Parenting Podcast, our free parenting support Facebook group, and our weekly parenting emails, “Weekend Reflections” and “Weekend Support” - plus our Flourish With Your Complex Child Summit (coming back in the spring for the 3rd year!) All of this free support for you takes a lot of time and energy from me and my team. If it has been helpful or meaningful for you, your support would help us to continue to provide support for free, for you and for others.In addition to knowing you are supporting our mission to support parents and children, you get the podcast ad free and access to a monthly ‘ask me anything' session.Our sponsors:YOTO is a screen free audio book player that lets your kids listen to audiobooks, music, podcasts and more without screens, and without being connected to the internet. No one listening or watching and they can't go where you don't want them to go and they aren't watching screens. BUT they are being entertained or kept company with audio that you can buy from YOTO or create yourself on one of their blank cards. Check them out HEREPodcast transcript:Sarah: Hey everyone. Welcome back to another episode of the Peaceful Parenting Podcast. Today we have two guests who co-authored a book called Real Skills for Real Life: A DBT Guide to Navigating Stress, Emotions, and Relationships.And you may be wondering why we're talking about that on a parenting podcast. This was a really great conversation with Shireen Rizvi and Jesse Finkelstein, the co-authors of the book, about all of the skills of DBT, which is a modality of therapy. We talked about the skills they teach in DBT and how we can apply them to parenting.They talk about how emotional dysregulation is the cause of so much of the pain and suffering in our lives. And I think as a parent, you will recognize that either your own emotional dysregulation or your child's is often where a lot of issues and conflict come from.So what they've really provided in this book—and given us a window into in this conversation—is how we can apply some of those skills toward helping ourselves and helping our children with big feelings, a.k.a. emotional dysregulation. It was a really wonderful conversation, and their book is wonderful too. We'll put a link to it in the show notes and encourage you to check it out.There are things you can listen to in this podcast today and then walk away and use right away. One note: you'll notice that a lot of what they talk about really overlaps with the things we teach and practice inside of Peaceful Parenting.If this episode is helpful for you, please share it with a friend. Screenshot it and send it to someone who could use some more skill-building around big emotions—whether they're our own big emotions or our child's. Sharing with a friend or word of mouth is a wonderful way for us to reach more people and more families and help them learn about peaceful parenting.It is a slow process, but I really believe it is the way we change the world. Let's meet Shireen and Jesse.Hi, Jesse. Hi, Shireen. Welcome to the podcast.Jesse: Thank you so much for having us.Sarah: Yeah. I'm so excited about your book, which I understand is out now—Real Skills for Real Life: A DBT Guide to Navigating Stress, Emotions, and Relationships. First of all, I love the format of your book. It's super easy to read and easy to use. I already thought about tearing out the pages with the flow charts, which are such great references—really helpful for anyone who has emotions. Basically anyone who has feelings.Jesse: Oh, yes.Sarah: Yeah. I thought they were great, and I think this is going to be a helpful conversation for parents. You've written from a DBT framework. Can you explain what DBT is and maybe how it's different from CBT? A lot of people have heard more about cognitive behavior therapy than dialectical behavior therapy.Shireen: Sure. I would first say that DBT—Dialectical Behavior Therapy—is a form of cognitive behavioral therapy. So they're in the same category. Sometimes we hear therapists say, “I do DBT, but I don't do CBT,” and from my perspective, that's not really possible, because the essence of dialectical behavior therapy is CBT. CBT focuses on how our thoughts, behaviors, and emotions all go together, and how changing any one of those affects the others.That's really the core of DBT—the foundation of CBT. But what happened was the person who developed DBT, Marsha Linehan—she was actually my grad school advisor at the University of Washington—developed this treatment because she was finding that standard CBT was not working as well as she wanted it to for a particular population. The group she was working with were women, primarily, who had significant problems with emotion regulation and were chronically suicidal or self-injuring.With that group, she found they needed a lot more validation—validation that things were really rough, that it was hard to change what was going on, that they needed support and comfort. But if she leaned too much on validation, patients got frustrated that there wasn't enough change happening.So what she added to standard CBT was first a focus on validation and acceptance, and then what she refers to as the dialectical piece: balancing between change and acceptance. The idea is: You're doing the best you can—and you need to do better.Jesse: Mm-hmm.Shireen: And even though DBT was developed for that very severe group that needed a lot of treatment, one of the aspects of DBT is skills training—teaching people skills to manage their emotions, regulate distress, engage interpersonally in a more effective way.Those skills became so popular that people started using them with everyone they were treating, not just people who engaged in chronic suicidal behavior.Sarah: Very cool. And I think the population you're referring to is people who might be diagnosed with borderline personality disorder. I bring that up only because I work with parents, not kids, and parents report to me what their children are like. I've had many parents worry, “Do you think my child has borderline personality disorder?” because they've heard of it and associate it with extreme sensitivity and big feelings.A lot of that is just typical of someone who's 13 or 14, right? Or of a sensitive child—not diagnosable or something you'd necessarily find in the DSM. I've heard it so many times. I say, “No, I don't think your child has borderline personality disorder. I think they're just really sensitive and haven't learned how to manage their big feelings yet. And that's something you can help them with.”With that similar level of emotional intensity—in a preteen or early teen who's still developing the brain structures that make self-regulation possible—how can we use DBT skills? What are a couple of ideas you might recommend when you have a 13-year-old who feels like life is ruined because the jeans they wanted to wear are soaking wet in the wash? And I'm not making fun—at 13, belonging is tied to how you look, what jeans you're wearing, how your hair is. It feels very real.So how might we use the skills you write about for that kind of situation?Jesse: Well, Sarah, I actually think you just practiced one of the skills: validation. When someone feels like their day is ruined because of their jeans, often a parent will say, “Get over it. It's not a big deal.” And now, in addition to fear or anxiety, there's a layer of shame or resentment. So the emotion amplifies and becomes even harder to get out of.Validation is a skill we talk about where you recognize the kernel of truth—how this experience makes sense. “The jeans you're wearing are clearly important to you. This is about connection. I understand why you feel this way.” That simple act of communicating that someone's thoughts and feelings make sense can be very powerful.Alongside that—back to what Shireen was saying—there are two tracks. One is the skills you help your teen practice. The other is the skills you practice yourself to be effective. In that moment, your teen might be dysregulated. What is the parent's emotion? Their urge? What skills can they practice to be effective?Sarah: I love that you already went to the next question I was going to ask, which is: when that kid is screaming, “You don't understand, I can't go to school because of the jeans,” what can parents do for themselves using the skills you describe?Shireen: I often think of the oxygen-mask analogy: put on your own oxygen mask before helping others. That was certainly true for me when I had fussy infants—how do you manage that stress when you are already heightened?What do you need to do to regulate yourself so you can be effective in the moment? Sometimes that's literally taking a time-out—leaving the room for a minute. The kid comes after you about the jeans, and you say, “Hold on, I need a minute.” You sequester yourself in the bathroom. You do paced breathing—a DBT skill that helps regulate your nervous system. You do that for a minute, get centered, and then return to the situation.If you're not regulated and your child is dysregulated, you'll ping-pong off each other and it becomes messier and messier. But if you can regulate yourself and approach calmly, the whole interaction changes.Sarah: It's so interesting because people who've been listening to my podcast or know my work will think, “Oh yeah, these are the things Sarah talks about all the time.” Our first principle of peaceful parenting is parental self-regulation. It doesn't mean you never get upset, but you recognize it and have strategies to get back to calm.And I always say, if you forget everything else I teach about dealing with upset kids, just remember empathy—which is another way of saying validation. I tell parents: you don't have to agree to empathize. Especially with situations like the jeans.I love the crossover between the skills parents are practicing in my community and what you've written about. And again: those flow charts! I'm going to mark up my book with Post-its for all the exercises.One of the things you talk about in the book is problem solving. As parents, we can find ourselves in these intense situations. I'll give an example: a client's daughter, at 11 p.m., was spiraling about needing a particular pair of boots for her Halloween costume, and they wouldn't arrive in time. No matter what the mom said, the daughter spiraled.This is a two-part question: If you've validated and they're still really upset, how do you support a kid who is deep in those intense feelings? And when is the place for teaching problem solving—especially when there is a real logistical problem to solve?Jesse: I'm going to say the annoying therapist thing: it depends. If we think about how emotions impact our thinking on a scale from 0 to 10, it's very hard to engage in wise-minded problem solving when someone is at an 8, 9, or 10. At that point, the urge is to act on crisis behaviors—yell, fight, ruminate.So engaging your child in problem solving when they're at a 9 isn't effective.Often, I suggest parents model and coach distress-tolerance skills. Shireen mentioned paced breathing. Maybe distraction. Anything to lower the emotional volume.Once we're in the six-ish range? Now we can problem solve. DBT has a very prescribed step-by-step process.But it's really hard if someone is so dysregulated. That's often where parents and kids end up in conflict: parent wants to solve; kid is at a 9 and can't even see straight.Sarah: Right. So walk us through what that might look like using the boots example. Play the parent for a moment.Jesse: Of course. I'd potentially do a couple of things. I might say, “Okay, let's do a little ‘tipping the temperature' together.” I'd bring out two bowls of ice and say, “We'll bend over, hold our breath for 30 seconds…”Shireen: And put your face in the bowl of ice water. You left out that part.Jesse: Crucial part of the step.Sarah: You just look at the ice water?Jesse: No, you submerge your face. And something happens—it's magical. There's actually a profound physiological effect: lowering blood pressure, calming the sympathetic nervous system.I highlight for parents: do this with your child, not didactically. Make it collaborative.And then: validate, validate, validate. Validation is not approval. It's not saying the reaction is right. It's simply communicating that their distress makes sense. Validation is incredibly regulating.Then you check in: “Do you feel like we can access Wise Mind?” If yes: “Great. Let's bring out a problem-solving worksheet—maybe from Real Skills for Real Life or the DBT manual. Let's walk through it step by step.”Sarah: And if you have a kid screaming, “Get that ice water away from me, that has nothing to do with the boots!”—is there anything to add beyond taking a break?Shireen: I'd say this probably comes up a lot for you, Sarah. As parents—especially high-functioning, maybe perfectionistic types (I put myself in that category)—if my kid is upset, I feel so many urges to fix it right away. Sometimes that's helpful, but often it's not. They either don't want to be fixed, or they're too dysregulated, or fixing isn't actually their goal—they just want to tell you how upset they are.I have to practice acceptance: “My kid is upset right now. That's it.” I remind myself: kids being upset is part of life. It's important for them to learn they can be upset and the world doesn't fall apart.If they're willing to do skills alongside you, great. But there will be times where you say, “I accept that you're upset. I'm sorry you feel this way. It sounds terrible. Let's reconnect in an hour.” And wait for the storm to pass.Sarah: Wait for the storm to pass.Jesse: I'll say—I haven't been a therapist that long, and I've been having this conversation with my own parents. Yesterday I called my mom about something stressful, and she said, “Jesse, do you want validation or problem solving right now?”Shireen: Love it.Jesse: I thought, “You taught her well.” I was like: okay, therapy works. And even having that prompt—“What would you like right now? Problem solving? Validation? Do you want me to just sit with you?”—that's so useful.Sarah: Yeah. I have to remind myself of that with my daughter, especially when the solution seems obvious to me but she's too upset to take it in. Just sitting there is the hardest thing in the world.And you've both anticipated my next question. A big part of your book is distress tolerance—one of the four areas. Can you talk about what distress tolerance is specifically? And as you mentioned, Shireen, it is excruciating when your kid is in pain or upset.I learned from my friend Ned Johnson—his wonderful book The Self-Driven Child—that there's something called the “righting instinct.” When your child falls over, you have the instinct to right them—pick them up, dust them off, stand them up. That instinct kicks in whenever they're distressed. And I think it's important for them to learn skills so we don't do that every time.Give us some thoughts about that.Shireen: Well, again, I think distress tolerance is so important for parents and for kids. The way we define it in DBT is: distress tolerance is learning how to tolerate stressful, difficult, complicated situations without doing anything to make it worse. That's the critical part, because distress tolerance is not about solving problems. It's about getting through without making things worse.So in the context of an interaction with your kid, “not making it worse” might mean biting your tongue and not lashing out, not arguing, not rolling your eyes, or whatever it is. And then tolerating the stress of the moment.As parents, we absolutely need this probably a thousand times a day. “How do I tolerate the distress of this moment with my kid?” And then kids, as humans, need to learn distress tolerance too—how to tolerate a difficult situation without doing anything to make it worse.If we swoop in too quickly to solve the problem for them—as you said, if we move in too quickly to right them—they don't learn that they can get through it themselves. They don't learn that they can right themselves.And I think there's been a lot written about generations and how parenting has affected different generations. We want our kids to learn how to problem solve, but also how to manage stress and difficulty in effective ways.Sarah: I think you're probably referring to the “helicopter parents,” how people are always talking about helicopter parents who are trying to remove any obstacles or remove the distress, basically.I think the answer isn't that we just say, “Okay, well, you're distressed, deal with it,” but that we're there with them emotionally while they're learning. We're next to them, right? With that co-regulation piece, while they're learning that they can handle those big feelings.Shireen: Yes. Yeah. Yeah.Sarah: I thought it might be fun, before we close out, to do a deep dive on maybe one or two of the skills you have in the book. I was thinking about maybe “Check the Facts.” It would be a cool one to do a deep dive on. You have so many awesome skills and I encourage anyone to pick up your book. “Check the Facts” is one of the emotion regulation skills.Do you mind going over when you would use Check the Facts, what it is, and how to use it?Jesse: Not at all. Check the Facts is, in many ways, a foundational skill, because it's so easy for us to get lost in our interpretation of a situation. So the classic example is: you're walking down the street and you wave to a friend, and they don't wave back. And I don't know about you, but it's easy for me to go to, “Oh, they must be mad at me.”Sarah: Right, yeah.Jesse: And all of a sudden, I'm spinning out, thinking about all the things I could have done to hurt their feelings, and yada yada yada. Then I'm feeling lots of upset, and I may have the urge to apologize, etc.What we're doing with Check the Facts is returning our attention back to the facts themselves—the things we can take in with our senses. We're observing and describing, which are two foundational mindfulness skills in DBT. And then from that, we ask ourselves: “Does the emotion I'm feeling—the intensity and duration of that emotion—fit the facts as I'm experiencing them?”So in many ways, this is one of those cognitive interventions. DBT rests on all these cognitive-behavioral principles; it's part of that broader umbrella. Here we're asking: “Do the facts as I see them align with my emotional experience?”From there, we ask: if yes, then there are certain options or skills we can practice—for instance, we can change the problem. If no, that begs the question: “Should I act opposite to this emotion urge that I have?”So it's a very grounding, centering type of skill. Shireen, is there anything I'm missing?Shireen: No. I would just give a parenting example that happens for me a lot. My kid has a test the next day. He says he knows everything. He doesn't open the book or want to review the study guide. And I start to think things like, “Oh my gosh, he has no grit. He's going to fail this test. He's not going to do well in high school. He's not going to get into a good college. But most importantly, he doesn't care. And what does that say about him? And what does it say about me as a parent?”I hope people listening can relate to these sorts of thoughts and I'm not alone.Sarah: A hundred percent. I've heard people say those exact things.Shireen: And even though I practice these skills all the time, I'm also human and a mother. So where Check the Facts can be useful there is first just recognizing: “Okay, what thoughts am I having in response to this behavior?” The facts of the situation are: my kid said he doesn't need to study anymore. And then look at all these thoughts that came into my mind.First, just recognizing: here was the event, and here's what my mind did. That, in and of itself, is a useful experience. You can say, “Wow, look at what I'm doing in my mind that's creating so much of a problem.”Then I can also think: “What does this make me feel when I have all these thoughts?” I feel fear. I feel sad. I feel shame about not being a good parent. And those all cause me to have more thoughts and urges to do things that aren't super effective—like trying to bully him into studying, all of these things.Then the skill can be: “Okay, are these thoughts exaggerated? Are they based in fact? Are they useful?” I can analyze each of these thoughts.I might think, “Well, he has a history of not studying and doing fine,” is one thing. Another thought: “Me trying to push him to study is not going to be effective or helpful.” Another: “There are natural consequences. If he doesn't do well because he didn't study, that's an important lesson for him to learn.”So I can start to change my interpretations based on the facts of the actual situation as opposed to my exaggerated interpretations. And then see: what does that do to my emotions? And when I have more realistic, fact-based thoughts, does that lead me to have a better response than I would if I followed through on all my exaggerated thinking?Does that make sense?Sarah: Yeah, totally makes sense. Are there any DBT skills that are helpful in helping you recognize when you need to use a skill—if that makes sense? Because sometimes I think parents might spiral, like in the example you're talking about, but they might not even realize they're spiraling. Sometimes parents will say, “I don't even know until it's too late that I've had this big moment of emotional dysregulation.”Jesse: I think there's a very strong reason why mindfulness is the foundation of DBT—for exactly the reason you've just described. For a lot of us, we end up engaging in behaviors that are ineffective, that are not in line with our values or goals, and it feels like it's just happening to us.So having a mindfulness practice—and I want to highlight that doesn't necessarily mean a formal meditation practice—but developing the skill of noticing, of being increasingly conscious of what you're feeling, your urges, your thoughts, your behaviors. So that when you notice that you are drifting, that you're engaging in an ineffective behavior, you can then apply a skill. We can't change what we're not aware of.Sarah: I love that. It's so hard with all the distractions we have and all of the things that are pulling us this way and that, and the busyness. So just slowing down and starting to notice more what we're feeling and thinking.Shireen: There's a skill that we teach that's in the category of mindfulness called Wise Mind. I don't have to get into all the particulars of that, but Wise Mind is when you're in a place where you feel wise and centered and perhaps a little bit calmer.So one question people can ask themselves is: “Am I in a place of Wise Mind right now?” And if not, that's the cue. Usually, when we answer that we're not, it's because we're in a state of Emotion Mind, where our emotions are in control of us.First, recognizing what state of mind you're in can be really helpful. You can use that as a cue: “I'm not in Wise Mind. I need to do something more skillful here to get there,” or, “I need to give myself some time before I act.”Sarah: I love that. So helpful. Before we wrap up, was there anything you wish I'd asked you that you think would be really helpful for parents and kids?Shireen: I just want to reiterate something you said earlier, which is: yes, this treatment was developed for folks with borderline personality disorder. That is often a diagnosis people run screaming from or are very nervous about. People might hesitate to think that these skills could be useful for them if they don't identify as having borderline personality disorder.But I think what you're highlighting, Sarah—and we so appreciate you having us on and talking about these skills—is that we consider these skills universal. Really anybody can benefit.I've done training and teaching in DBT for 25 years, and I teach clinicians in many different places how to do DBT treatment with patients. But inevitably, what happens is that the clinicians themselves say, “Oh, I really need these skills in my everyday life.”So that's what we want to highlight, and why we wrote this book: to take these skills from a treatment designed for a really severe population and break it down so anybody can see, “Oh, this would be useful for me in my everyday life, and I want to learn more.”Sarah: Totally. Yeah. I love it. And I think it's a continuum, right? From feeling like emotions are overwhelming and challenging, and being really emotionally sensitive. There are lots of people who are on that more emotionally sensitive side of things, and these are really helpful skills for them.Jesse: Yeah. And to add on that, I wouldn't want anyone—and I don't think any of us here are suggesting this—it's such a stigmatized diagnosis. I have yet to meet someone who's choosing suffering. Many of us are trying to find relief from a lot of pain, and we may do so through really ineffective means.So with BPD, in my mind, sometimes it's an unfortunate name for a diagnosis. Many folks may have the opinion that it means they're intrinsically broken, or there's something wrong with their personality. Really, it's a constellation of behaviors that there are treatments for.So I want anyone listening not to feel helpless or hopeless in having this diagnosis or experience.Shireen: Mm-hmm. Mm-hmm.Sarah: Thank you so much. The question I ask all my guests—I'll ask Shireen first and then Jesse—is: if you could go back in time, if you had a time machine, if you could go back to your younger parent self, what advice would you give yourself?Shireen: Oof. I think about this a lot, actually, because I feel like I did suffer a lot when my kids were babies. They were super colicky. I didn't sleep at all. I was also trying to work. I was very stressed. I wish that at that time I could have taken in what other people were telling me, which is: “This will pass.” Right? “This too shall pass,” which is something we say to ourselves as DBT therapists a lot. Time changes. Change is inevitable. Everything changes.In those dark parenting moments, you get stuck in thoughts of, “This is never going to change. It's always going to be this way. I can't tolerate this.” Instead, shifting to recognize: “Change is going to happen whether I like it or not. Just hang in there.”Sarah: I love that. My mother-in-law told me when I had my first child: “When things are bad, don't worry, they'll get better. And also, when things are good, don't worry, they'll get worse.”Shireen: Yes, it's true. And we need both the ups and the downs so we can actually understand, “Oh, this is why I like this, and this is why I don't like this.” It's part of life.Sarah: Yeah. Thank you. And Jesse, if you do ever have children, what would you want to remember to tell yourself?Jesse: I think I would want to remember to tell myself—and I don't think I'm going to say anything really new here—that perfection is a myth. I think parents often feel like they need to be some kind of superhuman. But we all feel. And when we do feel, and when we feel strongly, the goal isn't to shame ourselves for having that experience. It's to simply understand it.That's what I would want to communicate to myself, and what I hope to communicate to the parents I work with.Sarah: Love that. Best place to go to find out more about you all and what you do? We'll put a link to your book in the show notes, but any other socials or websites you want to point people to?Shireen: My website is shireenrizvi.com, where you can find a number of resources, including a link to the book and a link to our YouTube channel, which has skills videos—animated skills videos that teach some of these skills in five minutes or less. So that's another resource for people.Sarah: Great. What about you, Jesse?Jesse: I have a website called axiscbt.com. I'm also a co-founder of a psychoeducation skills course called Farrah Hive, and we actually have a parenting course based on DBT skills—that's thefarrahhive.com. And on Instagram, @talk_is_good.Sarah: Great. Thank you so much. Really appreciate your time today.Jesse: Thank you, Sarah.Sarah: Thank you. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit sarahrosensweet.substack.com/subscribe

Mental Health: Hope and Recovery Episode Title: Dialectical Behavior Therapy – The Journey from Pain to Purpose Episode 60 | Duration 45:00 Episode Date: November 26, 2025 Hosts: Helen Sneed and Valerie Milburn EPISODE OVERVIEW Named one of the top 100 scientific inventions, Dialectical Behavior Therapy has successfully guided and supported into recovery hundreds of thousands battling mental illness.  DBT teaches an entire system of dealing with psychiatric disorders and building a life worth living. One of its most effective components is the development of scores of powerful skills to be used daily to overcome the onslaught of uncontrollable emotional dysregulation. Its methods are behavior-oriented and emphasize taking action. Helen and Valerie also share personal stories as they explore how DBT has shaped their own recovery journeys—and why its principles continue to offer hope to millions around the world. WHAT YOU'LL LEARN The history and development of DBT by Marsha Linehan The four core components of DBT, with real-life examples How DBT supports recovery from severe mental illness Ways to apply DBT skills to everyday challenges Personal stories of resilience and transformation from Helen and Valerie MEMORABLE QUOTES “DBT is not just a treatment; it's a way of life that can transform how we relate to ourselves and others.” — Helen “To get better, we must accept where we are and also strive for change. That's the essence of dialectics.” — Valerie TOOLS AND TAKEAWAYS Mindfulness: Skills for grounding and staying present Distress Tolerance: Techniques for getting through crisis moments safely Emotion Regulation: Strategies to manage overwhelming feelings Interpersonal Effectiveness: Skills for improving communication and relationships RESOURCES AND LINKS Book: Building a Life Worth Living by Marsha Linehan Website: mentalhealthhopeandrecovery.com Listen on: Apple Podcasts | Spotify | Audible | Pandora Transcript: Available at mentalhealthhopeandrecovery.com Crisis Support: Call or text 988 (U.S.) for immediate help CONNECT WITH US Website: https://mentalhealthhopeandrecovery.com Listen/Subscribe: Apple Podcasts | Spotify | Audible Join the Conversation: How has DBT impacted your life or recovery journey? Share your stories with Helen and Valerie at https://mentalhealthhopeandrecovery.com DISCLAIMER This podcast is for educational and inspirational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. The hosts are not licensed mental health professionals. They are your peers. If you are in crisis, please call or text 988 (U.S.) or contact your local emergency services. EPISODE TIMESTAMPS 00:00 — Intro / Welcome 1:20 — What Is DBT? 3:15 — Marsha Linehan and the Creation of DBT 5:00 — The Core Dialectic: Acceptance + Change 7:00 — Linehan's Public Disclosure & DBT Structure 8:50 — CBT vs DBT Comparison 10:00 — Goals of CBT vs Goals of DBT 11:30 — Introduction to DBT Skill Areas 12:15 — Overview of the Four DBT Skills Modules 15:00 — Interpersonal Effectiveness 18:50 — Distress Tolerance Overview 20:00 — Radical Acceptance & When to Use Distress Tolerance 22:10 — DBT for People Without Mental Illness 23:15 — Valerie's Two Lifelong DBT Skills 26:45 — Helen's Story: DBT Became the Lifeline 32:30 — How DBT Helped Helen Save Her Own Life 36:30 — Closing Reflections 39:00 — Mindfulness Exercise   Learn more about your ad choices. Visit megaphone.fm/adchoices

Hoje vamos mergulhar nas três lições mais importantes do livro "Construindo uma vida que vale a pena viver", de Marsha Linehan. Além das nossas reflexões, vamos trazer alguns trechos do próprio livro, para inspirar. Vamos fazer essa reflexão juntos?!

In this mini-episode, Kate and Michelle discuss the revised editions of the DBT Skills Training Manual and the accompanying DBT Skills Training Handouts and Worksheets (both by Marsha Linehan). They share their 15% discount code that is good on ALL Guildford Press books and discuss two other Guilford Press titles they recommend.Check out their book recommendations here: Real Skills for Real Life - https://www.guilford.com/books/Real-Skills-for-Real-Life/Rizvi-Finkelstein/9781462555574The Mindful Self-Compassion Workbook - https://www.guilford.com/books/The-Mindful-Self-Compassion-Workbook/Neff-Germer/9781462526789Support the showWant to get 15% off of ALL Guildford Press titles? Use this link (code is DBTME at checkout): https://www.guilford.com/dbtmeIf you want to sign up for Kate's free DBT peer support group, you can sign up here: https://www.eventbrite.com/e/dbt-discussion-group-tickets-518237601617Check out our Etsy shop for DBT-inspired items and our journaling workbook (only $7.50!): https://www.etsy.com/shop/dbtandmeOur book, "DBT for Everyone" is available! Order your copy on Amazon here: https://www.amazon.com/Dbt-Everyone-Pitfalls-Possibilities-Better/dp/1839975881/Consider providing ongoing support to the podcast by becoming a patron at https://www.patreon.com/dbtandmeYou can join our facebook community here: https://www.facebook.com/groups/dbtandmepodcastCheck out our other podcast, The Couch and The Chair, on Apple Podcasts (https://podcasts.apple.com/gb/podcast/the-couch-and-the-chair/id1554159244) or on Spotify (https://open.spotify.com/show/3MZ8aZPoRKxGmLtFcR4S4O)If you need support/have questions, email us at dbtandmepodcast@gmail.com

What's a skill that can instantly improve your relationships, communication, and even your influence? In this episode, Yael talks with Caroline Fleck, a licensed psychologist and author of Validation, to unpack exactly that. Caroline explains what validation really is, how it's different from empathy or sympathy, and why it can be so powerful in both personal and professional relationships.  They walk you through how validation first gained traction in therapy, especially in dialectical behavior therapy, and Caroline shares simple techniques like attending, copying, and proposing that anyone can use. You'll get Caroline's take on the challenge of validating someone when you strongly disagree, the role of self-disclosure in connection, and how our understanding of emotions has shifted from classic microexpressions to a more nuanced view of emotional experience. If you're looking for practical ways to build better relationships and truly connect, this episode is full of insight. Listen and Learn:  What is validation? Why feeling truly seen and accepted is the key to deeper trust, love, and real connection in your life How invalidation can be toxic to your relationships and how empathy and validation actually heal them Can validation help you connect with someone even if you don't agree or relate to their situation? How accepting someone else's view first can actually boost your influence and get you heard more often The simple act of repeating exact words in conflict helps fights cool down and allows real conversations to happen Why messing up shows you're trying to truly understand, and how that keeps the connection real Why you don't have to agree with someone's whole view to validate it; just find the part that makes sense How to be open, but balanced, to create space for real connection and trust to grow Resources:  Validation: How the Skill Set That Revolutionized Psychology Will Transform Your Relationships, Increase Your Influence, and Change Your Life https://bookshop.org/a/30734/9780593541210 Visit Caroline's website: https://drcarolinefleck.com/ Connect with Caroline on social media:  https://www.linkedin.com/in/carolinefleck/ https://www.instagram.com/carolinefleckphd/ https://www.youtube.com/@Dr.CarolineFleck https://www.tiktok.com/@drcarolinefleck  Boogie Board Tablet on Amazon: https://www.amazon.com/stores/page/B551B3AA-1FD5-4BBA-AB25-58D0F67052FE?ingress=0&visitId=8be7808f-e257-437b-b72f-b8e79fd8fca9  Study on empathic effort versus accuracy How Emotions Are Made by Lisa Feldman Barrett The Autistic Brain by Temple Grandin About Caroline Fleck:  Dr. Caroline Fleck is a licensed psychologist, writer, and corporate consultant who has served as a supervisor and consultant for some of the most rigorous training programs in the country, including Dr. Marsha Linehan's program at the University of Washington, the Department of Psychiatry at Stanford Medical Center, and the VA Palo Alto. She is a respected voice in psychology and has been featured in national media outlets, including The New York Times, Good Morning America, and The Huffington Post. Her new book, which we're here to discuss, is the first of its kind to make the specialized validation skills therapists master to get through to anyone available to everyone. Related Episodes: Episode 120: Use DBT Skills to Regulate Emotions and Be More Effective in Relationships with Matthew McKay Episode 241. Emotion Coaching Skills for Families with Mindy Solomon Episode 282. Toxic Positivity with Whitney Goodman Episode 397. The Mindful Path to Intimacy with James Cordova Episode 408. Connecting like a Hostage Negotiator with Gary Noesner Learn more about your ad choices. Visit megaphone.fm/adchoicesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In this enlightening episode, we are joined by Elizabeth Cohn Stuntz, LCSW, a cancer survivor and expert in emotional well-being, to explore the power of collective wisdom and practical strategies for those touched by cancer. Elizabeth, a psychotherapist trained in contemporary psychoanalysis and Dialectical Behavior Therapy (DBT), shares her invaluable insights on how to manage the intense emotional stresses of a cancer diagnosis. She offers concrete, effective skills for decision-making, emotional regulation, and managing the uncertainties that come with cancer.Elizabeth also discusses how to effectively communicate with family, friends, colleagues, and medical providers, helping individuals navigate the complex relational dynamics that arise during cancer treatment. Drawing from her experience and her collaboration with Marsha Linehan to create the program Coping with Cancer: DBT Skills to Manage Your Emotions and Balance Uncertainty with Hope, Elizabeth provides actionable tools to help those affected by cancer live meaningfully and with a sense of hope.About Our Guest:Elizabeth Cohn Stuntz, LCSW, is a cancer survivor, psychotherapist, and advocate for emotional well-being. With expertise in contemporary psychoanalysis and DBT, she has dedicated her career to supporting individuals and families navigating cancer. As co-author of Coping with Cancer: DBT Skills to Manage Your Emotions and Balance Uncertainty with Hope, Elizabeth combines her personal and professional experiences to offer transformative coping skills that empower cancer patients and caregivers. She is also a faculty member at the Westchester Center for Psychoanalysis and Psychotherapy.

Emotional wirklich gesehen und gehört zu werden ist extrem wichtig. In der Familie, der Partnerschaft, im Beruf - eigentlich immer und überall! Atze und Leon tauchen tief in das Thema emotionale Validation ein – was sie bedeutet, wie sie unsere zwischenmenschlichen Beziehungen stärkt und was passiert, wenn sie fehlt. Denn Validation ist kein "Nice-to-have", sondern ein zentrales Element echter Verbindung. Doch wie schafft man es, anderen das Gefühl zu geben, in ihren Emotionen ernst genommen zu werden? Atze und Leon haben wissenschaftlich fundierte Antworten und praktische Tipps. Fühlt euch gut betreut Leon & Atze Instagram: https://www.instagram.com/leonwindscheid/ https://www.instagram.com/atzeschroeder_offiziell/ Mehr zu unseren Werbepartnern findet ihr hier: https://linktr.ee/betreutesfuehlen Tickets: Atze: https://www.atzeschroeder.de/#termine Leon: https://leonwindscheid.de/tour/ VVK Münster 2025: https://betreutes-fuehlen.ticket.io/ Start ins heutige Thema: 11:00 min. Buchtipp: Und Nietzsche weinte - Irvin D. Yalom Quellen: M. Linehan: https://psych.uw.edu/people/2724 Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford press. Linehan, M. M. (1997). Validation and psychotherapy. https://www.researchgate.net/profile/Marsha-Linehan/publication/232561580_Validation_and_psychotherapy/links/54eba9c70cf2a030519476eb/Validation-and-psychotherapy.pdf Geschichte von Linehan: https://www.nytimes.com/2011/06/23/health/23lives.html Invalidation im Gesundheitswesen: Bontempo, A. C., Bontempo, J. M., & Duberstein, P. R. (2025). Ignored, dismissed, and minimized: Understanding the harmful consequences of invalidation in health care—A systematic meta-synthesis of qualitative research. Psychological Bulletin, 151(4), 399. https://psycnet.apa.org/fulltext/2026-10154-001.html Shenk, C. E., & Fruzzetti, A. E. (2011). The impact of validating and invalidating responses on emotional reactivity. Journal of Social and Clinical Psychology, 30(2), 163-183. https://www.researchgate.net/publication/266136126_The_Impact_of_Validating_and_Invalidating_Responses_on_Emotional_Reactivity Gehirnaktivität: Morelli, S. A., Torre, J. B., & Eisenberger, N. I. (2014). The neural bases of feeling understood and not understood. Social cognitive and affective neuroscience, 9(12), 1890-1896. https://academic.oup.com/scan/article/9/12/1890/1615491 Weiterlesen: https://psyche.co/guides/learn-to-validate-others-and-transform-your-relationships Fleck, C. (2025): Validation: The New Approach to Change That Will Transform How You Love, Lead, and Live . Avery, 320 p. https://www.amazon.de/-/en/Validation-Approach-Change-That-Transform/dp/0593541219 Alles zu Bertha Pappenheim und der Geschichte von Anna O. Brownstein, G. (2024). The Secret Mind of Bertha Pappenheim: The Woman Who Invented Freud's Talking Cure. Hachette UK. Validation bei Demenz: https://demenz-portal.at/aktuelles/validation-bei-demenz-die-grundsaetze/ Redaktion: Andy Hartard Produktion: Murmel Productions

Dialectical Behavior Therapy, more commonly referred to as DBT, is a evidence-based therapy model developed by Marsha Linehan that was initially developed to treat individuals experiencing intense emotional responses and interpersonal issues, however, has been adapted over years to treat a wide variety issues and populations such as eating disorders, substance use, and working with individuals with intellectual disabilities. Join Dave and Greg as they discuss the therapeutic modality, it's structure and core elements.   Intro/Outro Music by 13th Ward Social Club https://open.spotify.com/artist/5Gvw7YedKx6d2fhiObH5Cc https://www.youtube.com/channel/UCzmdJyWuzBpwlsCtn_sVC_A

Join this informative and engaging conversation with Diana Partington, licensed professional counselor in Nashville, Tennessee, and author of DBT for Life. Diana shares the philosophy behind Dialectical Behavioral Therapy and how every person can benefit from DBT. DBT was founded in 1993 by Dr. Marsha Linehan and became popular around 2010. Diana shares how DBT is a powerful treatment for suicidal thoughts and ideation, depression, borderline personality disorder, anxiety, bipolar disorder, substance abuse, and eating disorders. Diana talks about how her own life events and battle with suicidal thoughts led her to DBT as a client and the transformative power of the tool kit she took from it. Diana wrote DBT For Life to be user-friendly; something that people could consume in bite-sized chunks and enter in the most helpful way for the reader. The book is full of illustrations and stories of applying DBT skills. Diana dives into the four tenets of DBT therapy and takes the listeners through an example. Diana also runs groups online (https://dbtforlife.com/) and hosts a podcast called Suffering Optional (https://podcasts.apple.com/us/podcast/suffering-optional/id1767018426). DBT For Life can be purchased here: https://www.amazon.com/Dbt-Life-Skills-transform-Lotus/dp/B0CW2ZKB5S

Dave is out of rehab, so the boys get together to talk about his wild experiences over the holiday in which he haunted the streets of Omaha and Lincoln bouncing between rehabs, psych wards, Walgreens medicine aisles, and respite centers. Thankfully, at the end of the chaos, he felt a deep internal shift that many in recovery refer to as "being sick and tired of being sick and tired", and it gave him renewed energy and vigor on his long march to recovery.  Learn about, follow, or support Shoeless HERE Outro Song: "Please Please Please Let Me Get What I Want" by The Smiths Audio Clips used in this episode: - Marsha Linehan on acceptance - Meaning is a Jumper that you have to Knit Yourself

Send us a textDo you sometimes lose control of your emotions? Do you often feel overly frustrated or angry about little everyday things? Then, this episode is for you! These days, who doesn't need a little help with emotional regulation? Dr. Catherine Smith talks to Risa Williams about practical skills from DBT (Dialectical Behavior Therapy) that anyone can use to start to become more aware of how to regulate their emotions and frustration each day.They discuss:-The STOP technique for gaining awareness in the moment-Parts work - how our "inner parts" feel neglected sometimes and what we can do show ourselves more compassion when we're having big and intense feelings-How our childhoods might have affected the way we express our emotions-How learning how to radically accept our emotions can help us navigate them more easilyBooks discussed: Get Stuff Done Without the Stress by Risa Williams (new book coming out -preorder today), The Whole-Brain Child by Dan Siegel, Build a Life Worth Living by Marsha Linehan, The Polyvagal Theory by Stephen W. PorgesAlso, enter to win our new audiobook giveaway - three lucky winners will receive the audiobook version of The Ultimate Self-Esteem Toolkit! Enter on instagram (@risawilliamstherapy) by Dec. 22nd to win!Host: Risa Williams, risawilliams.com, @risawilliamstherapyGuest: Dr. Catherine Smith, drcatherinesmith.com, @catherinelistensSupport the showFor info on books, workshops, guests, and future episodes, please visit: risawilliams.com.*All tools discussed on the show are meant for educational purposes only and not as a replacement for therapy or medical advice.

Radical acceptance is about fully acknowledging and accepting reality as it is, especially when it's something we don't like or want to change. This approach, popularized by Dr. Marsha Linehan as part of Dialectical Behavior Therapy (DBT), encourages us to embrace what we can't control instead of resisting it. But radical acceptance isn't easy. The idea challenges our instincts, often triggering discomfort and frustration, especially if we're used to holding tightly to that illusion of being in control. Or, if you can't get past that something isn't right or fair. Today we'll explore the origins of radical acceptance, why it's so challenging, how you can incorporate this life-changing approach and, of course, my top tips for creating a life of resilience, peace, and healthier relationships.____________________________Full blog and show notes: https://abbymedcalf.com/radical-acceptance-5-steps-to-embrace-reality-for-lasting-peaceGrab my Radical Acceptance Journal Prompts: https://abbymedcalf.com/radical-acceptance-journal-promptsLearn how to create and hold healthy, loving boundaries. Buy my newest book on Amazon, Boundaries Made Easy: Your Roadmap to Connection, Ease and Joy https://abbymedcalf.com/boundariesWant to feel happier and more connected in your relationship? Buy my #1 bestselling book on Amazon, Be Happily Married: Even If Your Partner Won't Do a Thing: https://abbymedcalf.com/book____________________________ Looking for past episodes of the Relationships Made Easy Podcast? Head over to https://abbymedcalf.com/podcast and https://abbymedcalf.com/podcast-the-archives where you'll find past episodes.Subscribe today to get my love letter to you! This biweekly reminder will keep you on the path to creating connected, happy relationships (especially the one with yourself!). https://abbymedcalf.comReady to dig deeper? Take one of my online courses (some are FREE!) or grab a workbook: https://abbymedcalf.com/shopA great idea to stay motivated and keep your head in a positive direction is to buy some of my fabulous, inspirational merchandise. Get yourself a t-shirt, mug, tote bag or notebook with that daily reminder that you've got this! https://abbymedcalf.com/shopSay hello on social:Facebook: https://www.facebook.com/abbymedcalfInstagram: https://www.instagram.com/abbymedcalfthrivingLinkedIn: https://linkedin.com/in/abbymedcalfthrivingYouTube: https://abbymedcalf.com/youtube Hosted on Acast. See acast.com/privacy for more information.

Ethan Sapienza is a clinical social worker and therapist specializing in EMDR and DBT. He discusses the benefits of these modalities and shares practical DBT coping mechanisms that everyone can find useful. More About Ethan and DBT https://www.psychologytoday.com/us/therapists/ethan-sapienza-beverly-hills-ca/879732Ethan's practice's site: https://behavioralpsychstudio.com/-Info on what DBT is: https://www.mcleanhospital.org/essential/dbt-Info on what DBT-PE is: https://dbtpe.org/-An article he wrote breaking down DBT and its trauma adaptations, DBT-PE and DBT-PTSD https://behavioralpsychstudio.com/10389-2/-A resource to find a DBT therapist (this is from one of the major training orgs for DBT called BTech, which Marsha Linehan started): https://behavioraltech.org/find-a-therapist-app/-Info on what E/RP is: https://www.mcleanhospital.org/essential/erp#:~:text=Exposure%20and%20response%20prevention%20therapy%20is%20the%20opposite%20of%20flooding,ability%20to%20handle%20their%20obsessions.This episode is sponsored by Smalls cat food. For 50% off your first order, head to Smalls.com/MENTAL and use code MENTAL.This episode is sponsored by 23andMe. For your limited time offer go to www.23andme.com/mental. Total Health membership includes services initiated and performed by third-party clinicians and lab providers through the 23andMe platform. Additional terms and conditions also apply. See 23andme.com to learn dmore. Total Health Membership not available to residents of HI, NJ, NY, RI and US territories.This episode is sponsored by Vimergy. Go to www.Vimergy.com and use offer code MENTAL for free shipping. If you're interested in seeing or buying the furniture that Paul designs and makes follow his IG for his woodworking which is transitioning from @MIHHfurniture to its new handle @ShapedFurniture WAYS TO HELP THE MIHH PODCASTSubscribe via iTunes. It costs nothing. It's extremely helpful to have your subscription set to download all episodes automatically. https://itunes.apple.com/us/podcast/mental-illness-happy-hour/id427377900?mt=2Spread the word via social media. It costs nothing.Our website is www.mentalpod.com our FB is www.Facebook.com/mentalpod and our Twitter and Instagram are both @Mentalpod Become a much-needed Patreon monthly-donor (with occasional rewards) for as little as $1/month at www.Patreon.com/mentalpod Become a one-time or monthly donor via PayPal at https://mentalpod.com/donateYou can also donate via Zelle (make payment to mentalpod@gmail.com) To donate via Venmo make payment to @Mentalpod See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Today I'm sharing various techniques using neuroscience to help us escape negative thought spirals. All this is extremely subjective and not meant to be used all at once. Pick one, try it, and give it some time and repetition. Maybe it helps, maybe you move on to the next. Don't be so hard on yourself, either way!!!RESOURCES: Marsha Linehan's Technique: https://www.campuswell.com/cognitive-distortions/#1690237279413-809f9f34-cc86Lisa Daino's technique: https://www.talkspace.com/mental-health/conditions/articles/catastrophic-thinking-thought-spirals-how-to-stop/Dilshad Edibam Khurana's technique: https://mpowerminds.com/blog/Understanding-the-psychology-behind-downward-spiralAshley Fletcher's Techniques: https://www.mindful.org/halting-the-spiral-navigating-repetitive-thought-patterns/Ethan Kross's interview: https://magazine.columbia.edu/article/best-way-stop-negative-thought-spiralThe science: https://pmc.ncbi.nlm.nih.gov/articles/PMC2908186/Cognitive distortions list: https://psychcentral.com/lib/cognitive-distortions-negative-thinking#5-tips-to-stop-cognitive-distortionsDONATE:www.pcrf.netGet Involved:Operation Olive Branch: Spreadsheets + LinksGET AN OCCASIONAL PERSONAL EMAIL FROM ME: www.makeyourdamnbedpodcast.comTUNE IN ON INSTAGRAM FOR COOL CONTENT: www.instagram.com/mydbpodcastOR BE A REAL GEM + TUNE IN ON PATREON: www.patreon.com/MYDBpodcastOR WATCH ON YOUTUBE: www.youtube.com/juliemerica The opinions expressed by Julie Merica and Make Your Damn Bed Podcast are intended for entertainment purposes only. Make Your Damn Bed podcast is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Get bonus content on PatreonSupport this show http://supporter.acast.com/make-your-damn-bed. Hosted on Acast. See acast.com/privacy for more information.

Hi, this is Brian, and today we've got another Heroic +1 for you featuring wisdom from Steven Hayes and Marsha Linehan.   If you're enjoying the podcast, make sure to subscribe.   And if you're really enjoying it, I think you'll love checking out all of the other ancient wisdom, modern science, and practical tools you need to activate your Heroic potential and change the world, together.   Head to heroic.us to check out all of the goodness. You can download free Philosopher's Notes, master classes, and our scientifically-proven app that was built by the same team who helped create Slack, Tinder, and Uber Eats.   It's time to forge excellence, activate your heroic potential, fulfill your destiny, and change the world with us.   YOU are the hero we've been waiting for!   Welcome to your new training platform.

Hi, this is Brian, and today we've got another Heroic +1 for you featuring wisdom from Steven Hayes, Marsha Linehan, Jon Kabat-Zinn and Donald Robertson.   If you're enjoying the podcast, make sure to subscribe.   And if you're really enjoying it, I think you'll love checking out all of the other ancient wisdom, modern science, and practical tools you need to activate your Heroic potential and change the world, together.   Head to heroic.us to check out all of the goodness. You can download free Philosopher's Notes, master classes, and our scientifically-proven app that was built by the same team who helped create Slack, Tinder, and Uber Eats.   It's time to forge excellence, activate your heroic potential, fulfill your destiny, and change the world with us.   YOU are the hero we've been waiting for!   Welcome to your new training platform.

In this episode, Dr. Ettensohn draws on psychodynamic dimensional models of personality development to describe narcissism and NPD at the borderline level. Characterized by identity diffusion, blurred boundaries, and disrupted internal experience, borderline personality organization represents an "in between" level where the perceptions of the self and others float in and out of clear focus. This episode reviews the important concepts of personality style vs. organization, helping the viewer to understand what a personality disorder actually is and why all personality disorders share common features. It discusses the developmental arrests thought to underlie borderline organization and describes common defense mechanisms that characterize this level of object relations. Borderline-level NPD is then discussed using these concepts. The episode concludes with a discussion of treatment.   References: Berney, S., de Roten, Y., Beretta, V., Kramer, U., & Despland, J.-N. (2014). Identifying psychotic defenses in a clinical interview. Journal of Clinical Psychology, 70(5), 428–439. Clarkin, J. F., Cain, N. M., & Lenzenweger, M. F. (2018). Advances in transference-focused psychotherapy derived from the study of borderline personality disorder: Clinical insights with a focus mechanism. Current Opinion in Psychology, 21, 80-85. http://dx.doi.org/10.1016/j.copsyc.2017.09.008 Di Giuseppe, M., & Perry, J. C. (2021). The hierarchy of defense mechanisms: Assessing defensive functioning with the Defense Mechanisms Rating Scales Q-Sort. Frontiers in Psychology, 12:718440 https://doi.org/10.3389/fpsyg.2021.718440 Kernberg, O. F. (1970). Factors in the psychoanalytic treatment of narcissistic personalities. Journal of the American Psychoanalytic Association, 18, 51- 85. Kernberg, O. F. (1984). Severe personality disorders: Psychotherapeutic strategies. New Haven: Yale University Press. Lingiardi, V., & McWilliams, N. (Eds.). (2017). Psychodynamic diagnostic manual: PDM-2 (2nd ed.). New York: Guilford Press. McWilliams, N. (2011). Psychoanalytic diagnosis: Understanding personality structure in the clinical process (2nd ed.). Guilford Press. Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH   LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 VISIT THE WEBSITE: https://www.healnpd.org   *A note about the title: The title is a partial quote from BPD specialist Marsha Linehan, describing borderline personality disorder. I am aware of her original intent to describe that specific patient population. I also use the quote in the video to describe the emotional vulnerabilities that necessitate splitting. Although she was describing BPD specifically, I feel the quote also works for borderline organization in general. The intense emotional vulnerabilities and exposure to unprocessed experience reflect the absence of moderating internal capacities - "skin" so to speak.

Today's +1 features wisdom from Marsha Linehan. Heroic: https://heroic.us ← "Heroic is the best self-development platform in the world." — John Mackey, co-founder & former CEO of Whole Foods Market

Today's +1 features wisdom from Kristin Neff, Rainer Maria Rilke and Marsha Linehan. Heroic: https://heroic.us ← "Heroic is the best self-development platform in the world." — John Mackey, co-founder & former CEO of Whole Foods Market

Today's +1 features wisdom from Marsha Linehan, Jon Kabat-Zinn, Steven Hayes and Russ Harris.   Heroic: https://heroic.us ← "Heroic is the best self-development platform in the world." — John Mackey, co-founder & former CEO of Whole Foods Market   Want access to more wisdom in time? Get access to over 1,500 +1's (just like this!) and 650+ Philosopher's Notes (distilling life-changing big ideas from the best self-development books ever written) and a LOT more with our Heroic Premium membership. Learn more and get 30 days free at https://heroic.us

Today's +1 features wisdom from Marsha Linehan, David Reynolds, and Dan Millman.   Heroic: https://heroic.us ← "Heroic is the best self-development platform in the world." — John Mackey, co-founder & former CEO of Whole Foods Market   Want access to more wisdom in time? Get access to over 1,500 +1's (just like this!) and 650+ Philosopher's Notes (distilling life-changing big ideas from the best self-development books ever written) and a LOT more with our Heroic Premium membership. Learn more and get 30 days free at https://heroic.us

Today's +1 features wisdom from Marsha Linehan and Peter Attia.   Heroic: https://heroic.us ← "Heroic is the best self-development platform in the world." — John Mackey, co-founder & former CEO of Whole Foods Market   Want access to more wisdom in time? Get access to over 1,500 +1's (just like this!) and 650+ Philosopher's Notes (distilling life-changing big ideas from the best self-development books ever written) and a LOT more with our Heroic Premium membership. Learn more and get 30 days free at https://heroic.us

Today's +1 features wisdom from Marsha Linehan, While Churchill, David Goggins and Steve Chandler.   Heroic: https://heroic.us ← "Heroic is the best self-development platform in the world." — John Mackey, co-founder & former CEO of Whole Foods Market   Want access to more wisdom in time? Get access to over 1,500 +1's (just like this!) and 650+ Philosopher's Notes (distilling life-changing big ideas from the best self-development books ever written) and a LOT more with our Heroic Premium membership. Learn more and get 30 days free at https://heroic.us

Today's +1 features wisdom from Marsha Linehan, Winston Churchill and David Goggins.   Heroic: https://heroic.us ← "Heroic is the best self-development platform in the world." — John Mackey, co-founder & former CEO of Whole Foods Market   Want access to more wisdom in time? Get access to over 1,500 +1's (just like this!) and 650+ Philosopher's Notes (distilling life-changing big ideas from the best self-development books ever written) and a LOT more with our Heroic Premium membership. Learn more and get 30 days free at https://heroic.us

Today's +1 features wisdom from Marsha Linehan and Phil Stutz.   Heroic: https://heroic.us ← "Heroic is the best self-development platform in the world." — John Mackey, co-founder & former CEO of Whole Foods Market   Want access to more wisdom in time? Get access to over 1,500 +1's (just like this!) and 650+ Philosopher's Notes (distilling life-changing big ideas from the best self-development books ever written) and a LOT more with our Heroic Premium membership. Learn more and get 30 days free at https://heroic.us

Today's +1 features wisdom from Marsha Linehan, Thich Nhat Hanh, and Ellen Langer.   Heroic: https://heroic.us ← "Heroic is the best self-development platform in the world." — John Mackey, co-founder & former CEO of Whole Foods Market   Want access to more wisdom in time? Get access to over 1,500 +1's (just like this!) and 650+ Philosopher's Notes (distilling life-changing big ideas from the best self-development books ever written) and a LOT more with our Heroic Premium membership. Learn more and get 30 days free at https://heroic.us

Today's +1 features wisdom from Marsha Linehan, Abraham Maslow, Daisaku Ikeda, and Dr. Allen Frances.   Heroic: https://heroic.us ← "Heroic is the best self-development platform in the world." — John Mackey, co-founder & former CEO of Whole Foods Market   Want access to more wisdom in time? Get access to over 1,500 +1's (just like this!) and 650+ Philosopher's Notes (distilling life-changing big ideas from the best self-development books ever written) and a LOT more with our Heroic Premium membership. Learn more and get 30 days free at https://heroic.us

Today's +1 features wisdom from Marsha Linehan, Phil Stutz, Michael Singer, and Paramahansa Yogananda.   Heroic: https://heroic.us ← "Heroic is the best self-development platform in the world." — John Mackey, co-founder & former CEO of Whole Foods Market   Want access to more wisdom in time? Get access to over 1,500 +1's (just like this!) and 650+ Philosopher's Notes (distilling life-changing big ideas from the best self-development books ever written) and a LOT more with our Heroic Premium membership. Learn more and get 30 days free at https://heroic.us

Today's +1 features wisdom from Marsha Linehan, Phil Stutz, and Byron Katie.   Heroic: https://heroic.us ← "Heroic is the best self-development platform in the world." — John Mackey, co-founder & former CEO of Whole Foods Market   Want access to more wisdom in time? Get access to over 1,500 +1's (just like this!) and 650+ Philosopher's Notes (distilling life-changing big ideas from the best self-development books ever written) and a LOT more with our Heroic Premium membership. Learn more and get 30 days free at https://heroic.us

Dr. Greg Chasson talks about Dialectical Behavioral Therapy, or DBT. DBT is a type of talk therapy (psychotherapy). It's based on cognitive behavioral therapy (CBT), but it's specially adapted for people who experience emotions very intensely.“Dialectical” means combining opposite ideas. DBT focuses on helping people accept the reality of their lives and their behaviors, as well as helping them learn to change their lives, including their unhelpful behaviors.Dialectical behavior therapy was developed in the 1970s by Marsha Linehan, an American psychologist.

Have you found yourself in crisis situations over and over? Does it feel like you can't catch a break? Sometimes we just need some quick and basic skills to help be effective when we are in a stressful situation. In this episode, you will hear some basic Distress Tolerance skills taken from DBT (Dialectical Behavioral Therapy). This is a curriculum that was developed by Marsha Linehan. Distress Tolerance skills are about not making a bad situation worse. Many people have remastered these skills and people do these groups all over the world. They are structured and to the point of teaching skills, not diving into healing trauma. Some of the skills you will hear today about improving the moment, self-soothing and distracting. Normally my podcasts talk about trauma, but this episode is simply about skills.“For God gave us a spirit not of fear but of power and love and self-control.” ~2 Timothy 1:7To sign up for the women's retreat April 2024: https://www.discovermyinsidestory.com/extraordinary-2024Find more about Heidi: www.heidimortensonlmft.comPurchase the book The Brave Encourager: https://www.amazon.com/Brave-Encourager-Power-Encouragement-Changes/dp/B09TN45H36/ref=sr_1_1?crid=3HGP5FPY2E5GD&keywords=the+brave+encourager&qid=1646608516&sprefix=the+brave+encourager%2Caps%2C223&sr=8-1Join my mailing list: https://landing.mailerlite.com/webforms/landing/t5u2y5If you are in crisis, help is available by call or text 1-800-273-8255 24/7. You can also visit https://suicidepreventionlifeline.org. You are loved!

In this eye-opening episode of TAM+, hosts Duane and Eric Osterlind dive into the transformative concept of radical acceptance. They explore how embracing reality as it is—without avoidance or escape—can break the vicious cycle of addiction, anxiety, and depression. The discussion begins with an introduction to the concept's roots in Buddhist teachings and its development into a key component of Dialectical Behavior Therapy by Marsha Linehan. The hosts share personal anecdotes and practical advice, highlighting the difference between acceptance and approval, and offer strategies for practicing radical acceptance in daily life. This episode is a must-listen for anyone looking to navigate life's challenges with grace and resilience, proving that acceptance is not about giving up but about empowering oneself to effect meaningful change.Free Download: The Power of Radical Acceptance WorksheetKey Topics: The origins and importance of radical acceptance in overcoming negative thought patterns and behaviors. The distinction between accepting reality and approving of it. Practical tips and radical acceptance statements to integrate into daily life. The role of mindfulness and meditation in fostering acceptance. How to begin practicing radical acceptance and its benefits in mental health and well-being. Timestamps: [00:00] Introduction to Radical Acceptance and its Role in Overcoming Addiction [03:12] Exploring the Meaning and Practice of Radical Acceptance [04:53] The Origins of Radical Acceptance and its Therapeutic Impact [07:00] The Difference Between Acceptance and Approval [10:27] Emotional Barriers to Radical Acceptance and How to Overcome Them [14:32] Situations Where Radical Acceptance is Not Appropriate [17:28] The Proven Benefits of Radical Acceptance and How to Start Practicing Free Download: The Power of Radical Acceptance WorksheetFollow and Review:We'd love for you to follow us if you haven't yet. Click that purple ‘+' in the top right corner of your Apple Podcasts app. We'd love it even more if you could drop a review or 5-star rating over on Apple Podcasts. Simply select “Ratings and Reviews” and “Write a Review” then a quick line with your favorite part of the episode. It only takes a second and it helps spread the word about the podcast.Supporting Resources:If you live in California and are looking for counseling or therapy please check out Novus Mindful Life Counseling and Recovery CenterNovusMindfulLife.comWe want to hear from you. Leave us a message or ask us a question: https://www.speakpipe.com/addictedmindDisclaimer Learn more about your ad choices. Visit megaphone.fm/adchoicesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In this eye-opening episode of TAM+, hosts Duane and Eric Osterlind dive into the transformative concept of radical acceptance. They explore how embracing reality as it is—without avoidance or escape—can break the vicious cycle of addiction, anxiety, and depression. The discussion begins with an introduction to the concept's roots in Buddhist teachings and its development into a key component of Dialectical Behavior Therapy by Marsha Linehan. The hosts share personal anecdotes and practical advice, highlighting the difference between acceptance and approval, and offer strategies for practicing radical acceptance in daily life. This episode is a must-listen for anyone looking to navigate life's challenges with grace and resilience, proving that acceptance is not about giving up but about empowering oneself to effect meaningful change. Free Download: The Power of Radical Acceptance Worksheet Key Topics: The origins and importance of radical acceptance in overcoming negative thought patterns and behaviors. The distinction between accepting reality and approving of it. Practical tips and radical acceptance statements to integrate into daily life. The role of mindfulness and meditation in fostering acceptance. How to begin practicing radical acceptance and its benefits in mental health and well-being. Timestamps: [00:00] Introduction to Radical Acceptance and its Role in Overcoming Addiction [03:12] Exploring the Meaning and Practice of Radical Acceptance [04:53] The Origins of Radical Acceptance and its Therapeutic Impact [07:00] The Difference Between Acceptance and Approval [10:27] Emotional Barriers to Radical Acceptance and How to Overcome Them [14:32] Situations Where Radical Acceptance is Not Appropriate [17:28] The Proven Benefits of Radical Acceptance and How to Start Practicing Free Download: The Power of Radical Acceptance Worksheet Follow and Review: We'd love for you to follow us if you haven't yet. Click that purple ‘+' in the top right corner of your Apple Podcasts app. We'd love it even more if you could drop a review or 5-star rating over on Apple Podcasts. Simply select “Ratings and Reviews” and “Write a Review” then a quick line with your favorite part of the episode. It only takes a second and it helps spread the word about the podcast. Supporting Resources: If you live in California and are looking for counseling or therapy please check out Novus Mindful Life Counseling and Recovery Center NovusMindfulLife.com We want to hear from you. Leave us a message or ask us a question: https://www.speakpipe.com/addictedmind Disclaimer Learn more about your ad choices. Visit megaphone.fm/adchoices

Do you struggle in your conversations with others? Do you wish you could improve with your skills in communication? Sometimes we just need some quick and simple basic skills to help be effective with other people. In this episode, you will hear some basic Interpersonal Effectiveness skills taken from DBT (Dialectical Behavioral Therapy). This is a curriculum that was developed by Marsha Linehan. Many people have remastered these skills and people do these groups all over the world. They are structured and to the point of teaching skills, not diving into healing trauma. Normally my podcasts talk about trauma, but this episode is simply about skills. “Do not let any unwholesome talk come out of your mouths, but only what is helpful for building others up according to their needs, that it may benefit those who listen”. ~Ephesians 4:29 “May these words of my mouth and this meditation of my heart be pleasing in your sight, LORD, my Rock and my Redeemer”. ~Psalms 19:14 To sign up for the women's retreat April 2024: https://www.discovermyinsidestory.com/extraordinary-2024 Find more about Heidi: www.heidimortensonlmft.com Purchase the book The Brave Encourager: https://www.amazon.com/Brave-Encourager-Power-Encouragement-Changes/dp/B09TN45H36/ref=sr_1_1?crid=3HGP5FPY2E5GD&keywords=the+brave+encourager&qid=1646608516&sprefix=the+brave+encourager%2Caps%2C223&sr=8-1 Join my mailing list: https://landing.mailerlite.com/webforms/landing/t5u2y5 If you are in crisis, help is available by call or text 1-800-273-8255 24/7. You can also visit https://suicidepreventionlifeline.org. You are loved!

In unserem Leben befinden wir uns immer in einem Balance-Akt: wir wollen uns verändern, aber wir tun uns schwer, uns einzugestehen, dass wir mindestens ein Teil des Problems sind. Marsha Linehan entwickelt anhand ihrer eigenen Erfahrung mit der Borderline-Persönlichkeitsstörung einen integrativen Therapieansatz, bestehend aus Akzeptanz und Veränderung: die dialektisch behaviorale Therapie! Heute sprechen Atze und Leon über diesen interessanten und relativ neuen und vielfältigen Therapieansatz, führen Übungen selbst durch und beschäftigen sich besonders mit Marsha Linehans Biografie. Wie so oft in Therapieansätzen verbirgt sich auch in der DBT so einiges, was jedem von uns helfen kann. Fühlt euch gut betreut Leon & Atze Instagram: https://www.instagram.com/leonwindscheid/ https://www.instagram.com/atzeschroeder_offiziell/ Der Instagram Account für Betreutes Fühlen: https://www.instagram.com/betreutesfuehlen/ Mehr zu unseren Werbepartnern findet ihr hier: https://linktr.ee/betreutesfuehlen Hier gehts zur Masterclass: https://wemynd.de Buchempfehlung: Marsha Linehan - Building a Life Worth Living: A Memoir Quellen: Quellen: Hier geht es zum Dachverband DBT: https://www.dachverband-dbt.de/ddbt/was_ist_dbt#:~:text=Die%20Dialektisch%2DBehaviorale%20Therapie%20(DBT,stellt%20die%20kognitive%20Verhaltenstherapie%20dar. Und hier geht es zu einer Informationsseite auf Englisch: https://behavioraltech.org/knowledge-center/ Und ein spannender Artikel über Marsha Linehan aus der NY Times: https://www.nytimes.com/2011/06/23/health/23lives.html Redaktion: Linda Caporale Produktion: Murmel Productions

Today I thought it would be fun to take a look at how to navigate client resistance in therapy using four therapeutic approaches. I hope you enjoy this format! FREE Guide: Start a Private Practice in Counseling:https://tinyurl.com/y9ek9en8 Links to citations and related information: Book Section: Essay and Review: Overcoming Resistance in Cognitive Therapy https://journals.sagepub.com/doi/abs/10.1177/009318530203000106?journalCode=plxa What is Cognitive Behavioral Therapy? https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral Deliberate Practice in Cognitive Behavioral Therapy https://www.apa.org/pubs/books/deliberate-practice-cognitive-behavioral-therapy Managing resistance in cognitive behavioural therapy: the application of motivational interviewing in mixed anxiety and depression https://pubmed.ncbi.nlm.nih.gov/15625790/ Practice Time! Ep. 6 - CBT Responding to Client Resistance https://www.youtube.com/watch?v=iUlSDZjxaVE How to Approach Resistance in Therapy with Marsha Linehan, PhD https://www.youtube.com/watch?v=tqhzvyjJGcM IFS Institute Website: https://ifs-institute.com/ How to Work with a Client's Resistance (IFS) https://s3.amazonaws.com/nicabm-stealthseminar/Resistance2017/confirmed/Resistance-Video5.1.pdf APA Definition of Psychodynamic Therapy https://dictionary.apa.org/psychodynamic-psychotherapy A psychodynamic perspective on resistance in psychotherapy: vive la résistance https://pubmed.ncbi.nlm.nih.gov/11793328/ LINKS *Some links are affiliate links. A percentage of purchases come back to me and help my channel immensely!

I thought it would be fun to take a look at the wins and flops of 2023 (spoiler: a bunch of stuff I'd planned didn't happen!) and look ahead towards my plans for 2024. I hope you have fun joining me! Books Mentioned (these are affiliate links, but you can also try your local library or Thriftbooks - I LOVE Thriftbooks!): Building a Life Worth Living by Marsha Linehan: https://amzn.to/3vPzp15 The Dialectical Behavior Therapy Skills Workbook: https://amzn.to/490XVuu Decolonizing Therapy by Dr. Jennifer Mullan: https://amzn.to/3RX1KtW Better Results: Using Deliberate Practice to Improve Therapeutic Effectiveness: https://amzn.to/3S17xid LINKS*Some links are affiliate links. A percentage of purchases come back to me and help my channel immensely!

Welcome to 2024. Thanks for being here and joining me for another season and another year. This week is an introduction to a cognitive behavior therapy called Dialectical Behavior Therapy. Dialectic means to combine opposite ideas. For example, "I am scared, but I am going to do it anyway." DBT is a skills-based talk therapy created by Marsha Linehan. --- Send in a voice message: https://podcasters.spotify.com/pod/show/stephanie431/message

Lauren and JJ discuss emotional regulation and distress tolerance skills, plus make plans for the holiday episode! Please note that at the time of this recording neither Lauren nor JJ are licensed mental health providers. This podcast is for informational purposes only and does not constitute therapy. If you or someone you know is struggling, reach out to a licensed therapist in your area. Note that dialectical behavior therapy (DBT), a type of therapy referenced in this episode, was developed by Marsha Linehan. Learn more here: https://dbt-lbc.org/ References: (1) Rosenhaft, A. The dialectical behavior therapy skills I still use today. Psychology Today. Posted January 24, 2023. Accessed 11/30/2023. https://www.psychologytoday.com/us/blog/from-both-sides-of-the-couch/202301/the-dialectical-behavior-therapy-skills-i-still-use-today (2) Crossfield, A. How to tolerate emotional distress. Psychology Today. Posted March 23, 2020. Accessed 11/30/2023. https://www.psychologytoday.com/us/blog/emotionally-healthy-teens/202003/how-tolerate-emotional-distress (3) Moore, M. 4 DBT skills for everyday challenges. PsychCentral. Last updated July 7, 2022. Accessed 11/30/2023. https://psychcentral.com/health/dbt-skills-therapy-techniques (4) Rosenthal, J. Dialectical behavior therapy (DBT) distress tolerance skills: TIPP [sic] skills. Manhattan Psychology Group. Date of writing/ posting not indicated. Accessed 11/30/2023. https://manhattanpsychologygroup.com/dbt-tipp-skills/ (5) Robinson, B. E. The 90-second rule that builds self-control. Psychology Today. Posted April 26, 2020. Accessed 11/30/2023. https://www.psychologytoday.com/us/blog/the-right-mindset/202004/the-90-second-rule-builds-self-control Resources: (1) Use the Psychology Today therapist finder to locate a DBT practitioner in your area: https://www.psychologytoday.com/us/therapists/dialectical-dbt (2) DBTselfhelp.com is a free resource containing a lot of information about distress tolerance and emotional regulation skills: https://dbtselfhelp.com/ (3) Visit the DBT website for free skills information: https://dialecticalbehaviortherapy.com/

In this episode Rev. Mikey Noechel offers a talk on radical acceptance, the practice of honor and validating all experience. Mikey reflects on the work outlined by Marsha Linehan as well as Tara Brach. Peace & Love. Hope you enjoy! 

Hey everyone, it's Thanksgiving week. Time for episode 232. Will & TPP are taking a break and this is the first of some special reissues of older AGP episodes. We did a series highlighting Dialectical Behavior Therapy severeal years ago. We are going to share these episodes with you. Hope you enjoy. This week on Above Ground Podcast Will and Tim start their self care September with an overview of Dialectical Behavior Therapy. This form of therapy was developed by Marsha Linehan, to originally help people with Borderline Personality Disorder. It is incredibly useful for people facing overwhelming emotions.  DBT for short is a set of four skills; -Distress Tolerance -Mindfulness -Emotional Regulation -Interpersonal Effectiveness   Like all skills it takes practice and perseverance. You can benefit yourself greatly by learning these skills in managing your emotions. Always talk to a licensed professional.  https://www.psychologytoday.com/us/therapy-types/dialectical-behavior-therapy Happy Thanksgiving to everyone!!!! get well, be safe, stay ABOVE

How does the intertwining of our past traumas shape our daily lives, and can the combined power of Dialectical Behavior Therapy (DBT) and Prolonged Exposure (PE) offer a beacon of hope for those with PTSD and BPD? In this episode, Annie McCall delves deep into the resilience of the human spirit and the transformative potential of specialized therapies. She also sheds light on an intriguing notion: often unknowingly, each one of us has practiced some form of exposure in our daily lives, making therapy more relatable than one might initially believe. For individuals with a history of self-harm, suicidal tendencies, or Borderline Personality Disorder, DBT emerges as a beacon of hope. Moreover, she addresses the lesser-discussed impacts of trauma, including persistent feelings of shame and self-loathing, and emphasize how DBT PE offers tailored solutions for these emotional wounds. Lastly, Annie extends the conversation beyond the conventional understanding of PTSD symptoms, underscoring its profound influence on various aspects of daily life—from personal relationships to work and academic successes. Join us to understand how the integration of DBT and PE provides a holistic approach to healing, transforming traumatic experiences into narratives of strength and recovery. Annie began training in DBT as a graduate student at New York University in 1999. Since receiving her Masters degree in 2000, she has continued to develop her skills as a DBT practitioner, including acting as a skills trainer and individual therapist on two research studies led by treatment developer Marsha Linehan, Ph.D. at the University of Washington. Annie has worked closely with Melanie Harned, Ph.D. in the development and training of the DBT Prolonged Exposure protocol, including providing individual therapy in the original treatment development study.  Annie now focuses her work on training and consulting, primarily related to treating PTSD within DBT. Click the link below for DBT PE information and training: https://dbtpe.org ----------------------------------------------------------------------- This episode is proudly sponsored by Hope for BPD Hope For BPD is that resource, a beacon of hope. Whether you're personally affected by BPD, or you're supporting a loved one through their journey, this platform is here to assist you every step of the way. Hope For BPD provides confidential and compassionate treatment consultation, information and research about evidence-based treatments, ongoing solution-focused and nonjudgmental support for individuals with BPD and family members, and more. Visit https://www.hopeforbpd.com/ to learn more about their services, and to find that glimmer of hope you've been looking for. ----------------------------------------------------------------------- Thank you so much for tuning into this Show! If you've enjoyed it then share, subscribe, and leave a review if you haven't already :) Join us on social media: Instagram: @bpdbravery Facebook YouTube and feel free to contact me via email at braverybpd@gmail.com --- Support this podcast: https://podcasters.spotify.com/pod/show/bpd-bravery/support

Dialectical Behavior Therapy, or DBT, is a type of cognitive-behavioral therapy created by psychologist Marsha Linehan in the early 1980s. It's an evidence-based, highly successful type of therapy used to help people regulate intense emotions and improve their relationships. What does this have to do with problem-solving? Well, in all its brilliance, DBT outlines four ways to solve any problem and I've been using this strategy with great success with all my clients. These four ways to solve any problem are easy to learn and integrate so you can start meeting challenges with clarity and calm.  ____________________________ Full blog and show notes: https://abbymedcalf.com/the-four-ways-to-solve-any-problem Grab my FREE Mindfulness Starter Kit: https://abbymedcalf.com/product/mindfulness-starter-kit/ ____________________________ Want to feel happier and more connected in your relationship? Buy my #1 bestselling book on Amazon, Be Happily Married: Even If Your Partner Won't Do a Thing: https://abbymedcalf.com/book Looking for past episodes of the Relationships Made Easy Podcast? Head over to https://abbymedcalf.com/podcast and https://abbymedcalf.com/podcast-the-archives where you'll find every single episode. Subscribe today to get my love letter to you! This biweekly reminder will keep you on the path to creating connected, happy relationships (especially the one with yourself!). https://abbymedcalf.com/ For more quick tips, subscribe to my YouTube channel: https://abbymedcalf.com/youtube Ready to dig deeper? Take one of my online courses (some are FREE!) or grab a workbook: https://abbymedcalf.com/shop/ A great idea to stay motivated and keep your head in a positive direction is to buy some of my fabulous, inspirational merchandise. Get yourself a t-shirt, mug, tote bag, or notebook with that daily reminder that you've got this! https://abbymedcalf.com/shop/ Say hello on social: Facebook: https://www.facebook.com/abbymedcalf Instagram: https://www.instagram.com/abbymedcalfthriving LinkedIn: https://linkedin.com/in/abbymedcalfthriving YouTube:  https://abbymedcalf.com/youtube

Alex Dayton has an impressive history in the mental health field including serving as the Clinical Director for Freedom Institute and the Chief Clinical Officer of Veritus. In this revisited episode, he joins us today to talk about addiction treatment and recovery for licensed professionals. Because of their license, professionals like doctors, lawyers, and judges are  more reluctant to seek treatment. The program offered by Veritus, which uses technology, helps to make treatment more a accessible.to this population. Listen to today's episode as Alex talks about the correlation among addiction, wealth, and success, explains dialectical behavior therapy (DBT)T, and shares exciting trends in the mental health field.   IN THIS EPISODE   [01:46] Similarities and differences between licensed professionals and the average person getting  support for substance use. [06:22] How doctors compare to other patients in treatment [09:54] How treatment for lawyers is specialized [12:54] The correlation among  addiction, success, and wealth [18:21] An explanation of DBT [23:42] Alex shares what he is looking forward to in the field in the coming years   KEY TAKEAWAYS   Technology is being used in the mental health field making treatment more accessible and offering different solutions for clients. DBT is an effective therapy technique because it is applicable in real-time. Doctors, lawyers, and other licensed professionals often have a hard time seeking help for substance use because they are afraid it will affect their license. Veritus and the Freedom Institute both aim to help treatment be more accessible to this population.   RESOURCES:   Beyond the Balance Sheet Website   Veritus Website   BIO:   Alex Dayton is a Psychotherapist in private practice and an advisor to several organizations helping to support mental healthcare programming and strategy. Alex served for several years as the Clinical Director for Freedom Institute, an outpatient treatment program located in New York City.. In addition, Alex served as the Vice President of clinical strategy and business development for Freedom Institute. Alex served as Chief Clinical Officer of Veritus, a virtual intensive outpatient program he helped launch and design to treat medical professionals, lawyers, and judges struggling with substance use disorder. Alex remains a consultant for both Freedom Institute and Veritus as a senior advisor. In addition to his Masters degree from New York University, Alex has received intensive training in DBT, and advanced practices in DBT from Marsha Linehan at Behavioral Tech. He  has received training in cognitive behavioral therapy (CBT) from the Beck Institute, completed the Foundations in Family Therapy Program at The Ackerman Institute for The Family, and completed training in advanced practices for Motivational Interviewing from MINT. Alex  completed training at Bellevue hospital and at FEGS, working with adults who have both chronic mental illness and addiction. He has worked with adults, adolescents, and children at the Brooklyn Center for Psychotherapy and on a research team at New York University conducting HIV and substance use research.  

Welcome back to Analyze Scripts, where a psychiatrist and a therapist analyze what Hollywood gets right and wrong about mental health. Today, we are analyzing the '90s movie "Girl, Interrupted" based on the memoir by Susanna Kaysen. This film depicts two years of a young adult woman's life at McLean Hospital in the 1960s where she was diagnosed with borderline personality disorder (BPD). This episode analyzes everything from why it's so hard to talk about BPD, psychoanalytic vs behavioral treatment methods, the deinstitutionalization movement, antipsychotics, and our opinions about Angelina Jolie's portrayal of sociopathy. We hope you enjoy! Instagram TikTok Website [00:10] Dr. Katrina Furey: Hi, I'm Dr. Katrina Fieri, a psychiatrist. [00:12] Portia Pendleton, LCSW: And I'm Portia Pendleton, a licensed clinical social worker. [00:16] Dr. Katrina Furey: And this is Analyze Scripts, a podcast where two shrinks analyze the depiction of mental health in movies and TV shows. [00:23] Portia Pendleton, LCSW: Our hope is that you learn some legit info about mental health while feeling like you're chatting with your girlfriends. [00:28] Dr. Katrina Furey: There is so much misinformation out there and it drives us nuts. [00:32] Portia Pendleton, LCSW: And if someday we pay off our student loans or land a sponsorship, like. [00:36] Dr. Katrina Furey: With a lay flat airline or a major beauty brand, even better. [00:39] Portia Pendleton, LCSW: So sit back, relax, grab some popcorn. [00:42] Dr. Katrina Furey: And your DSM Five and enjoy. We get started with this episode. We just wanted to add a trigger warning. Some of this content could be disturbing to listen to. We're talking about the film Girl Interrupted, and there are some themes of suicide, disordered eating, and I would say institutional traumatization. So again, if any of these themes hit too close to home or could potentially be damaging, please feel free to skip this episode and join us again next time. Otherwise, enjoy. Hi, thanks for joining us. Today we are going to talk about the hit movie Girl Interrupted. A real blast from the past from my favorite decade, the 90s. This movie is based on the 1993 memoir by Susannah Casey, who wrote about two years of her life spent at McClain Hospital in the 1960s in Massachusetts, where she was diagnosed with borderline personality disorder. Portia so when I recommended we covered this movie, I totally didn't remember the plot. I don't actually know if I saw the whole thing. I was just like, oh yeah, there's a movie with Angelina Jolie and she got an Oscar and it's probably really good. I totally forgot that the main character was diagnosed with Bpd, which I actually think is great for us to talk about because we've alluded to this diagnosis and some of our other know, I'm thinking like, what about Bob Succession White Lotus? And I still find that this is a tricky diagnosis to talk about with patients to explain to patients to explain to other. I thought, you know, Winona Ryder's character like, did a great job being like, what is it? On the borderline of what? What are you talking about? Right? [02:38] Portia Pendleton, LCSW: Yeah. And at the time, though, this was newish. Marsha Linehan hadn't written her book yet on DBT. [02:47] Dr. Katrina Furey: I don't even think there was DBT yet. Thinking about the 1960s, I thought this film did a great job depicting what it probably was like to be psychiatrically hospitalized in the 60s, which is so different from what it's like today. Place that is very true. So this film was filmed at Harrisburg State Hospital in Harrisburg, Pennsylvania. It was filmed in 1999, but it was based on McLean Hospital, which is probably the number one psychiatric hospital in our country for a long time. I think it is affiliated with Harvard, and I think they do still have some longer term units like this, but you see a lot of treatment. You know, she goes to therapy many times a week. She's sitting on the couch. Her therapist is sitting behind her. Unfortunately falls asleep at one point, which I don't think actually happens in real life, but speaks to how she felt probably like there was a disconnect and you hear about how she's there for two years. That just doesn't happen anymore. But in the did, that was the treatment. People used to be admitted and stay for a really long time until in the mid 1960s, in the Reagan era, there was this big move not just in our country but internationally to deinstitutionalize patients, right? So sort of close down these long term hospitals which we called asylums and invest more in community mental health centers. And I think I don't know this for sure, but I believe that coincided with the invention of modern day antipsychotic medication like Thorazine and the other medications that came from that, like Haldol, basically medications that could treat schizophrenia and thereby treat these patients in a way that hopefully they didn't have to live in an institution. Sadly, we haven't invested enough in the community mental health centers that were supposed to be created to sort of support patients and we've had some really awful side effects from that. Primarily homelessness and institutionalization in jails. That is the number one provider of mental health treatment in our country. How awful and disgusting is that? And again, it's because not enough money goes into these community mental health centers. So nowadays you might be admitted for a couple of days to really stabilize you, tweak your meds, but you're not getting this type of intensive, insight oriented therapy anymore that we see depicted in this movie. And I think that's really sad. You can get that if you can pay for. [05:29] Portia Pendleton, LCSW: I mean, it's wildly expensive. [05:31] Dr. Katrina Furey: Wildly expensive. And I think some places, like other, you know, hospitals might take insurance. I don't know if insurance would cover it. [05:41] Portia Pendleton, LCSW: Yeah, they take some and especially for some programs. Like, I've had some people go to McLean, I've known some people to go to Silver Hills. Those two places over the years have definitely taken more of an insurance route for some of their programming and other tracks that they have. Other parts of their residences or programs are not insurance based. [06:03] Dr. Katrina Furey: And I think that also just speaks. [06:04] Portia Pendleton, LCSW: To like there's not a lot of people who can afford to be somewhere for a year and pay that. So I think they've also just had to do that where it's like some of their income is insurance based and others they are able to get private pay. [06:19] Dr. Katrina Furey: And I would like to think that they would take insurance for more situations if insurance would freaking pay, right? But insurance is the worst. That's a whole nother tangent for another day. But they don't pay. They don't even pay know, short just it's really an abomination. Yeah. So anyway, getting back to the movie, we have an all star cast. So Winona Ryder is playing Susanna, the main character. We have Angelina Jolie playing Lisa, the woman with sociopathy. She won an Academy Award for this role. I think Winona Ryder did too. Or maybe she was nominated. I can't remember. We have Whoopi Goldberg playing Valerie, the nurse. Elizabeth Moss playing Polly, the girl who was a burned victim from childhood. Clea duvall is played. Georgina susanna's roommate. [07:12] Portia Pendleton, LCSW: And she is in the show Veep. [07:14] Dr. Katrina Furey: That I really love. I haven't seen it before, but I've heard really good. [07:17] Portia Pendleton, LCSW: I was like, oh, my gosh. Oh, my gosh, it's her. Yeah, I couldn't believe it. [07:21] Dr. Katrina Furey: And then we had Brittany Murphy, who played Daisy. Who. That's just a tragic death and weird circumstances on its own. But I loved her, and I loved her roles in the then we had Jared Leto, who knew? Playing Toby. [07:36] Portia Pendleton, LCSW: I was like, who? Before I looked at the cast list, I was like, who is that? Why does he look so familiar? I couldn't believe it. So young. [07:43] Dr. Katrina Furey: I know. [07:43] Portia Pendleton, LCSW: Like a baby. [07:44] Dr. Katrina Furey: They all look so young. And then we have Jeffrey Tambor playing Dr. Melvin Potts, her first psychiatrist. And then we see Vanessa Redgrave playing Dr. Wick, the female psychiatrist. And there's a lot of other characters too, but those are just some of the main heavy hitters. [08:01] Portia Pendleton, LCSW: Yeah. [08:02] Dr. Katrina Furey: So what did you think, Portia, about the opening? [08:07] Portia Pendleton, LCSW: A little confusing. I mean, I was like, Is this present know? And then I was confused because it starts with her in the hospital, right, getting her stomach pumped. [08:16] Dr. Katrina Furey: Then I think the very first thing is you see, like, a broken light bulb in a syringe, and the girl's like, in the psych hospital, and you're like, what's going on? And then it flashes. [08:24] Portia Pendleton, LCSW: So then she wakes up. [08:26] Dr. Katrina Furey: And I was like, okay. [08:27] Portia Pendleton, LCSW: So was that a flashback? Was that a memory? Is her stomach getting pumped real? I was confused with those two first scenes. [08:36] Dr. Katrina Furey: Yeah, totally. And I wonder I would imagine that was kind of intentional. And then we see her being pretty aggressively restrained. We see the tube down her throat, I think, pumping her stomach. And my first thought was, what did she overdose on? This looks like they're trying to treat her for an overdose. And then someone screams out, oh, she's a wristbanger. I was like, what does that mean? And she said something about, there's no bones in my hand. And I was like, what is going on here? But I think it did give a pretty good snapshot into her mental state at that point in time. I was like, okay, she's overdosed on something that's dangerous enough where they have to aggressively pump her stomach. Now, we can't wait. We have to hold her down before we even get a sedative in her. Maybe back then they didn't even really have sedatives. Honestly, I'm not sure when things like Adivan and stuff were invented. And that thing about not having bones in her hand made me think, is she psychotic? Is she not? What's going on? Then we see her lock eyes with that man in the hallway, who we later learn is, like, her dad's colleague who's married, and she's had some sort of sexual relationship with him. And then she's pretty quickly seeing a psychiatrist in his home. You see her looking out the door, seeing his family and looking out the window and seeing her mom unpacking a suitcase. And I was like, Uhoh, yeah. [10:04] Portia Pendleton, LCSW: And still does happen. But I think it was more common in the past with these kind of, like, voluntary, but involuntary getting someone to treatment. Right. So it's like, whether you're an adolescent, and it's not voluntary at all, and your parents are taking you there, so it's under their voluntary, but not telling them where they're going. So, hey, we're going to go for a car ride. They don't know their suitcases packed, and then we're taking you to treatment. Or the horror stories of those wilderness camps where you're, like, abducted in the middle of the night. I was kind of thinking of that with Susanna being an adult. Right. It's like, in my head, I'm like, at any time, she can kind of. [10:40] Dr. Katrina Furey: Back out of this. Well, can she? It turns out she couldn't. Right. [10:45] Portia Pendleton, LCSW: That was also my question was, why. [10:47] Dr. Katrina Furey: Was it different in the so I don't know the full rules, but I do know that a lot of things they depicted in terms of getting her to the hospital don't happen these days. So she's seeing this psychiatrist. So an old white man, by the way, and he doesn't do this anymore. He very readily volunteers that way to instill confidence in your patient. I thought he was very shaming. I didn't like the way he spoke to her. He was not connecting with her. It was very clear she was, like, a bother to him in that the way he was saying, like, I'm just doing this as a favor to your dad. Why are you doing this to everyone around you? I just thought it was awful. What a terrible way to treat someone who is just clearly attempted suicide, even if she's saying, I always just had a headache. I didn't mean to take that much. It's clear what was going on. And then he just puts her in a cab and trusts the cab driver to take her to the psychiatric hospital. Okay. Yeah. Okay. [11:49] Portia Pendleton, LCSW: That's his responsibility. [11:50] Dr. Katrina Furey: We 100% don't do that. If you need to send someone to the psychiatric hospital, hopefully you can talk with them and talk with their family and come up with a plan where they're on board. That's the ideal way, right, to sort of have their family bring them, and they're voluntarily seeking help. Sometimes people aren't willing to go and they need to go for their safety. And that's when, at least in the state of Connecticut, a psychiatrist can involuntarily hospitalize someone by signing what's called the Physician's Emergency Certificate or a PEC form. There's only two conditions in our state where you can basically take away someone's civil liberties by saying you have to be institutionalized against your will. That would be if you are an imminent threat to yourself or someone else. So in terms of like suicidality or homicidal threats or if you are so gravely disabled from your mental illness that there is fear of your being able to survive without immediate intervention. So people who unfortunately have something like a psychotic disorder, who aren't eating, who are harming themselves in some way but might not realize it like if they have diabetes and aren't taking their insulin, things like that. But it has to be really severe in order for you to be able to check that box. You can't check it for things like substance abuse. That's a different type of involuntary commitment and that one's really hard to get. [13:12] Portia Pendleton, LCSW: You can also send people involuntarily to the hospital just for the eval. You know what I mean? Like cops can do that. [13:20] Dr. Katrina Furey: You're right. Sometimes people will voluntarily sign themselves in. Once you do that, though, you can't voluntarily sign yourself out. Usually the team does have to kind of be in agreement that you're ready to leave. If not, then they could petition the courts to then involuntarily commit you to sort of see out your treatment. But it's not like, for two years anymore. [13:44] Portia Pendleton, LCSW: Yeah. So we learn later in the movie. But that Lisa has been there for eight years. [13:49] Dr. Katrina Furey: Not surprising, right, given her personality pathology. And it seems like she frequently elopes, which is the fancy word to say. [13:59] Portia Pendleton, LCSW: You know, my question was just thinking about is she making herself known? Is she kind of coming back? Is she presenting in a hospital somewhere? Like, how are they finding her? [14:08] Dr. Katrina Furey: Right. Are they finding her or is she finding them? Does she have some sort of tie of dependency to the institution that's been taking care of her? Because it seems like she's like the leader in some ways. Right. And I thought that I mean, what were your thoughts, Portia, of Angelina Jolie's depiction of Lisa with antisocial personality disorder? [14:27] Portia Pendleton, LCSW: I thought it was good because you can see how those people can kind of suck others in yes. [14:35] Dr. Katrina Furey: That charming. [14:37] Portia Pendleton, LCSW: And appear really interesting and powerful and fun and light and it's almost like they know what you need. So she was all these things to different people. [14:49] Dr. Katrina Furey: Yes. And then knows also how to get under people's skin. Like we see with Daisy in a really sinister way. [14:57] Portia Pendleton, LCSW: Oh, yeah. Like horrific. I mean, I didn't really, I guess, get the flair of oh, my. Like, I really don't like her. She's horrible. Until that moment. [15:09] Dr. Katrina Furey: Yeah. Right. [15:10] Portia Pendleton, LCSW: Until the because she doesn't let it go. It wasn't just like, oh, I kind of threw this out there. Maybe someone may do that. I'm thinking maybe who has, like, a borderline personality disorder. They're kind of pushing the limits a little bit, but take it that far is not typical, right? [15:26] Dr. Katrina Furey: And I thought at first in seeing her on the screen, I thought she was depicting Bpd because she comes in very provocative. You can tell, like, the staff is all up in arms, right? Like, Nurse Valerie, played by Whoopi Goldberg, I think is helping Susanna settle in and then gets some kind of someone comes in, like, whispers in her ear, like and then you see all the staff is ah. Some of the patients there get really nervous, but then some of them are excited to see her again. I think that actually displayed the concept of splitting really well. That these types of patients tend to rile people up. And some people are on the good side, some are on the bad side. And then you pit them against each other. [16:05] Portia Pendleton, LCSW: Really manipulative. [16:06] Dr. Katrina Furey: Really manipulative. And so at first, I thought that was the type of character she was portraying until the movie went on. And you'd see her get under people's skin and then not let go. And you could sense she got off on that. Even in the rolling chair when she steals the nurse's pen and has it at her throat with that sort of suicidal gesture. You got the sense they've done this before. You knew that this nurse had opened. [16:32] Portia Pendleton, LCSW: Up to her, which huge red flag. [16:37] Dr. Katrina Furey: Don't do that. [16:37] Portia Pendleton, LCSW: And also, though, it's like that is most likely to happen with that kind of a patient, 100%. They're really good at getting under your. [16:45] Dr. Katrina Furey: Skin and getting you to open up to feel safe and comfortable. This is how serial killers abduct people. This is how it happens. So I thought she did an amazing job portraying both sides of that. Like, both the charming, fun, playful nature that attracts people and then that sinister, manipulative, sadistic side. [17:07] Portia Pendleton, LCSW: I mean, not being impacted by Daisy's death. So, like, Susanna is very appropriate reaction. And again, I'm saying this like, ha ha. But even someone with a personality disorder. [17:23] Dr. Katrina Furey: It'S like, yeah, because she has appropriate. [17:25] Portia Pendleton, LCSW: Emotions that maybe are extreme. But like, wow, you see someone who a dead body, someone who's hanging very disturbing. And you have this emotional reaction because you're a human with you know, Lisa. [17:38] Dr. Katrina Furey: Is not she takes her money and she goes I think, again, that was just such smart writing and depiction. I guess I was reading that didn't actually happen. Like, they didn't escape together. I was reading a little bit on Wikipedia about the author's take on this movie and I think she actually didn't love it. But there were some things that didn't actually happen like that scene. So whether it happened or not, I hope it didn't for daisy's Sake. But it was really smart writing to portray these two women who are both struggling psychiatrically, but with different personality flavors. And I think you do see some overlap between the Bpd and ASPD antisocial personality disorder, which, again, are all under the same cluster of personality development, like the provocative nature, the splitting, the intense mood swings, the all or nothing way of thinking and feeling and relating to people. But you see how antisocial personality disorder is different, right? [18:36] Portia Pendleton, LCSW: There's lacking empathy, there's lacking people with Bpd can relate to others. They do experience emotions appropriately and sometimes extreme. It's not a lack of in most cases, it's intense. [18:48] Dr. Katrina Furey: Exactly. [18:48] Portia Pendleton, LCSW: Too many emotions. [18:50] Dr. Katrina Furey: Right. It's a very intense emotions for the situation, but you still experience them. And they're not always, quote unquote, too intense. Sometimes they're totally accurate. But even, like, the scene with Susanna and Valerie where Susanna's in the bathtub, and she says awful things to thought. I don't know about you, but I felt like that was the scene where I really saw the Bpd side of Susanna. Kind of like until then, I was like, I don't really know if I buy that she has this diagnosis or if she's just, like, a struggling. Like, maybe it's a little too early to diagnose her with something like this, but then she really throws out, like, racial slurs, really derogatory things. Because I think Valerie was trying to connect with her. And I think for someone with Bpd, that feels very scary. Right. It's like you crave attachment, and you also fear it because you might lose it. So I felt like that was her trying to push her away in a really extreme way. And then later, though, you see that Susanna has a lot of remorse and guilt for what she said, whereas someone like Lisa would not. Daisy's character as well, is very you. [20:04] Portia Pendleton, LCSW: Know, I think there's a lot there. I think also, if we're going on what Lisa said is true, which sounded like her dad was molesting her for. [20:14] Dr. Katrina Furey: And again, like, no one else had kind of brought that up. And I do feel like people with sociopathic traits have this uncanny ability to sniff these things out and pull them out. Right. I don't know how, but they do. They can sense this stuff and pull it out and really dig at you. Yeah. [20:34] Portia Pendleton, LCSW: We didn't know that until that scene where she was kind of pushed over the edge. But she talked about being wealthy a lot. It seemed like she was abusing laxatives. They were kind of trading colase for Valium, which can happen at residential or inpatient places. That's why you're typically supposed to show your mouth. You lift your tongue, move it around to show that you're not tonguing meds. [21:00] Dr. Katrina Furey: Right. Or cheeking them or throwing them up afterwards before they've been metabolized. Yeah. [21:07] Portia Pendleton, LCSW: So that's a part that's just I mean, it can happen, and it is. [21:11] Dr. Katrina Furey: What it is, but it does happen. [21:12] Portia Pendleton, LCSW: The trading is just so unhelpful, right? Because it's like you don't know what drugs you're trading something for that then you're taking could be interacting with something else that your prescriber is giving you that they don't know that you're doing this. Very dangerous do not do thought. And maybe you can speak on this a little bit. It was interesting, which I know would never happen. [21:30] Dr. Katrina Furey: Right. [21:30] Portia Pendleton, LCSW: So before she's seen by a medical and I'm talking about Susannah before she's evaluated or sees any psychiatrist, she's already taking medication and they're giving her laxative. Why? [21:40] Dr. Katrina Furey: I thought they were giving her sleeping pill at first. Well, I guess they also give her choli. Right? [21:45] Portia Pendleton, LCSW: Well, anyway, but any medication. [21:47] Dr. Katrina Furey: Yeah. So there were definitely, I would say, some positive elements of the movie about the way they depicted mental health treatment back at that time. As it was. It could be at these beautiful institutions where you would have, like, a nurse's station. Then the patients would have their rooms. There'd be a common area. There would be other rooms like the art room, the music room, stuff like that. I think even nowadays, at more residential type places, you try to have that stuff so that during the day, you're not just sitting around, there's some therapeutic intervention. Right. So that I thought was pretty positive and spot probably, I would imagine McLean still might kind of look like that. The things that I thought were not great was that, like you said, she didn't see a psychiatrist at all and she's already taking medication. Like, that doesn't happen nowadays, and she. [22:34] Portia Pendleton, LCSW: Wasn'T already on it. [22:36] Dr. Katrina Furey: Right. It's not like they were continuing what she was on. But even for that, if you're admitted to a psychiatric hospital and you get to the unit at 03:00 in the morning, there's a psychiatrist on staff who will at least come and do a physical exam. Listen to your heart, listen to your lungs, check your blood pressure. [22:52] Portia Pendleton, LCSW: You're getting labs. [22:53] Dr. Katrina Furey: You're getting labs done. Maybe you need an EKG just because they might have hurts like a murmur or you're on a medication, they want to make sure that your heart is functioning okay, especially her, who just had a recent overdose. And then you go through like, do you have any allergies? What other medications do you take? Do you have any dietary preferences? Nowadays they also ask you what are your pronouns? All of this stuff happens the second you hit the floor. It doesn't wait till the morning. You might not meet your primary treater and get into the therapy side of things at 03:00 in the morning, but you would have that done, and you would talk about what medications they were going to prescribe or not and why and why. So I didn't like that. And you can't force anyone to take medication. That's the other thing that was inaccurate and made me upset, is like when susannah would express, like, I don't want to take this. You can't force them. That is totally coarse. If you can't do that, you need a court order to give anyone medication, which sometimes you do have to apply for, and sometimes it is granted. Like, if you have a patient with really severe chronic schizophrenia who needs their injectable antipsychotic to maintain wellness, that gets really tricky. But for stool softener, no one's forcing you to take a stool softener, okay? And like you said, they do like, tongue and cheek checks and make sure you are taking your medication. And they depicted that sometimes, but not all the time. But yeah, the chicken carcasses. What do you think about that? Interesting. [24:20] Portia Pendleton, LCSW: I mean, it seemed like she does like, purge, right? So either laxative use or there was some alluding to maybe some binging, like some little bit of bulimia both at the unit and then when she was in her apartment. That made me think that again, I mean, I'm going very loosely making that diagnosis. I also would say that the other patient on the unit who appears to have anorexia, which the weird comment of she's like, yelling about wanting her clothes, and then the nurse says, then you'll have to eat something, does not happen. [24:50] Dr. Katrina Furey: Now you can't manipulate people to eat. [24:52] Portia Pendleton, LCSW: And also that's typically why there are now so many separate units. It's very unhelpful and doesn't happen frequently to have eating disorder patients within a general psych population. They are, I think, inpatient like, in a hospital can go to like a medical but even then there are very specific and I think there's really only like a couple in the country, but there's a Cute out west, and then there is Walden and McLean out east, where they have inpatient units specifically for that. Because I think it's so important for staff to be trained in a very specific way. [25:32] Dr. Katrina Furey: I did think some of the stuff they portrayed, like not giving you your clothes until you eat doesn't happen. Other stuff, though, that they portrayed, like her exercising all the time on the unit, super accurate. And that's one of the things that the staff get trained in is like, being able to pick up these subtle ways of exercising in an attempt to burn calories and things like that. [25:53] Portia Pendleton, LCSW: Well, a lot of patients will share that if they are admitted into a general hospital and they do have primary ed, it's often like the worst time, which, again, is probably for many different reasons. One, they're so medically compromised. Two, this is like the beginning of the long road of often. Then maybe you're switching to an inpatient ed unit and then residential and then PHP and then IOP. There is some controversy in the community with the ethics around tube feeding. There's even more controversy within it if you are being tubed placing and pulling same day or for each meal to get you off the tube, they want you to eat, and typically you're tubed if you're really malnourished or if you're refusing. Again, I don't think they can make you without a court order, but they'll do that if you're refusing. [26:44] Dr. Katrina Furey: Yeah, I think that gets really tricky. And it's probably when they call for a capacity evaluation where a psychiatrist I would believe a medical doctor could do it too. Medical doctor being like internal medicine, someone who's not a psychiatrist, but still a physician would evaluate, does this patient have the capacity to refuse meals when they're this malnourished? Or is that malnourishment causing impaired cognitive what is the ethical decision of like can you make this decision knowing it's going to hasten your death or not? I mean, that's probably a huge ethical. [27:18] Portia Pendleton, LCSW: And there was a case and the judge sided with the patient and the patient went on to die. They went into hospice. Just it's really horrible. Do not recommend. But these places are there for you because you are that know, you really need support. So anyway, Janet should be, I think, in a more specialized unit where she's getting meal coaching other than just being threatened or withholding other things. [27:45] Dr. Katrina Furey: Right. [27:45] Portia Pendleton, LCSW: I think there were some eating disorder places around Renfrew's really old. They started in Philadelphia. They're all over now, but they're like the oldest big center for eating disorder. So if they were open then she should have been there. I think she probably would have gotten better care and more specialized care. So she should transfer if it opens soon. [28:07] Dr. Katrina Furey: Well, and I'm just thinking too, back in that time, in the mid sixty s, I feel like a lot of the treatment was still very psychoanalytic. Right. So I don't know how much about. [28:16] Portia Pendleton, LCSW: Your mother, let's lie down and talk about your mom. [28:20] Dr. Katrina Furey: And as a psychodynamic, psychotherapist I so fully believe in, there's huge connections cases in certain instances. Right. [28:30] Portia Pendleton, LCSW: But we need meal coaching, we need behavioral treatment, which often is DBT, and we absolutely need but I will say, too, like at that level of care, it's really hard, I think, when you're also that malnourished to exactly do that. [28:44] Dr. Katrina Furey: That's what I was going to say. Right. Like at the right time for the right patients. I feel like back then and again, I don't know, I wasn't alive in the 60s, but I feel like that's what everyone got. [28:54] Portia Pendleton, LCSW: Yeah. [28:55] Dr. Katrina Furey: And maybe that was like all we really had back then. We didn't really have the antipsychotics and stuff were just starting to come out. Maybe like CBT, DBT, these things, I don't think they were really out there yet. So yeah, I would imagine Janet was getting substandard care based on today's standards. And then it's like, well, I think Susannah was getting really good care based on today's standards. The difference in the comparison is really interesting. [29:23] Portia Pendleton, LCSW: And I wanted to just if you haven't listened yet, check out our episode on Shutter Island. Because that was in, I think, around the same late fifty s the mid to early 50s. So that's not that far off from this movie. Maybe, though, ten years can make a difference. However, I think this is also, again, like a private institution versus a forensic state forensic unit. Right. [29:46] Dr. Katrina Furey: But you're right, it's really interesting to sort of watch both of those and kind of compare and contrast them and they do get some of the historical points accurate. And I feel like back in the 60s, again, that was when a lot of these hospitals were being shut down in an effort to have people be treated in the community. Which again, is like, great, let's do it. But the money to actually do it, guys. [30:08] Portia Pendleton, LCSW: Yeah, no, totally. That's a huge problem. Anyway, there was a lot of other things wrong, like the orderly having oh. [30:16] Dr. Katrina Furey: My God, sexual relations. Even like them allowing her to make out or have sex with her boyfriend. No, you're not letting when people come to visit you, you don't just get to go behind closed doors and have a conjugal visit. [30:27] Portia Pendleton, LCSW: It's like a therapy session or you're playing a game. It's out in the open visiting time. [30:32] Dr. Katrina Furey: There's boundaries, especially for a patient like her. And how did the girls keep escaping and going to the basement all the time? There's people on staff overnight. The room check thing was accurate. You do come in and do checks at first, they are every 15 minutes. So I think that's really disruptive to your sleep. And we know how important sleep is to your mental health. [30:51] Portia Pendleton, LCSW: So I've done checks. I only had to do one, thank goodness, because I'm not an overnighter gal. But when I worked at a residential, I did get mandated to stay once overnight. And having to do ten minute checks on a new patient, because typically when they're new, they're on the highest level of watch. [31:09] Dr. Katrina Furey: Right. [31:10] Portia Pendleton, LCSW: So it just sucks, a, because I wasn't used to being on night shift, but yeah, it's really hard to do as an employee or as a mental health professional. And then also, I'm sure the patient didn't love it either, right. [31:23] Dr. Katrina Furey: Because they're not just like opening the door to see if you're there. They have to make sure you're safe. Right. So if you're turned and facing the wall and sleeping, they have to shine the light in your eye, make sure not only are you breathing, but you're not hoarding some sort of weapon or things like that. So that actually was accurate. But then I was like, if they're doing the checks, there's no one in the hallways. That's just not how it happens. I don't think they would have been able to escape. I thought this scene with them all reading their files was fascinating. And to me, it kind of reminds me of like, nowadays when patients have access to their notes and stuff like that, and how that is interesting and I think different for someone reading their note from their primary care annual physical and their therapy work. Right. What were your thoughts about all that? [32:11] Portia Pendleton, LCSW: Yeah, I think we talked about this in another episode, but I'm going to bring it up again. You're supposed to write your note like there's a lawyer on one shoulder and the patient on the other. So I think though, with more electronic medical records and with more open chart things like we have my chart here, maybe that's international, maybe it's national. It's basically where you can log in, send a message to your provider, look at your lab work, et cetera, schedule appointments, also see the notes. And so there are some questions around is it helpful or not for that to be in the mental health world? And is there like a level of notes that should be shared versus not what's helpful? [32:51] Dr. Katrina Furey: What do you think? [32:52] Portia Pendleton, LCSW: I think that patients should absolutely have access to treatment plans. I think that having access to all of your notes all the time, reading them on your own, is unhelpful. I totally agree. I think if you need to see the notes, you should be going over them with the provider so you can explain things. So if there's any questions or context, they can ask questions and not feel any kind. It shouldn't be negative. And they might be like, oh, well, what is that? What did that mean? And then you're there to explain exactly what that meant. [33:29] Dr. Katrina Furey: Right. I think, though, kind of like these women reading their files, it can be jarring. I don't think I'd want to read my psychological assessment of myself by myself. I feel like that's like really I. [33:43] Portia Pendleton, LCSW: Think it's more damaging it can be. [33:45] Dr. Katrina Furey: And I think it can really damage the therapeutic alliance with your provider too, because not everything you're observing the patient's going to see and that's going to. [33:55] Portia Pendleton, LCSW: Be it might not be ready to see. [33:56] Dr. Katrina Furey: Right. [33:57] Portia Pendleton, LCSW: And I'll just say too, just for clarity, we're not talking **** about you in your notes, we're writing things from our perspective, from our professional perspective of what's happening. Sometimes maybe we're wrong too, interpreted something wrong. So it's really for documenting purposes, it's for billing. [34:17] Dr. Katrina Furey: Yes. [34:17] Portia Pendleton, LCSW: And sometimes we might not do it perfectly. So I think that's I would lead. [34:22] Dr. Katrina Furey: With that preference and I think with, again, notes and stuff like that being more and more open, I feel like they've just become less and less helpful. I guess you leave so much out and you just have to keep it in your head, right, that it's kind of unfortunate. I do find myself being like, well, if this person ever read this, how would they feel about this? And I do think that can go both ways. On the one hand, I think it can help you remain not compassionate, but help you stay in a neutral space. And a lot of times be mindful of your own unconscious biases and be like, well, why am I putting this word in? Does it really need to be there or not? And on the negative side, it can make you withhold things that really should be there, but you're worried about if they read it before they're ready, how is that going to affect them? How will that affect our therapeutic alliance and their future treatment? And is that worth it? [35:23] Portia Pendleton, LCSW: Right? [35:23] Dr. Katrina Furey: Is that potential negative effect worth it? It's real tricky. [35:27] Portia Pendleton, LCSW: It is. No, I totally agree. It's nuanced. I think most providers feel the same way we do. [35:42] Dr. Katrina Furey: But I did think how interesting that this film, filmed decades ago, based on a time even further in the past, is still, like, on the pulse with something really active, like, in the mental health field presently. And I also thought it amazingly depicted how mental health providers really struggle to tell people their directly. It seems like none of these girls really knew, what am I here for? What am I being treated for? Some of them did. They were like, oh, Elisa, you're a sociopath. We all know know. But, like, Susanna being like, borderline personality disorder? What is that? [36:19] Portia Pendleton, LCSW: And then when she's in her family therapy session, she's like, what is that? And apparently the doctor's been telling her parents, but not her. [36:27] Dr. Katrina Furey: Right? And she is an adult. This isn't like a 14 year old. And especially, I don't know about you, Portia, but I feel like in the mental health field, we tiptoe around this diagnosis, and so we're so hesitant to talk about it and share it with people. And why do you think that is? [36:44] Portia Pendleton, LCSW: I think because societally, there are negative connotations with it. And I think that at least that's my discomfort sometimes. Versus I think the more we accurately diagnose people who have Borderline and talk about it, the better care they will get, because then we know the treatment plan and they can get better. We have more than people to participate in studies, there's more research. I think we really should be accurately diagnosing the disorder and also teaching clients about it and giving them education is, like, best practice. But I think in our society, like, Bpd has a lot of negative even I think it's even, like, joked about, you're crazy, and it's females. Obviously, we're careful of that, but I think ultimately, it does more damage, not sharing or being, for sure, hesitant. But again, diagnosing someone with a personality disorder does not happen immediately. One assessment, you're getting there with tons of data and information, and over time, it's like, you're probably there, right? [37:47] Dr. Katrina Furey: Let's just call it what it is, right? But yeah, I think that reminds me of, like, early on in the movie. I think it's in this scene when she's reading her file and she sees a cluster of diagnoses at the beginning. I can't remember what they were. Do you remember what they were. Yeah, they're not accurate today anymore. We call them different things now. [38:09] Portia Pendleton, LCSW: So it says Psychoneurotic Depressive Reaction, personality Pattern Disturbance resistant, mixed type, and then undifferentiated schizophrenia. [38:21] Dr. Katrina Furey: Those were yeah. And then all of a sudden, at the bottom, it's like, final diagnosis borderline Personality disorder. So can you imagine? Again, it's like, okay, she's reading all these words. Like, even as a psychiatrist, I don't understand what those early diagnosis mean because we don't use them anymore. They're a lot of big words that are confusing. So it's really hard for her to make sense of, like, what does that mean? And she goes and grabs it, looks like a DSM or something, and starts reading about it and is, like, all up in arms. And I just think, what a sad way for her to find out and then to also hear it in the family therapy where her parents know before she knows, but we're all keeping it. [38:55] Portia Pendleton, LCSW: Quiet, like talk about it. [38:58] Dr. Katrina Furey: And I think I loved when she said borderline of what? Like, what does that mean? And, you know, the way I was taught to think about it and where I think the phrase comes from. And again, I will say I don't love that we call certain things personality disorders. I feel like even that phrase is really stigmatizing. I don't know of a better one, though. [39:21] Portia Pendleton, LCSW: So much of we find in patients who have borderline personality disorder, there typically is some sort of attachment trauma. [39:28] Dr. Katrina Furey: Yes. [39:28] Portia Pendleton, LCSW: And so I would love for there to be a more specific trauma diagnosis other than PTSD or complex PTSD that talks more about attachment and how that then impacts relationships. I think that would be so much more helpful, better fit for people to understand. [39:46] Dr. Katrina Furey: Right, 100%. And I think when we use the word borderline, I believe where it came from is, again, harkening back to those psychoanalytic days, which we see in this movie of thinking about what are the defense mechanisms different people with different illnesses tend to use to live with and cope with their illness. And when we think of people in broad strokes, we think of people falling into what we call, like, the neurotic realm of personality development. These are people with, like, anxiety disorders, OCD, things like that, eating disorders. And then we think on the other end of the spectrum are people with psychotic disorders who use different types of defense mechanisms that are disconnected from reality, whereas people with neurotic disorders are maybe like uber connected to reality or a little too in their head. Borderline falls in the middle, where you sort of display some neurotic defense mechanisms and some psychotic defense mechanisms that doesn't make sense to the average person. And even as I'm trying to explain it, it's really confusing. But these are patients she did say in the movie, which was accurate, with an unstable sense of self, unstable moods, like a lot of mood swings again, some safety concerns in the most severe cases, which we see with her right at the beginning. But, again, it's like what I also loved about this movie was when they captured her at this age because some of these personality traits, again, not the safety concerns, like, we'll put that over here on the side. But some of the other stuff, the big mood swings, the idealization devaluation, the splitting that is normal in development from when you're very young, like, born to as you're growing up into adolescence. And then as your brain matures and you mature, you're able to sort of hold on to good and bad feelings and thoughts simultaneously. But that takes time. It does. And so a lot of people are also really hesitant to make this diagnosis, I hope, in a teenager or young adult, until you really see these traits and these issues sort of being persistent and present across all different facets of someone's life and over a long period of time. Otherwise, it does raise the question of is this just quote, unquote, like normal adolescent angst, like the suicide attempt? No, but some of her questions to Dr. Wick, like, well, how many partners is promiscuous? And what is it for a man, like, totally trapped, right? [42:21] Portia Pendleton, LCSW: And for the time, just thinking of being in the think thinking of Susannah and then her mom, I would say probably very different expectations for how to behave. They talk the Vietnam War. There's a draft going on. So I think this is also just like, a very culturally changing time for so many behaviors might seem so unsafe besides the safety safety issues, like the promiscuity that they keep talking about to even the doctors, right? Because they're of that other generation as well, that maybe is having just more of that judgment or thinking it's more of a behavior than her. Just like right in the 60s as a young adult, like, expressing herself and her sexuality, right? [43:02] Dr. Katrina Furey: And then it's like, well, yeah, and having sex with an older man who's married. Again, I felt like there was so much almost blame put on her. But it's like, what about him? Right? [43:15] Portia Pendleton, LCSW: The mom are there at the ice cream store for that scene, and that wife and daughter come in, and Susanna susanna's trying to kind of hide herself initially. And then the mom sees her, comes over and is like, It's her fault. And it's also like, okay, but of course, right, like, you're so you're not blaming the adult in the situation, your husband, who's and, you know, she's single, she's young. Of course it's her fault, right? [43:41] Dr. Katrina Furey: There's all these assumptions and a lot of blame on her. But it's like, what about him? And taking advantage of a younger girl. And again, not saying that there aren't cases where maybe the younger girl is more of the instigator, I guess you could say. But still, I was like, I see her point here. [43:58] Portia Pendleton, LCSW: Well, and then he was continuing to want to follow up, and she remember at the beginning like, no. And kind of shuts the door on him. So even that felt like it was a little bit more on him, or else it was going to be more on him. But at the ice cream scene, I do think that that is when Susanna does kind of or Lisa's actions to kind of save Susanna is where Susanna does really align with her, and that's how that then, you know, then Lisa gets her trust on her. [44:24] Dr. Katrina Furey: And I think Lisa, with her sociopathic traits, can sniff out who's vulnerable. And I do think people with Bpd are vulnerable to attracting toxicity or finding themselves in these toxic relationships. Like, hearkening back to Tanya from White Lotus. As we're talking now, I'm wondering if that suicide attempt was somehow connected to that relationship with that man. Like if in some way she felt rejected and then attempted suicide. And if somehow, maybe the doctors knew that and we didn't quite hear that as a viewer. But that, to me would give more of more evidence for a true Bpd type of diagnosis where really the core inner wound and fear is related to attachment and feelings of abandonment or rejection are really hard to navigate, I think. As we wrap up, I wanted to just ask you, do you think Lisa would have actually been crying at the end? I did think her and the four point restraints were those are what restraints look like. Even these days, restraining someone is like the soul crushing thing that you have to do sometimes as a psychiatrist on inpatient units like this, when there's a real safety issue happening, we try to do it in the least restrictive way as possible. You do see another character earlier in the movie in a straitjacket. We really don't use those anymore, but what you saw depicted is what strait jackets looked like, and they were used back then. Do you think Lisa would have cried with Susanna's departure? [45:57] Portia Pendleton, LCSW: If the tears were real, they would. [45:59] Dr. Katrina Furey: Have to be about she's. [46:03] Portia Pendleton, LCSW: Yeah. [46:03] Dr. Katrina Furey: I don't think she's feeling sad to lose her friend. I think she's being manipulative. The tears are real about her to make Susanna feel bad for saying all those things. I think that is what it is. But I don't think a true sociopath is capable of having tears or really know if someone's coming or going. Right. [46:23] Portia Pendleton, LCSW: I also think, just like to add to Lisa is that the reason that we wanted to deinstitutionalize people is because you can become institutionalized, where you get used to living in a state like that, which I would also say you're around trauma a lot, and chaos. It's scary setting things. So I think that also, after eight years, I would imagine changes someone, and. [46:48] Dr. Katrina Furey: You become dependent on the institution. [46:50] Portia Pendleton, LCSW: Like, why she's there, sure. But for her to be there for eight years, I think also must impact her everything. So I'm just curious, even just thinking about what has that done to her? That's why we like to keep people in the communities, in their communities. It is what's best when there are enough resources. So I think that's also just something to think about, like, how have the eight years been there for her, impacted her? [47:19] Dr. Katrina Furey: Right. It's kind of like what we see when people are in the criminal justice system for a long time, then they get released and they reoffend and come back. Sometimes they don't know how to survive anymore, like, outside of an institution like that. [47:32] Portia Pendleton, LCSW: All right, well, thanks for joining us today. We hope that you enjoyed today's episode. If you did, please feel free to rate the episode with five stars and then check us out on Instagram at Analyze Scripts and TikTok at Analyze Scripts podcast. And we would love for you also to subscribe. We have gotten a little bit of a bump this week and we're really. [47:51] Dr. Katrina Furey: Excited about it, so we do see. [47:53] Portia Pendleton, LCSW: Every subscriber add on. It brings us joy. So if you'd like to participate in. [47:56] Dr. Katrina Furey: That, feel free and spread the news. All right, see you next Monday. [48:00] Portia Pendleton, LCSW: Thanks. [48:00] Dr. Katrina Furey: Bye bye. [48:07] Dr. Katrina Furey: This podcast and its contents are a copyright of analyzed scripts. All rights reserved. Any redistribution or reproduction of part or all of the contents in any form is prohibited. [48:19] Dr. Katrina Furey: Unless you want to share it with your friends and rate, review and subscribe, that's fine. [48:23] Dr. Katrina Furey: All stories and characters discussed are fictional in nature. No identification with actual persons, living or deceased places, buildings, or products is intended or should be inferred. This podcast is for entertainment purposes only. The podcast and its contents do not constitute professional mental health or medical advice. Listeners might consider consulting a mental health provider if they need assistance with any mental health problems or concerns. As always, please call 911 or go directly to your nearest emergency room for any psychiatric emergencies. Thanks for listening and see you next time. Don't.

Get early access to our latest psychology lectures: http://bit.ly/new-talks5 In this interview, I'm joined by Professor Michaela Swales - a consultant clinical psychologist, author, and DBT trainer, who has trained more than 1,000 professionals in the approach. There are few people on the planet who know as much about DBT as Michaela, so it was a real delight to have this conversation with her, in which we cover: — How DBT combines the best of Eastern and Western Philosophy into one modality, and what Michaela learned from training under Marsha Linehan — Why everything (including thoughts and emotions) can be thought of as behaviours and the therapeutic benefits of this perspective — The 4 core elements of DBT, including how the therapy is structural, and why DBT requires a team or community of therapists And more… You can learn more about DBT training by going to www.dbt-training.co.uk, and pick up a copy of Michaela's book here: https://amzn.to/3QU3ZeN. --- Michaela Swales, PhD, is a Consultant Clinical Psychologist with BCUHB and Reader in Clinical Psychology on the North Wales Clinical Psychology Programme at Bangor University. She trained in Dialectical Behaviour Therapy in Seattle in 1994 and 1995 with Marsha Linehan and for twenty years ran a clinical programme for suicidal young people in an inpatient service. After completing specialist supervision in DBT, she became one of the founder members of the UK DBT Training Team in 1997 and Director of the Training Team in 2002. She has trained more than a thousand professionals in DBT, seeding over 400 programmes, in both the UK and further afield. She is the co-author of Dialectical Behaviour Therapy: Distinctive Features, which had its second edition published by Routledge in 2016 and Changing Behavior in DBT: Problem-Solving in Action, published by Guilford in 2015. Interview Links: — www.dbt-training.co.uk — Marsha Linehan: https://en.wikipedia.org/wiki/Marsha_M._Linehan 3 Books Prof. Swales Recommends Every Therapist Should Read: — Regulating Emotion the DBT Way - Christine Dunkley: https://amzn.to/3LnAEso — DBT: Distinctive Features - Michaela Swales & Heidi Heard: https://amzn.to/3QU3ZeN — Building a Life Worth Living: A Memoir - Marsha Linehan: https://amzn.to/3QNfdly

My guest today, Natasha Briffa is an APHRA Registered Psychologist who specializes in working with individuals living with borderline personality disorder (BPD). She also has an interest in working with individuals who have complex trauma and eating disorders. Natasha has primarily worked in the public mental health service and NGO sector with adults and adolescents, and currently works in private practice.In this episode, Natasha shares the meaning of Borderline Personality Disorder (BPD), the different features of BPD, symptoms for people struggling with mental health challenges that need help in an emergency department, and how acceptance of mental health struggles help in recovery. She also talks about other mental health challenges that are associated with Borderline Personality Disorder.Natasha reminds us that BPD is a common disorder that can be treated. With the help of a trained mental health professional, individuals with BPD can learn to manage their symptoms, improve their relationships, and lead fulfilling lives.Topics we cover and where to find them:[00:00] Intro[04:52] Natasha's background information and clinical journey[10:23] Symptoms for people with mental health problems that need help in an emergency department[15:25] How acceptance of mental health struggles help in recovery[17:11] The meaning of Borderline Personality Disorder[24:37] The biosocial theory of BPD by Dr. Marsha Linehan[26:31] The area in mental health that Natasha has had the biggest success in her career[28:49] The different features of Borderline Personality Disorder[32:25] Other mental health challenges associated with BPD[35:03] Advice for people struggling with BPD and how their family can helpLike this show? Please leave us a review here - All comments and reviews help us break the stigma of mental health so that we can save more lives. Post a screenshot of you listening on Instagram & tag@livinorg @samwebb so we can thank you personally.Episode resources:Website: https://www.borderlinepersonalitydisorder.org/ : https://www.bpdfoundation.org.au/ : https://www.lifeworthlivingpsychology.com.au/Instagram: https://www.instagram.com/lifeworthlivingpsychology_/Facebook: https://www.facebook.com/lifeworthlivingpsychology/Join us at our FaceBook Group to continue the conversation and connect with our community to share stories, access mental health tools and strategies, and learn more about positive mental health because #itaintweaktospeak. Hosted on Acast. See acast.com/privacy for more information.

This episode is one of the most meaningful episodes I've ever done, and I'll tell you why in a sec. In it, I talked with psychologist Dr. Jennifer Dragonette about DBT, which stands for Dialectical Behavior Therapy, for a whopping hour and a half! DBT is a set of psychological tools developed by Marsha Linehan to help people truly process and deal with emotion dysregulation, interpersonal conflict, and the everyday issues of daily life. DBT is very important in my own life because it's what lifted me out of my most recent major depressive episode in 2017 and has helped me have way lower levels of anxiety and depression than I ever have before. It helped save my life, to be honest. So when Dr. Jen contacted me to be on the show to talk about how DBT can help climbers, it was a full-body yes from me. I've incorporated DBT into my own climbing, and I've seen the incredible results it can produce in every part of life. Dr. Jen does an excellent job of explaining some of her favorite DBT tools and how they can be used in climbing for things like: fear of falling knowing how you want to proceed when you're having a bad day climbing managing the urge to grab a draw, say take, give up, or not take enough rest communicating effectively with your partners or spotters about what you want from them how to allow our emotions to flow through us and out of us so we can move on I also go into some very personal details about how some OCD tendencies played out in my life to contribute to severe anxiety and how DBT helped me stop the OCD behaviors. As well as how I've been using DBT tools to help overcome body image issues. As a climber and a psychologist, Dr. Jen has such a deep understanding of how these tools apply to climbing that you'll hopefully feel confident using them in your very next climbing session. She's clearly very adept at teaching DBT, and I enjoyed every moment of this conversation

-What is Dialectical Behavior Therapy (DBT) and how can it be used to help us address our codependent thoughts, behaviors, and actions? -Why is it disempowering to use the term “codependent” when describing ourselves? And how might it be helpful to focus more on describing our behaviors? -What is a useful skill from DBT that we can begin to use to describe, express, assert, and reinforce our needs? Welcome to episode 102! This week, we are graced with the brilliance of Dr. Hollie Granato, PhD, who provides us a 101 lesson on Dialectical Behavior Therapy (DBT) and how it relates to codependency. You'll hear Dr. Hollie discuss how DBT challenges labels and terms like ‘codependency' and why it is important to focus more on the behaviors underlying the label: people-pleasing, conflict avoidance, self-doubt, etc. Hollie reveals the DBT methods and skills she uses with her clients to help them develop mindfulness, articulation of thoughts/feelings/needs, and self-acceptance. It's a must listen! More on the episode's guest: Dr. Hollie Granato is a DBT and CBT certified clinical psychologist practicing in Beverly Hills. She trained at the University of Washington where her work focused on the intersection of sexual trauma, substance use, and emotion dysregulation. Hollie is currently in private practice as well as remains involved in several research grants and supervision/training of clinical doctoral students. www.drholliegranato.com www.instagram.com/drholliegranato  Helpful links for the podcast: Work with me by emailing: marissa@codependummy.com https://linktr.ee/codependummy  Sign up for the newsletter to receive all things codependummy: https://keap.app/contact-us/2302598426037497  FREEBIE! The Self-Validation Challenge: Learn to validate your GD self: www.codependummy.com/challenge  Journal! The Confiding Codependummy: 30 Days of Journaling Prompts for a Less-Codependent and More-Conscious YOU for just $1 a day. www.codependummy.com/toolsforhealing  Money! Funds! Help support the show via a one-time donation via secure Paypal link: https://www.paypal.com/donate/?hosted_button_id=RJ3PSNZ4AF7QC  More deets on this episode:  We begin with a 101 lesson on Dialectical Behavior Therapy (DBT) thanks to Dr. Hollie's expertise int his therapeutic modality. The creator, Marsha Linehan, found herself in a dialectical dilemma, and thus, created a type of therapy to integrate cognitive and humanistic approaches to balance skills-building and fostering acceptance in patients.  And how does DBT define codependency? Hollie shares how there is an effort to avoid labels like ‘codependency' as they may disempower an individual to stay stuck in their own behavior. Instead, Hollie suggests that the definition of codependency should be defined “in behavioral terms and asking what are the individual's goals and what are the behaviors getting in the way of those goals?” Wow! We hear about the codependent behaviors found in the patients Hollie works with who struggle with emotion regulation, including staying in unhealthy relationships, denial/not seeing relationships for what they are, begging/pleading for their partner to change, resentment building, and passive-aggressive behavior.  How does DBT help address codependent behaviors? SKILLS! All the skills. As well as individual therapy, phone coaching, and consultation for the therapists. Hollie emphasizes how exposure is also paramount as it is a way for us to break codependent patterns on our own terms since we initiate the boundary setting, the saying “no,” or the assertion of our needs.  We conclude with a description of the DBT skill D.E.A.R.M.A.N: describe, express, assert, and reinforce our thoughts/feelings/needs. The M.A.N. part denotes being mindful, appearing confident, and negotiating. You can read more about it here: https://www.therapistaid.com/worksheets/dbt-dear-man Thanks for coming on Hollie! And thank you, dear listener, for listening!  PLEASE: Rate.  Review. Subscribe.  Share. We need more ratings on Spotify! Appreciate it! -Get your copy of the Confiding Codependummy: 30 days of journaling prompts for a less-codependent and more-conscious you! www.codependummy.com/toolsforhealing  -The Self-Validation Challenge - free 30-day guide to providing yourself with all the validation you seek: www.codependummy.com/challenge -Sign up for the newsletter: https://keap.app/contact-us/2302598426037497  -Support the show via a one-time secure donation: https://www.paypal.com/donate/?hosted_button_id=RJ3PSNZ4AF7QC  -Work with me, your hostess mostest! Dive deeper and heal from your codependency by reaching out via email to set up a free consultation: marissa@codependummy.com

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter Shireen Rizvi is a Professor of Clinical Psychology and Psychiatry at Rutgers University, where she is also the Director of the Dialectical Behavior Therapy Clinic. This episode focuses specifically on dialectical behavior therapy (DBT), a skills-based technique which was originally developed to treat borderline personality disorder (BPD) and has since been adapted to treat depression and other mental health conditions, as well as to help people who have difficulty with emotional regulation and self-destructive behaviors. Shireen explains the origins of DBT and how its creator, Dr. Marsha Linehan, came to find a need for something beyond cognitive behavioral therapy (CBT) when attempting to treat patients with suicidal behavior. From there, Shireen dives into how DBT works to resolve the apparent contradiction between self-acceptance and change to bring about positive changes in emotional regulation, interpersonal effectiveness, mindfulness, distress tolerance, and more. She also provides examples for how one can apply specific skills taught with DBT such as accessing the “wise mind,” applying radical acceptance, using the “DEAR MAN” technique, and utilizing an emotion regulation skill called “opposite action.” Finally, she explains how the tenets of DBT offer benefits to anyone, and she provides insights and resources for people wanting to further explore DBT. We discuss: The basics of dialectical behavior therapy (DBT) and how it differs from cognitive behavioral therapy (CBT) [3:00]; Treating depression with CBT: history, effectiveness, and how it laid the groundwork for DBT [8:15]; Marsha Linehan's inspiration for developing DBT [16:00]; Explaining borderline personality disorder (and associated conditions) through the lens of DBT [20:00]; How work with suicidal patients led to the development of DBT—a dialectic between change and acceptance [35:30]; Details of DBT: defining the term “dialectical” and how to access the “wise mind” [44:30]; Practicing mindfulness and radical acceptance in the context of DBT [51:00]; Applying “radical acceptance” to tragic scenarios [1:02:00]; The five domains of skills taught in DBT [1:07:15]; Why Marsha chose borderline personality disorder as her focus when developing DBT [1:13:30]; Is there any benefit in doing DBT for someone without a pathological condition? [1:15:45]; The DEAR MAN skill of DBT [1:20:00]; Adapting DBT skills for adolescents and families [1:31:00]; Identifying vulnerability factors, increasing distress tolerance, and the impact of physical pain [1:33:45]; The DBT chain analysis: assessing problem behaviors and identifying vulnerability factors [1:44:30]; Why the regulation of emotions can be so challenging [1:50:30]; The importance of mindfulness skills in DBT [1:53:30]; Opposite action: an emotion regulation skill [1:57:00]; Advice for those wanting to explore DBT [2:03:15]; Finding a well-trained DBT therapist [2:08:15]; More. Connect With Peter on Twitter, Instagram, Facebook and YouTube