Helping our youth to cope...

...one healthy behavior at a time

By TRACEY SHIPLEY
Updated: JULY 10, 2017 13:16
Rebellious teen and worried mother (illustrative) (photo credit: INGIMAGE)
Rebellious teen and worried mother (illustrative)
(photo credit: INGIMAGE)
In an age where we are keenly aware of challenging emotional issues among our youth, therapeutic treatments such as cognitive behavioral therapy (CBT) and dialectical-behavioral therapy (DBT) have become well known for their effectiveness.
CBT focuses on how our thoughts, beliefs and attitudes affect feelings and behavior, and explores alternative coping. DBT, a highly specialized form of CBT, addresses and successfully treats those struggling with regulating emotions, distress tolerance, interpersonal effectiveness and mindfulness practice. People undergoing DBT are introduced to, and engaged in, the four core principles mentioned above. A detailed description is cited below: • Mindfulness – focusing on the present (living in the moment).
• Distress tolerance – learning to accept oneself and the current situation. More specifically, people learn how to tolerate or survive crises using the following techniques: distraction, self-soothing and thinking of pros and cons.
• Interpersonal effectiveness – how to be assertive in a relationship (for example, expressing needs and saying “no”) but still keep that relationship positive and healthy.
• Emotion regulation – recognizing and coping with negative emotions (for example, anger) and reducing one’s emotional vulnerability by increasing positive emotional experiences.
DBT was originally intended for people with borderline personality disorder, but has since been adapted for other conditions where the patient exhibits self-destructive behavior, such as eating disorders and substance abuse. It is also used to treat post-traumatic stress disorder.
Gabrielle Thaler, a Jerusalem-based licensed master social worker and psychotherapist, has been utilizing CBT and DBT with clients suffering from a myriad of afflictions.
I asked her to describe some of her experiences.
“In working with clients, I often see a strong correlation between their issues and their upbringing and the maladaptive behaviors as a result.”
The first case she presented in our interview was about one of her clients who was struggling with interpersonal effectiveness. The client had been shamed a lot by her mother during her formative years and learned to be a people pleaser in order to be accepted. Her self-worth was compromised by feeling such a strong sense of shame.
The focus of treatment was for the client to begin to find self-compassion, which helped her to accept her true value and learn how to assert herself while repatterning her old belief systems and challenging her negative self-talk. This also allowed her to effectively create positive and sustainable interpersonal relationships.
Due to her mother’s inability to nurture her effectively, her lack of self-esteem permeated all aspects of her life. The work done through DBT increased her sense of self-worth, allowing her to work on all of these aspects of her life.
Another client Thaler worked with was not privy to healthy coping skills as a child and was never taught how to tolerate stress in healthy ways. He had extremely poor distress tolerance skills. When in distress, he turned to substance abuse, excessive sleeping habits and unhealthy sexual encounters. The ramifications of this client’s lack of healthy coping were debilitating and unrelenting.
Thaler explained that working with this client was very difficult, as the client’s level of resistance was very high, due to his old patterns. She spoke to her client’s parents and realized that they, too, were lacking basic coping skills, which made it impossible for them to direct their children.
DBT focuses on alternative “safety” behaviors, such as exercising, journaling, practicing mindfulness and meditation, self-validating, creative activities, imagery and prayer implementation.
Thaler explained that even when met with resistance, effective therapy is not only plausible but exciting to watch as the growth takes place.
She described another case where DBT was effective with a woman in her twenties. She was from a haredi home and had a very difficult time reconciling her innate personality with her religious upbringing. She was a very bright, colorful, independent thinker. The imposed judgments of her family created internal havoc.
The work Thaler was doing with her was primarily focused on mindfully suspending the imposed judgments of who she was “supposed” to be and what she was “supposed” to be doing in her life, while discovering who she was aspiring to become according to her core values. “Integrating the different parts of ourselves is the hardest work to be done,” Thaler explained.
Their work in DBT was aimed at regulating the client’s emotions, despite the parental influence, by practicing the DBT skills that require her to remain vigilant in limiting her negative self-talk and encouraging the practice of self-acceptance, self-compassion and safe self-expression.
Thaler went on to explain that the dichotomous thinking is challenged by the core concept of mindfulness which runs throughout DBT. This is commonly referred to as “getting into wise mind.”
Wise mind entails synthesizing “emotion mind” and “logic mind,” emphasizing the integration between the two. Wise mind allows us to make decisions more effectively. It is the middle path. The core sense of wise mind involves a deep sense of intuitive understanding.
Intuition goes beyond reason and what is perceived by the senses (Arthur J. Deikman, 1982). This deep-seated intuition comes from an integration of direct experience, immediate cognition, and the grasping of the meaning, significance or truth of an event, without relying too heavily on intellectual analysis.
As a counselor, I believe it is extremely important to work on behavior and thought modification to assist our teens and young adults in changing unhealthy habits. With this in mind, I was excited about my interview with Thaler and her use of CBT and particularly DBT as a treatment modality to help our youth cope with daily stressful situations and negative mind-sets.
Simply working on being mindful with our thoughts and actions already makes a tremendous difference, enabling us to develop insight into how we live our lives and become aware of how we perceive both our internal and external world.
Today, mindfulness training is globally practiced with all ages and many conditions. Through meditation alone, people can reduce stress, improve concentration, increase self-awareness, increase happiness, increase acceptance, slow down aging, build up brain cells and benefit their cardiovascular and immune health.
The work that Thaler and other CBT and DBT therapists are doing can literally change the way we and our youth interact with one another, the world around us and, most importantly, the way we interact with ourselves. Daily check-ins, self-acceptance, positive relationship development and emotional regulation are the keys to happy living.
As parents we do not have to become “behavioral therapists” to provide our kids with these basic skills. Practicing them in our daily lives and being living role models for our kids is the first step.
As we know, actions speak louder than words.
For more information about Thaler’s work, see her website: www.couragetochange.co The writer is a teen and young adult counselor specializing in addictions, who has been working with youth and their parents for over 26 years.
jerusalemteencounseling@gmail.com; www.jerusalemteencounseling.net