Inspirations

Radical Acceptance in 2023

The start of a new year can look different for everyone. Feelings around the end of 2022 and the start of 2023 may bring up both positive emotions for some and negative emotions for others. What is most commonly shared among the public eye about the new year exemplifies opportunity, newness, more rituals and routines people are striving to implement in their everyday lives. Many people make new fitness and health goals, while some implement activities they aim to complete each day or week. I would like to offer an additional perspective to the conversation about new year’s resolutions by reminding you that change is not easy. The “step by step guides” about how to keep your resolutions in 2023 that are plastered all over the media and magazines can sometimes fixate so much on the task and forget to acknowledge the difficulties of these processes. It seems that everything is so future oriented and emphasizes leaving the past behind.

    As someone who values health and fitness, I have found myself over the years writing down big goals to strive for and implement on the first day of January. While setting intentional goals with a timeline can be helpful, it can also present a lot of challenges, pressure and expectations. More commonly than not, I would find myself feeling like I bit off more than I could chew, which has led to disappointment and doubt in my abilities. In years past, I have been quick to focus on things I want to change, rather than first accepting my current situation and then making intentional steps towards implementing new behaviors or activities.

    This year I have focused on leaning in to accepting the current state of my body’s physical abilities. After having two hip surgeries this past year, I have been limited with my body’s physical mobility and movement, which has, at times, presented me with intense frustration. In DBT, radical acceptance is a distress tolerance skill that helps us accept reality as it is in order to implement change, avoid suffering and being stuck in unhappiness or other painful emotions. Radical acceptance can be considered one of the more difficult skills in DBT as it emphasizes accepting all the way in our mind, heart, and body. In order to change reality, we have to first accept reality. Practicing radical acceptance includes observing how we are questioning our reality, reminding us that unpleasant past events cannot be changed and leaning into mindfulness to help us find a place to be willing of acceptance.

    As we are nearing the middle of January, I’d challenge you to identify a part of your life that you seek to radically accept. Whether this is something from 2022 or years past, try to recognize some part of your life that interferes with your ability to let go of painful events and suffering. Remind yourself that radical acceptance can take time and a lot of practice, but that sometimes the path out of this suffering requires you to face reality with an openness to accept before being able to implement change.

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Transitions

by Nicholas Urban, LCSW

We’re at a time of year that is marked by transitions: Autumn into Winter, the current year into the new, longer days into shorter ones culminating in the Solstice on Wednesday the 21st.

Transitions can be exciting, can be something to look forward to, and can also be scary and provoke anticipatory anxiety. Even when we want to make the change, worry thoughts about whether it’s the right decision and if we’ll be able to adjust and if everything will be okay are to be expected. Prior to becoming a therapist, I spent many years in a different career. I was good at it, and my work was meaningful, and I advanced in the organizations I was employed by. But the work wasn’t good for me, and even though I had recognized this for some time, the idea of making the transition to something I’d been thinking about doing for years was highly stressful. I kept coming up with reasons to stay where I was, to not make the leap into something new, despite my growing dissatisfaction. For a long time, I was stuck in acceptance and unable to shift towards change. Have you had this experience, of justifying something that you aren’t happy with to avoid the fear of the unknown that comes with something new?

Transitions are the perfect opportunity to lean into the Acceptance/Change dialectic. They’re also ideal for Coping Ahead, anticipating what we’re feeling anxious about and planning out how we’ll deal with it. You may be coping ahead for the holiday season right now, and the stresses of travel and family and the disruption of routine. You may be thinking forward to 2023, and the changes you’re going to make to improve your quality of life and continue to grow as a person. For me, difficult and frightening as it was, making the transition couldn’t have been a better choice.

Much like the Solstice is the shortest, darkest day of the year, every day that comes afterwards gets a little longer and a little brighter. Once you’ve made the decision to take the first step and embrace the change side of the dialectic, the transition to something new and exciting and effective for you is on the path just ahead.

Happy Holidays!

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Letting Go

by Elisa Pompeo, LCSW

We are officially in the “holiday season”! Time celebrating with loved ones can be such an energizing and warming experience. At other times, it can be difficult to regulate our emotions if we lose control of our emotions. During a recent trip home, I was reminded of this.

While celebrating with family and friends, I felt such an immense amount of joy. I had a fun time seeing friends, especially the ones that make me laugh uncontrollably. Family members shared news about weddings, pregnancies, new homes, etc. I was happy to see them grow and succeed. Other times, I was reminded of my own self judgements, and lack of growth. I began to think about the ways that I had not change, instead of the positive things I have done. There were even times when friends and family made remarks that felt invalidating.

These situations can be very disregulating during the holiday season. I remembered that letting go of my emotional suffering was the only way for me to find peace in those moments. Letting go in DBT is a phrase we use to describe the process of releasing ourselves from suffering, not getting rid of the emotions themselves. First we notice what we are feeling; we observe that we have been activated, observe our sensations, and notice any judgements. We do not try to resist them, nor do we push them away. We simply observe and ride the wave of this discomfort. Like a wave crashing on the shore, these emotions have a start, middle, and end.

This can give us some distance from the painful emotions we have, and allow some acceptance in the moment. The next part is to remember that you are not the emotion itself, only experiencing it. Respect that something has made you feel unpleasant, and let it pass.

It is not easy, and it is rewarding. In DBT we like to say that all people feel pain, and not all have to suffer. Letting go of the need to control and manage our painful emotions, judgements, and wishful thinking, creates a sense of peace. I hope that this practice will make the busy holiday season an easier time for all.

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Relationship Mindfulness

by Heather Oros, LCSW

The holiday season is upon us. No matter your stance on this time of year, the holidays can be a naturally stressful time, especially with managing family relationships. A season of togetherness can easily prompt heightened emotion, and increase our vulnerabilities to regulate skillfully. Entering the holiday season reminds us of the importance of utilizing our mindfulness skills, specifically with others to help increase feeling of connectedness, decrease natural emotional vulnerabilities, and restore centeredness in the present moment.

Several years ago, my family gathered for our traditional large and loud Thanksgiving holiday together. At the time, I was in graduate school, and I recall taking the train to Baltimore from the city late Wednesday night to arrive at my childhood home swaddled in the smell of cinnamon, thyme, rosemary and spicy sausage. During this point in my life, I was an early student of DBT and mindfulness. I was a beginner in intentionally turning my awareness to meaningful observations that are so intimately tied to important relationships, like the all encompassing smell of stuffing that filled the house, or the sound of high pitched singing to Barbara Streisand and Whitney Houston that occurred during cooking time. My attention was so easily drawn to the “shoulds” of the moment. So many thoughts in my head – my brother should help prepare and clean up the meal, my mother should not have this much food, my aunt Amy should be more grateful. The last task that needed completing before we sat down for dinner was to broil the marshmallows on the sweet potatoes— a quick broil that required mindful attention to reach the perfect golden brown crisp. Twenty minutes later, the smoke alarm blared through the house, my mother cursing from the kitchen, everyone was swarming in to pour water over the potatoes and all were blaming one another for the demise of a classic and favorite thanksgiving dish. The night quickly took a turn, emotions were heightened, judgments were flowing, and the awareness of our family together became more about the marshmallow fire than the quality time of one another.

The holidays are a lot! It is so reasonable to get quickly overwhelmed and flooded with emotional distress during this naturally vulnerable time of year. What we know about emotional arousal is that it can easily sway us away from utilizing our wise mind. This holiday season, we are encouraging the practice of relationship mindfulness. We encourage you to check in when your awareness is drifting to emotion mind and is fixated on the “shoulds” of the moment, and is away from grounding self in the sensations of the current moment. A practice of relationship mindfulness might look like cooking side by side with someone, and noticing the smells in the room. It can look like a practice of bringing awareness to your surroundings when things get overwhelming, or noticing loved one’s smiles and eyes. The idea is to allow ourselves to get interested in the real moment occurrences. As I reflect back on the “marshmallow-gate” Thanksgiving, I practice allowing my mind to fully observe the sound of giggles that occurred a week later as we reflected the story, the feeling of a hug I received from my brother, and the smell of burnt marshmallow that turned out to be an association noticed with love.

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Building Mastery

by Nataleigh Kohn, LMSW

Early this summer, I moved out of the city and into the countryside. This move brought on many changes across essentially every aspect of life, as you can probably imagine. However, one change in particular stands out, and brings to mind a favorite DBT skill: I had to learn to drive. Learning to drive (skillfully and safely) was, for me, an incredible challenge in the art of Building Mastery.

Building Mastery is a skill from our Emotion Regulation module. To build mastery, we set out to purposefully do things that make us feel proud or accomplished, such as acquiring and mastering a new skill. Completing a challenge or becoming an expert (or merely just competent) in a task or activity helps to build our resilience and reduce our vulnerability to challenging emotions. Sometimes I like to think of it as if we are characters inside a video game, and in order to acquire points, we need to unlock new achievements—with each new achievement point, we build strength and resilience against future challenges.

One key of Building Mastery is to set tangible, attainable goals toward your ultimate goal. We want to strike a balance between challenging ourselves, while still setting ourselves up for success. Over the course of the past four months, I have gradually and mindfully driven further and further, on busier and busier roads—eventually completing a drive on my own three hours from our home into the city. I likely would not have been successful if I had attempted a drive like this from the beginning (which may have actually contributed to more negative emotions and fear around driving), however since I took my time and steadily built competence over time, patience and consistency paid off.

What is something you’ve built mastery of recently? If you can’t think of something, I challenge you to choose something this week and go for it!

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Sleep

by Alyssa Colbert, LCSW

At an early hour of the morning on October 1st, I was awoken by the hissing sound of my heater being turned on. The annual day when New York City buildings are required to turn on the heat had arrived. I felt the heat slowly start to emanate from the heater and before I knew it, my thermostat read 80 degrees. As I tossed and turned, unable to fall back asleep, I couldn’t help but think about the training that clinicians at our practice did last week led by Dr. Brian Curtis. Dr. Curtis is a clinical psychologist who specializes in sleep disorders, post-traumatic stress disorder (PTSD), and borderline personality disorder in adults. His training last week was on the integration of the treatment of sleep disorders and Dialectical Behavior Therapy.

Our quality of sleep can be a significant factor that interferes with behavior change and progress toward our goals. One of the clinicians at our practice has this great saying: “A sleep disorder is a mood disorder.” Dr. Curtis held this same wisdom when discussing how one of the functions of sleep is to process and regulate our emotions. As we know from our PLEASE skill, exposure to vulnerabilities makes us more susceptible to emotion dysregulation. It makes sense that poor quality of sleep or having a sleep disorder, can increase our emotional vulnerability and directly impact our quality of life.

One of Dr. Curtis’s recommendations for attempting to regulate your sleep and improve your sleep quality is to consider sleeping in cooler temperatures. This is because our core body temperature decreases when entering into a deeper sleep. If your environment is warm, you are likely going to have a more difficult time falling asleep because your body is tasked with the challenge of decreasing your temperature in a warmer environment. Once I remembered this fact on that October 1st morning, I quickly got activated to try and change my room’s temperature. Another recommendation from Dr. Curtis is to take a warm bath or shower prior to sleeping. While this is seemingly in contrast to the previous recommendation, if we remember the wisdom of dialectics, both can be true. Dr. Curtis discussed that taking a warm bath or shower actually functions to decrease our core body temperature by releasing some of our body’s temperature into our environment. This is what is happening when our skin appears flushed after a bath or shower.

Have you talked with your therapist about your experience with sleep? If not, we’d recommend that you consider putting it on your session agenda. The two recommendations from Dr. Curtis are just a few of many. You and your therapist could assess your sleep together and explore if there is a specific intervention that could be helpful for you. In the meantime, we’d encourage you to take a look at the Sleep Hygiene handout in the DBT skills workbook (Emotion Regulation Handout 20B). This handout can give you some more ideas to improve your experience with sleep.

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Forest Bathing

Forest bathing is the act of applying mindfulness to walking in the woods. This idea is based on a Japanese concept where individuals carve out time to walk in the forest, with the intention of slowing down and observing nature around them. This practice is known to help individuals feel happier and calmer. In DBT, we build Mindfulness into our daily routine in order to help us regulate emotion and to practice being in the moment. Walking mindfully, often outside, is a common practice.

Awe is a psychological concept that has recently gained attention within the field as a way to impact our mental health. Greater Good, a science center based at UC Berkley, defines awe as “the feeling we get in the presence of something vast that challenges our understanding of the world, like looking up at millions of stars in the night sky or marveling at the birth of a child. When people feel awe, they may use other words to describe the experience, such as wonder, amazement, surprise, or transcendence.” (for more information see www.greatergood.berkeley.edu).

Awe is something that occurs for me when I can experience nature. It is a feeling of connection to a vast world beyond ourselves, a reminder of the greater world that we inhabit. For me, awe is easy to access in the forest. Thus, the idea of forest bathing just makes sense to me. I encourage you to think about what places inspire awe for you. It may be a forest, beach, or lake. It may be noticing the song of a bird, a flower blooming, or leaves starting to change color.

Different aspects of nature may lead you to experience awe, and to help you access mindfulness. For myself, I know that time in the woods absolutely helps me feel calmer and happier. It serves as a reset – time away from the business and hustle of life, time to breathe and be present. Away from screens and distractions, I find it simple to settle into the present moment.

Last weekend, right before the transition to fall, I was able to sneak out and visit the woods with my family. During our hike, I observed how the forest looks in late summer, green and lush. A rocky path led me to observe the ground intently, noting where I placed my feet. Practicing Mindfulness was very accessible in these moments, with so much to observe. The smell of the forest captivates my attention. The trees and their leaves draw my eyes. And, even better, watching my dog’s huge grin as he gets to hike in the woods with his family brings a smile to my face as well.

Though it doesn’t happen as often as I wish it could, I hope this is a practice I can continue thoughout the fall in order to maintain my own mental health. In DBT we talk about applying skills intentionally. For Mindfulness, this means a commitment to the practice. Mindfulness helps us feel better overall when we can commit to it regularly. Though a hike may be ideal, even taking a few minutes to sit outside and breathe, observing the nature in our immediate environment, can help us maintain this practice.

I challenge you to take a moment to try your own version of forest bathing.

References

Matthew P. White et al., “Spending at Least 120 Minutes a Week in Nature is Associated with Good Health and Wellbeing,” Scientific Reports, January 14, 2020.

Gretchen Reynolds, “An ‘Awe Walk’ Might Do Wonders for Your Well-Being,” The New York Times, September 30, 2020.
Sturm, V. E., Datta, S., Roy, A. R. K., Sible, I. J., Kosik, E. L., Veziris, C. R., Chow, T. E., Morris, N. A., Neuhaus, J., Kramer, J. H., Miller, B. L., Holley, S. R., & Keltner, D. (2022). Big smile, small self: Awe walks promote prosocial positive emotions in older adults. Emotion, 22(5), 1044–1058.

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For many of us, change is challenging. We want things to stay the same, particularly when the conditions are in our favor. We like predictability, so much so that we’d prefer being stuck in unhealthy relationships so long as these people are familiar to us (see the familiarity principle or mere-exposure effect).

            Change is the idea of novelty, the idea that something doesn’t remain the same, that nothing is inherently permanent. The reason why we find change so scary and anxiety-provoking is that we simply don’t know and hence, cannot prepare for what is yet to come. If we had some validity in anticipating accurately change and its consequences, maybe that heartbreak of loss wouldn’t feel so painful. Maybe that feeling of missed opportunity wouldn’t make us feel so empty. Maybe our thought patterns surrounding the extremes (“I shouldn’t have done that, it’ll never be okay”) wouldn’t sting so strongly.

The truth of the matter is that we are constantly exposed to and practicing change. Some of us, without being aware of it, may be experts at change. Every day our bodies replace billions of cells. The values of stocks incessantly alter along with the market. An ice cube melting in the palm of your hand with every passing second changes. The human population, our breath, literally every existing thing changes. There is not one thing that is unsusceptible to change. Even as you’re reading this, your perception and beliefs about change may have changed.

We think that we know so little about change because of our stronghold resistance. But every day, every moment, is an opportunity to practice embracing change. Why hold onto fighting against change when you know it is an inevitable phenomena. Bring mindful awareness to what you’ve been practicing all along. Keep going.

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