Inspirations

Over the past few weeks, our clinicians at Metro have been participating in a presentation on a type of therapy called Internal Family Systems (IFS) therapy. As we have been learning about IFS, we have been observing similarities between IFS and DBT and discussing how the wisdom of IFS can be integrated into our DBT work.

In IFS, there is a large emphasis placed on observing and describing parts of oneself. When expressing our emotions, thoughts, sensations, and urges we often say “I feel _.” or “I have the thought that _.” IFS asks that we instead shift our language to say “a part of me is feeling _.” or “a part of me is thinking _.” This language helps us to hold a dialectical view that the emotions, thoughts, sensations, and/or urges that we experience moment to moment, are one of many parts of ourselves, and that our one observation in that moment does not define our whole self.

In DBT we regularly discuss states of self and primarily reference our three states of mind (Wise Mind, Emotion Mind, and Reasonable Mind). Similarly, IFS places emphasis on a state of self called our Inner Critic. Our Inner Critic is a piece of ourselves that is often harsh and perpetuates self-judgments and self-invalidation. When our Inner Critic state arises, we may also get activated in our emotion or reasonable mind and have a mood-dependent urge to change. This might be change through attaching to and listening to our Inner Critic or change through trying to get rid of our Inner Critic.

It actually makes sense that we may have the urge to listen to our Inner Critic because IFS holds that its function is to protect us. Our past experiences are what build and strengthen our Inner Critic’s individualized recipe for protection. However, when listening to our Inner Critic, the mindset of our Inner Critic often takes over and we forget about the other parts of ourselves. On the other hand, sometimes we may have the urge to reject our Inner Critic and we feel that it “shouldn’t” exist. This is also a totally understandable urge because our Inner Critic can feel painful! However, our Inner Critic is not something that we can just get rid of because it is a part of ourselves.

In DBT our primary dialectic is holding both acceptance and change. Instead of jumping on the urge for change in the presence of our Inner Critic, IFS suggests radically accepting our Inner Critic. Accepting the presence of our Inner Critic and approaching it with curiosity and compassion, without attaching to it or rejecting it, is how we can decrease its intensity and control over us.

Over the next week can you start to mindfully observe and describe the presence of your Inner Critic? Where in your body do you observe your Inner Critic? When your Inner Critic arises, before acting from your Emotion Mind or Reasonable Mind, we’d ask that you first practice your STOP skill. Take a pause and a moment to access your Wise Mind. From your Wise Mind, we ask that you consider approaching your Inner Critic with curiosity and ask, “Why does it make sense that my Inner Critic is present right now?” Then maybe try holding compassion for your Inner Critic by telling it, “Thank you for trying to protect me in this moment.” We might then tell our Inner Critic, “I know you’re trying to protect me and I’m going to ask that you take a step back while I decide what to do from my Wise Mind.” Over time, building compassion for our Inner Critic may also help us to build compassion for all parts of ourselves.

 

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Habits vs. Goal-Directed Behaviors
What is a habit? According to behavioral psychology, a habit is an automatic behavioral response to stimuli in the environment. The potency or strength of a habit is highly correlated with its repetition and consistency across contexts.

Oftentimes, the term “habit” becomes interchangeable with the concept of “goal-directed behavior.” However, habits and goal-directed behaviors are two distinct phenomena. In fact, these processes share different neural bases. Habits typically become implemented in the presence of antecedent cues, whereas goal-directed behaviors focus on consequences. In other words, habits tend to leave out the goal in mind and tend to be performed automatically. Typically, habits are not impacted by changes in the value of a goal or outcome, i.e., one would perform a habit regardless of whether the outcome is getting the reward or not.

Take, for example, addiction. Goal-directed behavior would involve a conscious process of an individual making predictions about the consequences of engaging in substances (i.e., If I engage in substances, I will attain pleasure). On the other hand, habits are more automatized behaviors in which an individual engages in substances regardless of the predicted consequences (i.e., It does not matter whether I attain pleasure from substance use or not; I am just doing it out of habit).

While the automaticity of habits helps alleviate cognitive load and effort and increase efficiency, especially for everyday behaviors, some habits are maladaptive and maybe even occur outside of our awareness. Most habits are bound by stimulus control; in other words, once a stimulus is presented, the habit automatically occurs. On that note, the advantage of goal-directed behavior is its flexibility because goal-directed behavior is not stimulus bound. Since goal-directed behaviors focus on the consequences or rewards, there are more options from which to choose.How can habit and goal-directed behaviors help us as we attempt to engage in new behaviors? In the initial stages of new behavior, it may be helpful to think about goal-directed behaviors and invest in the consequences associated with goal-directed behaviors to build motivation and commitment, especially given the fact that they recruit more effort and attention. When attempting to maintain and sustain behavior, it may be worth thinking about the principles of habit formation and pairing behavior with stimuli to evoke automaticity. For example, if my hope is to initiate the behavior of exercise, a goal-directed behavior mindset would prompt me to think about the rewards I would attain at the end of the task: an enjoyable meal, increased attractiveness, and more attention from others. When I aim to solidify this behavior into a habit, I would form a stimulus-response association between my alarm clock going off at 5pm every day with the behavior of exercise. In other words, upon hearing my alarm clock going off at 5pm, this stimulus would provoke me to exercise.

We hope that understanding the concepts and differences between habits and goal-directed behavior may help you in building and sustaining your life worth living goals.

 

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Judge Ketanji Brown Jackson is the first Black woman to be elevated to the pinnacle of the judicial branch, giving hope and inspiration for many generations to come. Her confirmation to the Supreme Court is a profound first in our country. In light of her recent accomplishment, we are interested in the importance of “firsts” this week.There are many types of “firsts”. The first day of school, the first time interviewing for a job, or the first person to break a record. What stands out about these examples, is how daunting they can initially feel. Especially, if there are obstacles along the way, including, people saying that you can’t, systematic limits, self-doubt, and many other things.

Usually, the first person to break a barrier becomes the inspiration for others who follow in their footsteps. The power of “firsts” is that they are a tremendous motivation for others to do things that they otherwise would not have believed they could. In some way, it creates hope and aspiration, “maybe I can do that too!”.

Doing something for the first time can be scary and exciting. Difficult and rewarding! DBT teaches us that we can work through difficult situations by using skills, such as cheerleading statements. Cheerleading statements can sound like, “I can do it! It’s hard and I will keep going. I believe in myself”. They can help us to work hard even in the face of obstacles.

We would love to hear how you feel inspired by others’ accomplishments and “firsts”. What do you want to be first at? How will you encourage yourself to do it?

 

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This week, our clinicians have been learning and gathering information about the process of dissociation. Simply put, dissociation occurs when our minds move away from present moment awareness. Research suggests that dissociation is experienced on a spectrum. We experience moments of everyday disconnection from the present such as the sensation of ‘driving on autopilot’ or becoming internally preoccupied that we forget the task at hand. When in this type of mind, we are easily absorbed by a stimulus outside of the present moment, and our attention is unable to be redirected by other sensations. This response serves a function of protection and self preservation, especially in the context of traumatic experiences.  Although protective at times, dissociation can easily become a learned habitual pattern of behavior.  We may find ourselves shutting down and being activated in a threat response of fight, flight or freeze, when our minds feel unable to judge who and what is safe around us.  This week, as we continue to learn about dissociation as a process, we invite you to think about your own processes of shutting down, and the practice of grounding techniques to help redirect to the here and now.

First, it is important to identify your personal warning signs of dissociation.  Maybe at times there is an experience of brain fog, or a feeling of deeper depersonalization.  By gathering useful information, we begin to observe and recognize the moments of disconnection.  Perhaps, to build this awareness, try writing down a number each day on a daily scale of 1-10 to begin identifying the range of experience and to build self awareness of the process.  Next, we invite you to consider practicing interventions that will help increase feeling grounded to redirect yourself to the present moment.  A useful technique is to bring attention to your five senses. Basically, list five things you can see, four things you can hear, three things you can feel, two things you can smell, and one thing you can taste.  We can also use our mindfulness observe and describe skills in these moments to scan the rooms we are in, choose an object, and describe the object in detail using our five senses.  In addition to reconnecting with our five senses, turning our awareness to our body can help redirect our ‘tuned out’ mind with the current moment.  Try opening your palms and tracing your fingers along the lines of your hands.  Place one hand on your belly and another on your heart and observe the rise and fall of your breath.

Our hope is that you will practice observing moments of disconnection this week and practice grounding interventions to turn awareness back to the present. Are you able to feel more mindful and present in your mind and body?  We look forward to hearing from you other ways you are practicing staying grounded and observing your mind.

 

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For years I practiced daily mindfulness. However, when the pandemic began in March 2020, I didnt stick to it.  I felt irrationally avoidant to sit in silence.  I was fearful that in the silence I would be overwhelmed with fear and despair.  The external environment coupled with my poor discipline impacted my sleep.  Thus, I still had to confront the stillness during my sleepless nights.

My emotion mind was wide awake and longing to feel peace and calmness.  During these times, I would focus on matters beyond myself to make me feel better. I also tried new hobbies, new habits, and new connections.  While I was helped, it still wasn’t enough.  Fortunately, my wise mind was awake too. I was reminded that what I sought could also be found from within.  I restarted my mindfulness routine.  In the stillness of my mindfulness practice, I found a source of strength.  It is in the here and now, in the moment, in the silence, I finally, again, found peace of mind.

I know silence can be hard. Can you turn your mind towards silence?  Do you have a mindfulness practice to welcome the silence?  We would like to hear about how silence is a source of strength for you.

 

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Effective use of Mindfulness strategies increases our awareness of our internal and external environments. One goal many of us have in using non-judgmental attention is to achieve a sense of acceptance with reality as it is. In doing so, we have less suffering and more psychological flexibility. When we are in sync with reality, we are moving with the flow of life and not against it.

Borrowing from one of DBTs skills training assumptions, we’d like to be thoughtful that all behaviors have causality. In thinking about what happens just before flow, or what might cause it, patterns of holding come to mind: before a muscle relaxes, it holds tension. Before someone tells a story, they hold information. Before it rains, the sky holds moisture. 

We tend to judge patterns of holding as being bad. Holding our breath, holding secrets, and holding tension carry negative connotations. What if we reframed this judgment and took the perspective that holding is a natural phenomenon that must occur before movement, speed, and flow. This is not to say that patterns of holding on can’t be destructive and painful – of course they can be! We wonder if perhaps that suffering is due to a deficit in Acceptance that when we notice holding, it’s a cue to release. 

This week please turn your attention to what you hold on to. Do you keep important details about yourself to yourself? Are you holding tension in your body? What is feeling heavy? Has it occurred to you to let it go, or share the weight? 

 

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