4 minute read
Practicing What We Teach
Professional Experience Article
-Marsha M. Linehan from Building a Life Worth Living
As therapists, we don’t always practice what we preach. There are skills that become natural for us and others we find that do not work. There are new philosophies we accept and those we reject. The nature of the world is dialectical, including our work. Dialectical Behavior Therapy (DBT) was created as a result of Marsha Linehan’s goal of creating a treatment she once needed herself. In the spirit of how DBT was created, I am learning these skills myself to be able to teach them more effectively to my clients, offer more accurate empathetic understanding, and to take care of myself How can I ask my clients to do something I do not do myself?
My implementation of DBT is far from perfect. A teenager disengages from our conversations each session when I transition into psychoeducation of the skills. Despite specifically identifying DBT as preference for our sessions, she appears to be uninterested. After alternating the times and days we met, including a parent, and a variety of different attempts at psychoeducation, nothing changed It was only after my personal practice of DBT skills that I have been able to have a more natural discussion of the skills with her each week It is easier to discuss and understand what we have experienced ourselves
My clients who meet the typical description of who DBT would be beneficial for those with Borderline Personality traits or anyone who experiences intense emotions are my clients who show the most initial resistance to learning and practicing these life changing skills. “I only did half of the chapter this week. I hope that’s okay. This chapter is heavy,” said a woman to me last week. She was assigned as homework, several times, to complete a chapter on emotional regulation skills in her DBT workbook. I smiled I am prone to the same resistance. She only did half after weeks of discussing the importance of it. Yes, and she is intentional, reading each page, completing each exercise. Completing even the exercises she does not want to do! That is actually more than I do I pick and choose, focusing on my “favorites.” She is right, it is actually heavy work. In meeting her where she is at, accepting quality over quantity, I have observed a meaningful change in her Her cutting has stopped and urges are increasingly rare now There has also been an increase in her self confidence and self-trust as a result As a result of my own practice, I can show up with more accurate empathic understanding.
As Linehan reminds us in Building a Life Worth Living, “I’ve got to learn the methods of acceptance myself, in order to be able to teach acceptance more effectively to my clients.” The therapeutic relationship and work we do as a whole embodies the essence of DBT Accept and work towards change. Occasionally, I need to observe my “mindlessness” in session, take a deep breath, and refocus I need to be in the present to provide my best work Regularly, I need to cultivate a sense of lovingkindness and release judgements With lovingkindness and fewer judgements, I can more fully accept my clients where they are at and my own progress in the evolution of my work. It is through this I can maintain a human-first mindset. My own resistance to committed change emerges when I am upset or managing anxiety, and now I can shift from not only rolling with my clients’ resistance but to having a greater sense of compassion, because now I have been there too. My overall sense of self-compassion increases in recognizing that, once again, I am human and working towards change, just as my clients are.
Written By: Karli Gallo, Registered Mental Health Counselor Intern
Karli is a Registered Mental Health Counselor Intern working in private practice with Seasons Psychotherapy Associates She is trained in EMDR and seeking certification She has a passion for w those who endure complex trauma and generational trauma, depression, anxiety, eating disorders, grief and loss, and spirituality concerns
