Mindfulness Monday: Wise Mind

Back during the A to Z Challenge, I spoke briefly about DBT and about Mindfulness.

Today, I'm going to talk about a core component of Mindfulness that is also a core component of DBT.

In DBT, there are three states of mind that are referenced. These three states are descriptors of different ways we interact with the world.

The first is "reasonable mind." When we are in this state, we are able to think logically or rationally about what's going on, about our options, and about the steps we want to take. We are focused, we pay more attention to facts, and we tend to plan out our behaviors. We may even be somewhat detached from what's happening, because we're only focusing on observable facts. Examples of behaviors that would be characteristic of "reasonable mind" might include: measuring ingredients to bake a cake, going to the WMATA website to check the metro schedules before going into DC on the weekend, studying for a final.

In contrast, the second state of mind is "emotion mind." This is what is sounds like - our feelings are driving the bus. When we're in "emotion mind," our thoughts are controlled by our emotions. We tend to be reactive, facts are distorted, and we can't remain (or have a very hard time remaining) objective. Examples of behaviors that would be characteristic of "emotion mind" might include: having a fight with someone that you've disagreed with, curling up in your favorite chair with your kitten and cuddling, buying something with your credit card that you can't afford just because you decided you wanted it.

This leads us to today's topic, "wise mind." We are operating in "wise mind" when we have balanced "reasonable mind" and "emotion mind." We're able to acknowledge our feelings and still think clearly about what we want to do about them. "Emotion mind" and "reasonable mind" have blended to develop a deep intuition, or knowing, that some describe as a "gut feeling" about what's best for the person. Your intuition tells you, this is the best course of action, because your emotions and logic are working together beautifully. "Wise mind" is sometimes the "calm after the storm" you feel after a crisis has passed, when you can see everything crystal clear.

Unfortunately, we don't stay in "wise mind" all the time. Things would be so much easier if we could!

Breathing Exercise
A simple breathing exercise you can do to practice being in "wise mind" follows:
Focus on your breath, on inhaling through your nose and exhaling through your mouth. Your breath should be soft and gentle. As you continue to focus your attention on you breath, let your attention settle so that it's deep in your breathing. The point where your attention is in the very bottom of your in-breath, at the center of your breathing, is "wise mind."

Drop into the Pauses

As you engage in mindful breathing, allowing yourself to notice the “pause” after each inhalation and each exhalation.  This pause is much like the still space that exists when leaping between trapeze bars. Notice the stillness within each pause.  Allow yourself to find awareness in the pauses at the top and bottom of each breath. Settle in to each pause and find stillness within.

Stone Flake on a Lake

To engage in this visualization exercise, imagine that you are seated next to a crystal clear lake on a beautiful sunny day.  Imagine that you are a small flake of stone, chipped from a much larger rock, that someone has gently thrown out into the center of the lake.  You are gently floating there on the placid surface of the still water. Now you begin to gently and slowly float downward in the cool water toward the smooth, sandy bottom of the lake.  Notice the look and feel of the water as you gently float to the bottom.  Notice the feel of the smooth sand as you lightly rest upon it.  Become aware of the peace and serenity at the bottom of the lake.  This deep stillness and serenity is the calm center of yourself.  Allow your attention to settle into this calm centered place within.

Breathe "Wise" In, Breathe "Mind" Out

This exercise is particularly helpful if you feel stuck in emotion mind and are feeling overwhelmed.  In these moments, it may be difficult to focus your attention on a longer visualization exercise.  At times like this, simply notice that you are feeling intense emotions and begin to direct your focus toward your breath.  As you pull the air into your lungs, say the word “wise” in your mind.  As the air leaves your lungs, say the word “mind” to yourself. The idea is to focus your attention entirely on these words as you breathe in and out to begin to settle yourself back into a place of calmness and wisdom.

Is This Wise Mind?

Many of us often know that we are doing or saying something that is not in our best interest, but for some reason we do it anyway.  This can happen for a wide variety of reasons, such as directing passive aggression towards yourself or choosing to self-sabotage.  If you find yourself experiencing even the slightest sense that you are about to do or are doing something that you will later regret, notice this and pause.  As you pause, take a slow breath in and ask yourself, “Is this (action, thought, etc.) wise mind?”  Listen for the answer… don’t tell yourself the answer.  Allow it to arise naturally within.  Pause, breathe, and notice what answer presents itself to you. Now, it is up to you whether or not to do what wise mind knows is best.

There are many other exercises, one of which involves journaling different thoughts from the different states of mind.

Try a few, see what works for you. Remember that it takes practice to be in our Wise Mind, so pick an exercise and practice it regularly.

Mental Health Monday: Expressive Therapies

Today I want to talk about expressive therapies.

Some examples of expressive therapies are art therapy, music therapy, dance therapy, and sand tray. However, pretty much any expressive activity can be used  - by a trained professional - in a therapeutic manner.

Art therapy can take the form of drawing, painting, creating collages, and working with clay. A subset might be arts and crafts (beading, knitting, painting bird houses, coloring pages, etc). Now, I'm not going to look at someone's drawing and say, "Oh, you used red, which symbolizes ______, so you must be feeling ______." Instead, I'd ask about the colors a person used and what they mean to the person. The whole point is for the person to get something out in a way that doesn't necessarily involve a lot of words.

Music therapy can be a lot of fun. I've done groups where we listen to a song and then talk about how it made people feel and what it brought up for them. 

Pretty much the only limit is a therapist's imagination. See? Therapy isn't necessarily all talking!

Mental Health Monday

Today's Mental Health Monday post is about getting help if you need it. Often, people find themselves in a crisis and they don't know where to start. There are tons of resources out there for finding treatment providers, or just finding someone to talk to about what's going on in your life.

SAMHSA, the Substance Abuse and Mental Health Services Administration, is a national agency whose purpose is to "target effectively substance abuse and mental health services to the people most in need and to translate research in these areas more effectively and more rapidly into the general health care system. Over the years SAMHSA has demonstrated that - prevention works, treatment is effective, and people recover from mental and substance use disorders. Behavioral health services improve health status and reduce health care and other costs to society. Continued improvement in the delivery and financing of prevention, treatment and recovery support services provides a cost effective opportunity to advance and protect the Nation's health." (SAMHSA website)

SAMHSA has several tools to help individuals in need. One is their Behavioral Health Treatment Services Locator. This website's sole function is to help a person find mental health or substance abuse treatment programs throughout the country. SAMHSA also has a toll-free, confidential Treatment Finder hotline, available 24/7 in English and Spanish: 1-800-662-HELP (4357), 1-800-487-4889 (TDD).

Another tool is their Disaster Distress Hotline at 1-800-985-5990. You can also reach them via SMS by texting 'TalkWithUs' to 66746. This hotline provides 24/7, multilingual crisis counseling and intervention for individuals who have experienced a disaster (think Hurricane Sandy). Know someone who has been impacted by a disaster? There's a great list of warning signs that the person may need some extra support.

Well, that's all the SAMHSA links.

Next up is the National Suicide Prevention Lifeline (see the badge over on the right?) This is another 24/7, toll-free, and confidential helpline. You call 1-800-273-8255 (TALK) and you are connected to the nearest crisis call center in their network (which spans more than 150 centers). This hotline provides crisis counseling and mental health referrals.

For the Northern Virginia area, there's the more local Crisis Link (which is our regional provider for National Suicide Prevention Lifeline). Their number is (703) 527-4077. Crisis Link started as a teen hotline and quickly expanded the services it provides. They have a great flyer for how to help someone in a suicidal crisis and another one about suicide warning signs.

Need support? NAMI, the National Alliance on Mental Illness often has lists of support groups in your area. This agency is a huge advocate for individuals experiencing mental illness. There's also DBSA, the Depression Bipolar Support Alliance. They run support groups all over the country. Having a substance abuse crisis? You can try to find an AA meeting close to you, you can call the Coalition against Drug Abuse's hotline at 1-800-943-0566, or you can look into SMART Recovery (866-951-5357).

Hopefully these links will help you, or someone you know, get the help that you or they need. The hardest part is asking for help!

D is for...

Welcome to day four of the A to Z challenge!

Today's topic is DBT. DBT stands for Dialectical Behavioral Therapy. It's a treatment modality used in counseling that was designed in the 80's by a psychologist named Marsha Linehan. She created DBT as a means to treat individuals diagnosed with Borderline Personality Disorder. Linehan was trying to help these individuals, who were often prone to dramatic mood swings, frequently viewed the world in a black and white fashion, and seemed to be experiencing either perpetual or a cycle of chronic crises; Linehan sought to provide these people with skills to better manage their own emotions and safety.

Today, DBT stands as one of the most prominent and popular evidenced-based practices in counseling.  Most community services boards offers their employees some kind of DBT training program to introduce them to the basics, so that they may begin to (with training and support) use this effective treatment method with consumers.

DBT has been found to be an effective treatment for not only Borderline Personality Disorder, but also for a multitude of other mental health or substance abuse needs - depression, bipolar, addiction. It's a complicated program, comprised for four modules (Mindfulness, Emotional Regulation, Distress Tolerance, Effective Communication) that are reviewed in group format, with concurrent individual therapy and homework. Time and again I have seen its effectiveness in improving an individual's quality of life by giving them skills to manage their own world more effectively, communicate more effectively, and respond more effectively.

If you or a loved one are seeking mental health treatment and willing to work for change, ask your treatment provider about DBT. See if that is on the table for your treatment plan.