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Dialectical Behavioral Therapy (DBT)

Dialectical Behavioral Therapy (DBT)

Dialectical Behavioral Therapy (DBT) is a transformative therapeutic approach that has been changing lives since its development in the 1970s by Dr. Marsha Linehan. Originally designed to treat individuals with borderline personality disorder (BPD), DBT has since expanded its reach to address a wide range of mental health challenges, including depression, anxiety, post-traumatic stress disorder (PTSD), and substance use disorders. At its core, Dialectical Behavioral Therapy (DBT) is about finding balance—between acceptance and change, between emotional intensity and calm, and between the complexities of life’s challenges and the skills to navigate them.

Charlton Hall, MMFT, PhD, LMFT, has been a dedicated practitioner of DBT since 2008, bringing over a decade of expertise to his work. As a Licensed Marriage and Family Therapist, Dr. Hall has helped countless individuals harness the power of DBT to transform their lives, fostering emotional resilience and healthier relationships.

What is Dialectical Behavioral Therapy?

DBT is a structured form of psychotherapy that combines elements of cognitive-behavioral therapy (CBT) with mindfulness practices. The term “dialectical” refers to the synthesis of opposites, a concept that is central to Dialectical Behavioral Therapy (DBT). This approach acknowledges that life is full of contradictions and that true growth often comes from finding a balance between opposing forces.

DBT is built on four key modules:

  1. Mindfulness: This foundational skill teaches individuals to be present in the moment, fostering awareness and acceptance of their thoughts and emotions without judgment.
  2. Distress Tolerance: This module equips individuals with tools to cope with difficult situations and emotions without resorting to harmful behaviors.
  3. Emotion Regulation: DBT helps individuals understand and manage their emotions, reducing the intensity of negative feelings and increasing emotional stability.
  4. Interpersonal Effectiveness: This module focuses on improving communication and relationship skills, enabling individuals to assert their needs while maintaining respect for others.

The Impact of DBT

One of the reasons Dialectical Behavioral Therapy (DBT) is so effective is its emphasis on both acceptance and change. It validates individuals’ experiences and emotions while also encouraging them to adopt healthier behaviors and thought patterns. This dual focus makes DBT particularly effective for individuals who struggle with intense emotions and impulsive behaviors.

Dr. Charlton Hall has witnessed firsthand the transformative power of DBT. Through his practice, he has helped clients develop the skills to navigate life’s challenges with greater confidence and resilience. His approach is compassionate and client-centered, ensuring that each individual receives the support they need to thrive.

Why Choose DBT?

Dialectical Behavioral Therapy (DBT) is not just a therapy; it’s a life-changing toolkit. Whether you’re dealing with overwhelming emotions, struggling to maintain healthy relationships, or seeking a greater sense of balance in your life, DBT offers practical skills that can make a profound difference.

Dr. Hall’s extensive experience in DBT, combined with his expertise in mindfulness and family systems therapy, makes him a trusted guide for those seeking emotional healing and growth. Since 2008, he has been at the forefront of helping individuals harness the power of DBT to create meaningful and lasting change.

Conclusion

Dialectical Behavioral Therapy is a beacon of hope for those navigating the complexities of mental health challenges. With its emphasis on balance, mindfulness, and practical skills, DBT empowers individuals to lead more fulfilling lives. Under the guidance of experienced practitioners like Charlton Hall, MMFT, PhD, LMFT, the journey toward emotional well-being becomes not just possible but transformative.

If you’re ready to take the first step toward a more balanced and resilient life, consider exploring Dialectical Behavioral Therapy (DBT) with a qualified therapist. The skills you learn could be the key to unlocking a brighter future.


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Schedule a Teletherapy Appointment with Charlton Hall, MMFT, PhD, LMFT

For those seeking personalized guidance in incorporating Mindfulness-Based Ecotherapy into their lives, Charlton Hall, MMFT, PhD, LMFT, offers professional teletherapy sessions. With extensive expertise in MBE, Dr. Hall provides tailored strategies to help individuals overcome insomnia and achieve restorative sleep.

How to Schedule an Appointment:

  1. Visit the Mindful Ecotherapy Center Website to find more information about Dr. Hall’s approach to sleep wellness and mindfulness-based therapies.
  2. Book a Consultation – Easily schedule a teletherapy session that fits your availability.
  3. Receive Expert Guidance – Work one-on-one with Dr. Hall to develop a personalized sleep-improvement plan using MBE techniques.

By integrating Mindfulness-Based Ecotherapy into your daily routine, you can naturally enhance your sleep quality, reduce stress, and achieve long-term wellness.


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Choices and Ruminating Cycles

Snowballing ruminating cycle

Our choices are sometimes a result of our ruminating cycles. Have you ever had a thought that led to another thought, and then another, and so on until your thoughts are snowballing out of control? If so, you’ve experienced a ruminating cycle. When we make choices after engaging in ruminating cycles like this, our choices aren’t usually the type of decisions that yield positive consequences.

Sometimes we make choices in an effort to quell such ruminations. When that happens, those choices may not produce the optimal outcome.

This is because our beliefs are a result of our thoughts and feelings. If our beliefs and choices are leading us to experience consequences that we don’t want, we can learn consciously change those thoughts and beliefs to create consequences that we do want. Poor choices are the result of negative cycles. Stress and anxiety are also usually the results of negative ruminating cycles.

Ruminating Cycle Exercise

Think about a time when you had a negative cycle and acted on it. How did the choices you made lead to consequences you didn’t want? It may help to write down that cycle on a piece of paper, using as much detail as possible. Feel free to get as personal as necessary to complete the exercise.

Here are the instructions for writing down your negative snowballing cycle:

  1. In the circle in the center of the page, write down the trigger that began the negative cycle. What happened that started the negative thought process? What did you think about what happened?
  2. Next, look at the trigger in the center circle, and write down the first thing that comes to mind. Write it next to the circle, and draw a circle around that thought and connect it back to the center circle.
  3. Now write down the next thing that comes to mind when you think about your trigger statement, and write it down as well. Draw a circle around it and connect it back to the center circle as well.
  4. Continue this process until you can’t think of anything else, or until the center circle is surrounded by other circled thoughts.
  5. Next, pick one of those circled thoughts and think about the first thing that comes to mind in response to that thought. Write it in a circle and connect it back to the thought that originated it.
  6. Go on in a similar fashion, listing all the thoughts in your ruminating cycle and linking them back to the thoughts that spawned them. Work outward in concentric ‘circles of circles’ until complete.

Choices and Ruminations

Triggers can lead to ruminating cycles if we choose to let them. Negative ruminating cycles can lead to poor choices, and poor choices can lead to adverse consequences. The more steps in a ruminating cycle we can identify, the more opportunities we have to change them or to stop them completely!
Refer to the Ruminating Cycle Graph you just completed in the previous exercise, and answer the following questions:

  • What are the triggers that activate your ruminating cycle?
  • What assumptions are sustaining your snowballing?
  • What perceptions are sustaining your cycle?
  • What feelings are sustaining your ruminating cycle?
  • What thoughts are sustaining your snowballing?
  • What beliefs are sustaining your cycle?
  • What physiological cues are sustaining your ruminating cycle?
  • What choices are sustaining your negative cycles?
  • What are the consequences of sustaining your snowballing?
  • What is your intention in engaging in this negative cycle?

Look at your answers to the questions above. Which of these answers would help you to either stop your negative ruminating cycle or to change it to a positive ruminating cycle? Why?

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Ruminating Cycles and Triggers

Ruminating Cycles and Triggers

In previous blogs we’ve talked about the idea of ruminating cycles. If I have a negative thought, and that negative thought leads to two or three more negative thoughts, then those negative thoughts lead to a couple of dozen more negative thoughts, I am ruminating on negative thoughts. “Ruminating” literally means “to chew on.” So a ruminating cycle is a cycle in which I am “chewing on” a chain of thoughts.

Ruminating is sometimes called snowballing because of the way it behaves. Negative thoughts tend to naturally multiply, attracting more and more negative thoughts and growing like a snowball rushing downhill. It’s much easier to stop a snowball at the top of the hill before it has accumulated mass, momentum and speed. Likewise, it is much easier to stop a negative ruminating cycle when it begins than it is to try to stop it once it has gained momentum.

This is accomplished by identifying triggers that lead to negative rumination. The earlier in the ruminating cycle it can be stopped, the easier it is to stop the cycle. The way to catch a ruminating cycle and to stop it before it begins is to identify your triggers for negative rumination.

Suppose your husband isn’t paying attention to you, and that this lack of attention becomes a trigger for a negative ruminating cycle. Your negative ruminating cycle in this case might look something like this:

“He’s not paying attention to me. Is he giving me the ‘cold shoulder’? What have I done this time? Is he mad about something? Great…now he’s going to ignore me for the rest of the day! Why do I put up with this? I don’t see how this relationship can continue if he’s going to keep acting like this!”

This entire cycle of negative rumination was started with the simple observation that, “My husband isn’t paying attention to me.” The rest of the cycle was perpetuated by the assumption that his lack of attention had a negative origin. If that assumption hadn’t been made, then the negative cycle of rumination would not have been necessary. In order to stop the cycle before it began, the original assumption could have been challenged.

Challenging Ruminating Cycles

One way to challenge such negative ruminating triggers is to reframe them by making a different assumption about the observation. In the example above, you could reframe that trigger in such a way that it starts a positive ruminating cycle. Some possible reframes might be:

My partner’s busy right now, so that means I can have some ‘me’ time!
Maybe he has a lot on his mind. I shouldn’t take it personally.
This is an opportunity to show my support!
Each of these reframes assumes a positive rather than a negative intent from the observation, “My partner isn’t paying attention to me.”

Note also that even if the original assumption was correct, it is still possible to reframe the trigger so that it doesn’t lead to a negative ruminating cycle. Remember that the original assumption about the observation was, “He’s not paying attention to me. Is he giving me the ‘cold shoulder’?”

This correct negative assumption could be reframed in the following positive way:
“Well, just because he is choosing not to interact with me right now, I don’t have to let his mood spoil my own mood.”

Such a reframe allows you to validate your husband’s feelings without having them impact negatively on your own. Negative ruminating cycles can act as barriers to compassion. By assuming compassionate motives from our loved ones, we tend to act in ways that create a compassionate environment. By choosing to avoid negative ruminating cycles, we can act out of compassion even if our loved ones choose not to.

This doesn’t mean that we have to be doormats. We can still set firm boundaries while acting out of compassion. The way to do this is to expect the best from our loved ones while preparing for less than the best if necessary. When they choose to act in ways that are not compassionate, we can make it clear that we love them and care about them even when we may not agree with the way they’re acting right now.

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Emotional Regulation

Emotional Regulation

Successful mood management comes from successful emotional regulation. Emotional regulation means recognizing patterns of emotional aggression and stopping the cycle of emotional aggression before it starts. This means becoming aware of and attuned to your own cycles of emotions.

Before you can become attuned to your own cycles of emotional behavior, you must first be able to identify your emotions.

Society often teaches us that there are acceptable emotions to display in public, and unacceptable emotions to display in public. Those emotions that we feel safe displaying are our secondary emotions. In situations where people tend to become emotionally aggressive, there are underlying emotions driving these secondary emotions.

These underlying emotions, called primary emotions, are emotions that we do not feel safe displaying or discussing in public. If we suppress these primary emotions for long enough, it is possible that we may eventually forget what these emotions are and what they feel like. When this happens, the first step to emotional regulation is to identify these lost emotions.

By using the mindful skills of observing and describing, you can distract yourself from drowning in unpleasant emotions by simply identifying the emotions and describing their characteristics to yourself. As you step outside of the stream of feeling by distracting yourself with the process of observing and describing, it may help to name these emotions to yourself.

For example, if you’re feeling angry, repeat to yourself, “That’s anger.” As you begin to ponder this emotional state, trace it back to its origin. Are there any primary emotions driving the anger? Could it be that you are angry because you fear losing someone or something? Are you angry because of a fear of being inadequate in some area of your life? Are you angry because you are frustrated at a personal failure? The feeling behind the secondary emotion is the primary emotion.

Ruminating Cycles and Emotional Regulation

As you use your skills of observing and describing, you will not only be distracting yourself from fully experiencing the negative aspects of the mood. You will also be exploring the primary roots of the secondary emotion being experienced. As you observe and describe your emotional states to yourself, you become more emotionally aware of their origins. The more aware you are about the origins of those emotions, the more you are able to choose which emotions to give your full attention, and which emotions to let go.

A ruminating cycle is a cycle of thought or emotion. There are positive ruminating cycles and negative ruminating cycles. Such cycles consist of the self-talk we engage in as we go about our daily business.

Let’s look at a couple of scenarios involving ruminating cycles. These cycles are from Joe and Jim. Joe’s negative ruminating cycle might look like this:

“My wife just frowned at me. I wonder what she’s upset about?”
“What have I done wrong this time?”
“Can’t I ever do anything right?”
“Why is it so hard to please her?”
“Maybe I should just divorce her and get it over with. She’s never happy.”
“I’ll show her! I’ll give her the silent treatment!”

Jim’s positive ruminating cycle might look like this:

“My wife just frowned. I wonder if she’s upset?”
“Maybe she’s just having a bad day.”
“I wonder if there’s anything I can do to help?”
“I’m happy that she trusts me enough to share her innermost feelings with me!”

Joe’s negative ruminating cycle assumes that his wife’s frown was personal in that Joe believes that his wife was frowning at him. Jim, on the other hand, simply noted that his wife had frowned, without assuming that the frown was directed at him personally. Joe also assumed that his wife’s frown was indicative of a pervasive problem: That Joe cannot ever do anything to please his wife. Jim, on the other hand, recognized that this was just one incident, and not a pervasive problem. His response to his wife’s frown was, “Maybe she’s just having a bad day.”

Finally, Joe’s ruminating cycle assumes a permanent problem: That Joe can’t “ever do anything right,” while Jim doesn’t see it as a permanent problem. He’s even willing to try to change the situation by wondering if there is anything he can do to help his wife.

Try this: The next time you find yourself in a ruminating cycle, whether it is a positive cycle or a negative cycle, begin talking out loud. Verbalize your thought and feeling patterns by observing and describing them. Look for any permanent, personal or pervasive patterns of thinking and feeling.

Be on the lookout for all-or-nothing thinking. You can usually identify such patterns of thought by looking for words like always and never. The good news about thoughts like, “Things have always been this way,” and “Things are never going to change,” is that you only need one example to disprove them. If Joe has ever done a single thing to please his wife, then he cannot say, “I can never do anything to please her.”

If Joe can find just one example of where things have gone well, then he can’t say, “I always do the wrong thing.” He might do the wrong thing 99,999 times, but if there’s even one case in which he did the right thing, then he is not justified in saying, “I always do the wrong thing.”

If Joe can think of a single time when he was able to do the right thing, then it means that it is possible to do the right thing. If it is possible to do the right thing once, it is possible to do the right thing again. All that remains is figuring out what made it possible, and repeating the conditions that made it possible.

The key point to remember about ruminating cycles is that they are self-reinforcing. Emotions like to hang around once they’ve shown up. Research has shown that once a ruminating cycle of emotional aggression gets started, we tend to act, think, and feel in ways that perpetuate the cycle. We’re conditioned to believe that when we have strong emotions, we must immediately act upon them.

Mindfulness-Based Ecotherapy teaches us that we do not have to act on those emotions, and we don’t have to dwell on them. We can simply observe and describe those emotions without feeling the need to react or respond.

It may help to remember that there is no such thing as a ‘good’ or ‘bad’ feeling. What may be considered ‘good’ or ‘bad’ is the behavior that comes after the feeling. So the problem is in the behavior, not the feeling itself. One of the behaviors that can be labeled as ‘good’ or ‘bad,’ or ‘positive’ or ‘negative,’ is the ruminating cycle itself.

It works in this way: You have a negative feeling (anger, hostility, sadness, etc.). You then activate a ruminating cycle by continuing to dwell on the feeling. As you continue to dwell on the feeling, the negative emotion feeds off of the ruminating cycle and the emotion causes you to become more and more emotionally aroused, until you act out with emotional aggression.

You can change this behavior in this way: When you note a negative emotion, simply observe it and describe it, while recognizing that you do not have to dwell on it. The feeling itself is not ‘good’ or ‘bad.’ It simply is. You can decide not to give it power over you by disengaging from the ruminating cycle. In doing so, you don’t feed the negative emotion, and it eventually subsides.

When you have mastered this, you will be well on the way to managing your moods.

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How Gaslighting Works

How gaslighting works

Last week we talked about what emotional aggression is and how emotionally aggressive people often use gaslighting to achieve their goals. Today we’re going to talk about how gaslighting works. We’ll also discuss some common statements used by gaslighters who are being emotionally aggressive.

The term “gaslighting” comes from the 1938 play, Gaslight. This was made into a film in 1944. The premise of the movie is that a husband is trying to convince his wife she is insane so he can gain control of her assets. He leads her to believe she’s stealing things without realizing it and hearing noises that aren’t really there. Because of his manipulations she begins questioning her sense of reality. The term “gaslight” comes from the fact that the husband goes into the attic at night to turn the gas lights on and off in hopes of making his wife question what she’s seeing. In other words, he’s trying to make her doubt her sense of reality.

When someone is being emotionally aggressive, the goal is to make you question your own sense of reality and to instead rely only on what they’re telling you your reality should be. Gaslighting confuses the victims, making them question their own judgment, sense of self-worth, ability to recall the past, and eventually their own sanity.

Here are some of the techniques emotionally aggressive gaslighters use:

Lying to You
People who engage in emotional aggression by gaslighting are habitual liars, and they’re usually so good at it that eventually you start to believe them. They eventually make you start second-guessing yourself. They say things like, “You’re making things up,” “That never happened,” or “You’re crazy.”

Discrediting You
Gaslighters like to try to turn others against you or to convince you that others are against you even when they aren’t. They will use those near and dear to you to accomplish their objectives. They will only tell you the negative things others say about you, and if others aren’t really saying negative things about you the emotionally aggressive person will invent things. Comments a gaslighter might make to discredit you would be things like, “Your family agrees with me…you’re crazy,” or “The kids think you’re being ridiculous.”

Distracting You
Emotionally aggressive people love to distract. This usually takes the form of “whataboutism” in which, whenever you bring up a problem, they say something like, “Oh yeah, well what about this problem instead?” This sometimes takes the form of “You do it too!” Regardless of whether or not you do it too, it doesn’t address the initial question of the gaslighter’s behavior.

Minimizing Your Thoughts and Feelings
One way that a gaslighter will use emotional aggression is to use your own emotional states against you. They might say things like, “Calm down,” “You’re overreacting,” or “Why are you so sensitive?” The goal here is to minimize how you’re feeling or what you’re thinking while trying to force you to be responsible for their emotional state instead.

Shifting Blame
Blame-shifting and blame-storming are other common gaslighting tactics. Every time you try to have a discussion with an emotional aggressor, they twist everything into making it your fault so that you feel you are to blame. Whenever you try to discuss how their behavior towards you makes you feel, they say things like, “We’d get along just fine if you’d see things my way,” or “If you acted right I wouldn’t have to treat you the way I do.”

Denying Wrongdoing
Emotional aggressors are notorious for denying that they did anything wrong. They make poor choices and then refuse to take responsibility for them, preferring to blame others. Denying the feelings of others in this manner can leave their victims feeling unseen, unheard, and unloved. Over longer periods of time victims develop “learned helplessness,” which is a state of giving up and losing hope that things will change. Gaslighters might deny wrongdoing by saying things like, “I never said that,” or “You’re just overreacting” or “Stop imagining things.”

Using Compassionate Words as Weapons
Emotional aggressors are very good at mixing lies with the truth to keep you off-balance. Sometimes they’ll through in positive reinforcement just to confuse you. They know that keeping you off-balance makes you easier to control. They might say something like, “You know how much I love you. I would never hurt you on purpose,” or “I only criticize you because I love you and want you to get better.” The most abusive form of this is when domestic violence offenders say things like, “I only hit you because I love you.”

Rewriting History
Gaslighters and emotional aggressors love to change the details of events to their favor. If your partner shoved you against the wall, and then you bring it up later, they might say something like, “What really happened is that you stumbled and I tried to catch you.”

All of these tactics are used by gaslighters to make you lose your own sense of reality. Emotional aggressors try to control others so they don’t have to learn how to control themselves. If you have a partner or a loved one who is trying to make you responsible for their emotional states, or who is trying to tell you what you should feel and should not feel, you’re probably a victim of gaslighting.

In the coming weeks we’ll be talking about how to address some of these issues. We’ll also be focusing on how people who use emotional aggression and gaslighting as their primary coping mechanisms can learn less maladaptive behaviors.


What Is Gaslighting and Signs It May Be Happening to You, Very Well Mind
By Sherri Gordon Updated on April 12, 2023