The Four Modules of DBT
DBT, or dialectical-behavioral therapy, is an evidenced-based treatment originally created by Marsha Linehan, Ph.D., for use in the treatment of patients diagnosed with borderline personality disorder (BPD). Those with BPD often experience intense mood swings, have challenging relationships, and engage in self-injurious behaviors. Thus, the core modules of DBT were developed to center on skills to increase awareness to emotional experiences, cope with overwhelming emotions, tolerate unpleasant feelings and situations, and communicate with others in an effective way.
Although DBT was originally used for treating BPD, these skills are truly applicable to anyone, as all humans, at some point, feel uncomfortable feelings, encounter challenging situations, and struggle in communicating with others.
The first module of DBT, mindfulness, centers on increasing awareness to the present moment. Mindfulness skills aim to increase the ability to be aware of what is going on in the present moment. This means awareness of not only what is going on in the moment externally (what is happening around you), but also what is going on in the moment internally (what is happening inside of you). Through being mindful of internal experiences, like thoughts, feelings, and physical sensations, we can gain awareness as to how these things effect our mood, behavior, and interactions. Mindfulness skills are the foundation for the rest of the DBT modules. Skills taught in the core mindfulness module include:
The second DBT module, distress tolerance, focuses on skills to increase resilience and manage emotions during stressful times. So many of us (consciously or subconsciously) seek to “numb out” during difficult times, turning to substances or other unhealthy behaviors. While these ways of “coping” may feel good in the moment, they are ultimately unhelpful. Distress tolerance skills, sometimes referred to as “crisis survival skills” aren’t necessarily about taking away the feelings or the stressful situation, but more about increasing the capacity to navigate these experiences in an effective way. Skills taught in the distress tolerance module include:
The third module of DBT, emotion regulation, teaches skills to promote increased understanding of the function of emotions, as well as the action urges that often accompany these emotions. This module also provides ways to decrease the intensity of strong emotions, and approaches to “ride” an emotional wave, without having to take action. Skills taught in the emotion regulation module include:
The final DBT module, interpersonal effectiveness incorporates skills that look similar to those taught in some assertiveness or interpersonal problem-solving trainings. These skills focus on identifying needs in relationships, learning when (and how) to say “no”, and dealing with interpersonal conflict. Each skill taught in this module shares a goal of maintaining respect, for oneself and for others. The skills taught in the interpersonal effectiveness module include:
There is no doubt COVID-19 has significantly impacted all of our lives. It has brought challenges we never thought we would face and has forced us to find new ways to do our jobs, sustain our relationships, and function in our day-to-day lives. There is no doubt this pandemic has taken an emotional toll on all of us, particularly those living with anxiety. And while we are still in the midst of uncertain times, there are ways we can better manage our anxiety and restore a sense of well-being.
Keep a Routine
Establishing a consistent routine that involves regular meals, exercise, and sleep is critical to regulating our moods and managing anxiety. But the pandemic interrupted many of our previously established routines. And if you have yet to create new one, now is the time. Having a new routine helps us remember that life is continuing on. Daily routines can also support us in feeling more grounded, purposeful, and resilient.
Maintaining healthy relationships with loved ones and friends is always essential to mental health and well-being. Unfortunately, the pandemic has made it difficult to connect with others in some ways in which we were previously accustomed. This has left many of us feeling lonely or isolated. But we can still pick up the phone, send a text, or get on a video call. The more we can connect with others, whether to share worries and fears, or just have a good laugh, can make a huge difference.
Focus on the Here and Now
The virus has brought a lot of uncertainty, and uncertainty triggers anxiety. It is easy to get caught in a cycle of anxious thoughts – all those “what-ifs” about what the future might bring. Unfortunately, this just compounds the anxiety. Concentrating on the present moment by focusing on what is happening right now, rather what might happen in the future is essential to managing anxiety. Of course, this is easier said than done. But our brains are trainable, and the more we can notice when our thoughts wander from the present moment and bring them back to the present moment, the easier it becomes. Some ways to come back to the present moment include:
COVID-19 has made our worlds smaller. Seeing friends, going to our favorite restaurants, or visiting family are all things that look very different these days. Working from home, which perhaps felt novel in the beginning, just feels mundane now. And any sort of travel, whether for business or pleasure, has certainly come to a halt. The monotony of the days can leave us feeling restless, anxious, and unmotivated. Thus, it is vital to find ways to “shake things up”. Instead of scrolling endlessly through social media feeds or mindlessly playing that phone game for hours, try using technology in a different way - by traveling virtually. After the pandemic hit, countless museums, national parks, and zoos created virtual tours for people to take from the safety of their homes. These virtual tours can help break up the monotony of the day and keep our minds stimulated, even if we are stuck on the couch. Check out this list of virtual tours, or do a quick internet search to find what might interest you.
During challenging times, it can be tough to notice the good stuff. However, finding ways to be grateful can really boost our ability to cope. Practicing gratitude increases the “feel-good” hormones in the brain – serotonin and dopamine, and has been shown to improve immunity and an overall sense of wellbeing. There are many ways to bring more gratitude into our lives:
Practice News Distancing
For months, every newspaper, social media platform, and tv station has been flooded with coverage about the pandemic. While staying up-to-date and informed is important, there is such a thing as too much information. Being inundated with any information, especially that which is stressful in nature, can be overwhelming. So, just as we are practicing social distancing, we also need to be practicing “news distancing”. Try designating certain times throughout the day to “unplug” from news and social media. Or try “unplugging” altogether for a day or two (you could designate a trusted friend or loved one to share news updates as necessary).
If you’re feeling overwhelmed by your anxiety, remember, it is OK to ask for help. Mental health support is more accessible than ever, with many therapists offering telehealth sessions remotely, either via phone or videoconference.
4 weeks vs. Months and Years of mental health treatment
The greatest tragedy in humankind is not being abandoned by your loved ones, but that you abandoned yourself!
When you doubt yourself and put other people’s needs before yours, and when you engage in self-destructive behavior, you have abandoned yourself!
This is the reason why I created my signature therapy, “Inner Twin.”
My job is to remind you of the truth. The truth is that you are absolutely powerful beyond measure, and whatever you want in your life, you can make it happen! No one can take that power
away from you!
Unfortunately, in the current mental health system, you may spend tons of money, and years in therapy and not get the results you desire!
Indeed, it is time for a big revolution in the mental health world!
At Zen Institute, we can help you achieve your desired outcome in as little as four weeks!
The variety of clients who have completed our program includes people who had never received psychotherapy treatment and people who had been in treatment for years.
The feedback we have received since day one, which was 12 years ago has always been the same:
“I can’t believe it works!”
“It needs to be made available to everyone in this world!”
We utilize the shortest amount of treatment time (4 weeks) to produce the most amazing desired outcome!
Since we opened up Zen Institute, the feedback from our alumni is that 100% of them would recommend their loved ones to come for treatment!
Here is what makes our treatment different from others:
#1. Inner twin therapy: It is indeed the missing link in traditional therapy – The powerful foundation of self-healing work!
Once you connect to your authentic self, your higher self, and tap into your inner power, you will be able to build this solid self-confidence, that will always stay with you no matter what is happening around you!
#2. Cognitive behavior therapy (CBT): Learn about the combination of Eastern and Western philosophy, change your thoughts; change your life!
#3. Dialectical Behavior Therapy: (DBT): it is focused on Mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness.
#4. Eye Movement Desensitization and Reprocessing: (EMDR) This is a very powerful treatment modality that can help you let go of unresolved issues and past traumas!
This program is uniquely tailored for your individual needs, which cannot be achieved in treatment that is mainly geared towards group work.
Over the years, we have been asked to open up Zen Institute branches in New York City and San Francisco.
As we continue to serve the world, our goal is to offer this program to everyone who is in pain and suffering!
Indeed, you are not here to compete; you are here to connect! You are not here to suffer; you are here to celebrate! Celebrate the fact that you are absolutely powerful beyond measure!
Part 1: Who are you?
Part 2: How to connect to your Authentic Self - Inner Twin
Part 3: Be one with your Inner Twin = Amazing Life!
“I love you! I will never give up on you!” ~ Your Inner Twin
Research has shown that positive self-talk can improve self-esteem, foster empowerment, and relieve symptoms of anxiety, depression and addiction. Unfortunately, the majority of our self-talk is often negative. It is unconscious and programmed from a very young age.
In order to change your negative self-talk, the first thing is to realize that you are talking to yourself in a negative way. Some may argue, “I don’t talk to myself, I am not a schizophrenic!” The truth is that if you are a human being, you do talk to yourself! Talking is thinking out loud, and thinking is talking quietly. We engage in dialogues constantly, both internally and externally. So, relax, talking to yourself does not mean you are crazy! In fact, it can increase your insight and allow you to clearly see what it is in front of you.
As human beings, we have two inner voices. One is called conscience, I call it “Inner Twin”, your authentic self; the other one is called ego, the nasty roommate you can never get rid of, your false self. When you are connected to your Inner Twin, you feel loved and at peace, even during times of trepidation. When you are driven by your ego, you often feel fearful and insecure, even when everything is going well for you.
Living in a shame and fear based world, our default is to doubt and criticize ourselves and others. It is done unconsciously. To live a life that is full of love, peace and joy means living consciously.
Positive self-talk requires imagination. Albert Einstein once said: "Imagination is more important than knowledge. For knowledge is limited, whereas imagination embraces the entire world, stimulating progress, giving birth to evolution." All of us love to have a best friend, a romantic partner who loves us unconditionally... we are waiting for this to happen, meanwhile we complain about how difficult it is to find someone who understands us. Do yourself a favor! Wait no more! Take business into your own hands! Today is the day you are going to take charge of your life!
What I want you to do is to start a dialogue with yourself, such as, “How is your day? Talk to me!” Then you respond to yourself just like talking to an old friend, someone you love dearly. There are three types of relationships you can have with yourself: enemy, stranger, or best friend. Make it ok, whatever it is. The sooner you can start this relationship with yourself the better your life will be.
When I first started to have a dialogue with myself - my Inner Twin, I felt awkward and uncomfortable, yet somehow it felt like a safe place I could go to and talk about my secrets without being judged. It was not a smooth ride in the beginning. I had suffered from on-going suicidal thoughts since I was 12 years old. For years, my negative point of view of life prevented me to see any possibility of getting any relief. I challenged my Inner Twin and doubted her constantly, I hated her because she was always right! Even though my love and hate relationship with my Inner Twin went on for a long time, my Inner Twin has never given up on me.
A simple dialogue with your Inner Twin could be like this. Just fill in the blanks:
You: Right now I am feeling _____, I need your help with _____.
Inner Twin: I love you, you are not alone. I am with you. I understand you. This is what I think _________. (use your skills as a best friend consulting someone you love.)
You: Thank you so much for your support. I will be sure to talk to you on a daily basis.
Inner Twin: I’d love that!
The trick is to personalize your relationship with your inner twin, make it as fun and creative as you can. Your Inner Twin knows everything about you, yet your Inner Twin will never judge or criticize you! The best part of it is that your Inner Twin is available to talk to you at 3 o’clock in the morning if you need to, you don’t need a phone or computer, and it costs $0/per session.
Many clients have reported that this loving connection with their Inner Twin has helped them create an amazing life! I believe that a spiritual connection with oneself is the most powerful element in healing! Without it, there will always be a void, and this void can only be filled by your Inner Twin!
“I love you, I am listening.” ~ Your Inner Twin
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3 Steps to simplify your life:
Step 1: Give up false Self-Identity
Step 2: Give up being perfect
Step 3: Give up being right
Forget about being perfect, let’s be curious. When you are trying to be perfect, you become rigid; when you are curious, you become creative.
Growing up in Taiwan, just like all the other kids in Asia, I was trained to strictly follow the rules. If one chose not to, the negative consequence could be harsh. For example, back in the 70’s, if someone robbed a bank, they could receive the death penalty.
When I was 12 years old, my favorite class was art. One of the assignments was to create a picture of a vase just as the one shown in the art book. I did this assignment with my friend Nina. As I was having fun making my vase look like a mosaic, with all different shapes and colors, Nina said, “Oh, no, you are doing this completely wrong! We are supposed to make our pictures look exactly like the one in the book.” The stubborn part of me refused to make another one, even though I understood what the rule was.
After turning in my artwork, it was time to review the results. Mr. Wong stood in front of the class and said, “Look at this picture. All of you in this class turned in this assignment exactly as I asked, except this one!” My heart dropped, “Holy shit, that is mine! I wish I could run away right now! Nina was right, I am in trouble!” I glanced over at her, and she gave me that “I told you so” look. Mr. Wong continued, “Indeed, this is the most creative piece I’ve seen in a long time. The shapes and colors in mosaic style bring a sense of playfulness and different meanings to us. The spirit of art really is to inspire others and to be inspired!”
Mr. Wong chose me to represent our school to compete with kids from other school districts. I felt flattered and scared at the same time. On the day of competition, after I set my easel up among other kids in a beautiful park, I panicked. I saw the watercolor picture done by the boy right next to me. There were beautiful palm trees, and by the sidewalk there was a bench and people walking around so vividly. It was an amazing painting! I said to myself, “I could never paint a beautiful picture like that…”
Finally, I got the courage to pick up brush and start to paint my picture, and I immediately messed up! The little perfectionist inside of me started talking: “The cloud is supposed to be fluffy, and the sky is supposed to be blue!” I used the wrong colors - dark gray, green and purple. Watercolor is the most unforgiving media. You can never go back to erase it if you don’t like the colors. I was very upset and I started to cry. I just wanted to pack everything up and go home.
Mr. Wong came by, and I told him why I wanted to give up. He looked at my picture and said, “No, you are doing just fine.” He picked up the paintbrush and added red, purple, orange, yellow and brown colors on the part where I messed up. It was magic! With just a few strokes on top of the mistake I made on my painting, it became a stunning sunset picture with dramatic colors in the sky. I couldn’t believe what I saw with my own eyes. Mr. Wong said, “See, sometimes the sky looks just like this!” This experience opened my eyes to see how my perfectionism had caused me to feel hopeless and helpless; and how giving up my need to be perfect actually brought a brand new perspective to my situation.
Being perfect is for “dead people”. Why? The heart rate of dead people is perfectly flat, and they will never make another mistake. They are done, and their lives are over! When you strive for perfection, you can be paralyzed by fear of failure or feelings of inadequacy and end up not wanting to do anything at all. The beauty of being a human being is that you are going to make many mistakes, and that’s okay. It’s how you learn. As long as you are alive, you have an unlimited ability to improve yourself! You get to play and go on a journey of self-discovery!
Being curious is the cure for perfectionism. Today, pick one thing you are afraid to do, set your fear aside, and focus on being curious – be creative, resourceful, and have fun! If you can learn to enjoy this moment, it is more than likely that you will continue to enjoy your adventure in the next moment too. This is how you simplify your life - by giving up being perfect!
“There is a crack in everything, that’s how the light gets in.” - Leonard Cohen
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Week 1: Be Forgiving
Week 2: Be Present
Week 3: Be Connected
The best present that your life can offer you is “The Present”! This is why every second of here and now is called the “Present” moment! Unfortunately, we often spend the present moment stuck in the past or the future, and our lives are slipping away right in front of our eyes without even being noticed.
In the winter of 1992, I was driving in a very bad snow storm on the US highway 23. It was about midnight, and I was afraid that I would get into a crash because I couldn’t see the road, which was covered by snow. To avoid switching lanes unknowingly, I came up with a brilliant idea to keep myself safe: Just follow the white line and stay on the far right side of the highway. Everything was ok, until about an hour later, when all of a sudden I had no choice but to stop. There was a huge airplane parked in front of my car. I was speechless. “Holy shit, where am I?” I panicked, and I stepped out of my car, the snow was deep, up to my knees. In the far distance, I saw a building. There was a man in the building who saw me walking around in the snow. He screamed at me, “You are trespassing, this is a domestic airport! What the hell are you doing here at one o’clock in the morning?” I was scared, confused, and frozen to death. All I wanted was to be able to get home safely.
This life experience taught me a precious lesson: Being present is the ultimate key to keeping myself safe, especially when I am freaking out. My brilliant idea was narrow-minded wishful thinking. By following the white line, I did not pay any attention to the exit signs on the highway. I was not being present and aware of my surroundings. That was how I ended up running into that huge airplane!
Most recently, I saw a TIME magazine cover titled: “Mindfulness - The new science of health and happiness”. It seemed odd to me that they called it the “New Science”, since the practice of mindfulness has been around for thousands of years. One of the most important qualities of mindfulness is the ability to be present. The benefits of being present include: better concentration and self-control, higher productivity, less stress, and increased self-compassion and acceptance. Thankfully, mindfulness is now becoming a mainstream practice in the western world.
Here is a very simple tool to help you be present. I called it “3 Boxes”. Imagine there are three boxes in front of you, on the left the box represents the Past; on the right the box represents the Future, and the box in the middle represents the Present.
Now, if you want to experience shame and guilt, which box do you focus on? The Past! If you want to experience fear, which box do you focus on? The Future! If you want to experience love, peace and joy, which box do you focus on? Yes, the answer is the Present! Just that simple!
In reality, the past is done, you can’t go back to fix it no matter how remorseful you are. The future is not here, but you can scare yourself to death by thinking about the worst-case scenario and all kinds of what ifs. You will end up being paralyzed by this kind of neurotic fear.
If you use this moment and focus on your past and/or your future, you are creating a life that is absolutely delusional! The definition of Zen is that there is no reality outside of here and now. So, why would you create a life that is delusional? Why would you choose to spend time being paralyzed? Do you have power to choose to be present? Yes! Absolutely yes!
The untrained mind will constantly take you to the past and the future. That is why it is very difficult for you to stay present. Here is a simple exercise you can do to stay present: Identify everything in your surroundings in a very quick fashion. You will notice that your anxiety goes down, simply because in the moment no one is attacking you, your house is not on fire, you are ok exactly where you are!
If you are depressed you are living in the past; if you are anxious you are living in the future; if you are at peace you are living in the present. – Lao Tzu
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Jenna Jarrold, MS, LAC, NCC