Radical Acceptance

Radical Acceptance is a distress tolerance skill taught by Marsha Linehan as part of Dialectical Behavior Therapy. I can still remember the first time I was taught about radical acceptance. I didn’t like it. I couldn’t get over the idea that accepting things would help anyone who was suffering. I couldn’t help but see problems when applied to issues of social injustice and disparity. I was someone who would scream from the rooftops if something felt unfair or problematic. It took a minute for me to understand that wasn’t what was meant by radical acceptance. It isn’t about accepting some horrific fate or complete injustice. In a recent video with Ms. Linehan, she talks about how you can do lots of things to possibly change your future, but there isn’t a lot that can be done to change the past or sometimes even the moment we are in.

In fact, sometimes it is necessary for us to understand and accept the reality of a situation in order for us to do the necessary actions to change it. This reminds me of the Transtheoretical Model of Change. It is the model that clinicians often use when talking about drug addiction. In the pre-contemplation stage, the individual does not view their use as a problem. During this period, there is very little actual possibility of change. The next state is the Contemplation stage, where the individual begins to recognize that their behavior has negative consequences in their life. It is at this state that change becomes possible. At this stage, they are accepting what is and are ready to take steps necessary to plan for a future without addiction.

I have been thinking a lot about radical acceptance as we move through the current pandemic. Like most everyone, I have no idea how long life will look the way it does currently. As someone high risk, I also know that it is even more important that I accept the reality that I am in, so as not to take unnecessary risks that put my family or myself in jeopardy. And it’s not my favorite thing. My children are bored. My beautiful office space stays empty. No vacations or thrift shopping. My eyes get tired from staring at screens. It’s a lot.

Radical acceptance isn’t something you do once and then forget it. It is a choice you have to make over and over again. I remember in 2012 when I was diagnosed with cancer. It isn’t an easy thing to accept, being a young woman with cancer. The “Why me” dialogues were all about willfulness. I will not accept this reality. It isn’t fair. Then, like many cancer patients, there is a moment where you look at yourself in the mirror and say, “Why not me.” This was the beginning of my journey of radical acceptance. This has happened. No amount of stomping my feet and yelling at the clouds was going to change my diagnosis. The only thing that would change anything, was my acceptance and willingness to embark upon treatment. I would have to remind myself of that conversation a million times throughout treatment. Luckily, I had a good outcome. And I recognize that not everyone does. More radical acceptance.

One thing that helps me with radical acceptance is to understand that even though life is hard, there is still so much worth living for; The extra time I have with my family, the snuggles while watching Avatar the Last Airbender with my son, the not wearing any shoes for days at a time, not having a morning or afternoon commute, eating lunch with my partner every afternoon. We will get through this - and hopefully we can do lots of things to stay healthy both physically and emotionally.

Ps. The image is of a Japanese Yokai named Amabie. Artists across the world are drawing her image as a way of protecting each other from the pandemic. I figure it couldn’t hurt. Click here to find out more about her story.

Birthdays

Yesterday was my birthday.

I know that our culture enjoys it when women hide their age or become extremely despondent at the notion of growing another year older.  We are a culture that worships youth and equates getting older with something stale or distasteful.  

But I am not that kind of woman.

 I wear my age like a badge of honor.  I have survived many things in my 52 years on this planet.  I have loved, been loved, made mistakes, had triumphs, and worried probably way more than I should about things that really didn’t matter.

I understand that I don’t look like I did in my twenties, thirties, or even forties.  And that is okay.  I often imagine my eighty year old self looking back at my 52 year old self and wonder what she would think about me.  I think eighty year old me would say that 52 year old me was beautiful.  I think she would wish I knew it.  The same way my 52 year old self wishes that my 25 year old self knew about her power and beauty.  So, I decided that I am going to start listening to wise future me.  

My brain has also changed over the years.  I may not be as quick at word puzzles as I once was, but I am an amazing creative problem solver.  I have sat with hundreds of people in my office and have tucked away all of their stories and experiences into the folds of my brain.  I have exchanged agility for wisdom.  And that is fine with me.

My sister-in-law passed away this year.  She was younger than me and full of wit, creativity, beauty, and love.  I understand that to age is a privilege.  I am grateful for every white hair and wrinkle this journey has given me.  I am hopeful that I have much more time to learn and grow.

Doing my best

I am a devout follower of the ideas behind the Four Agreements, that wonderful book written by Don Miguel Ruiz, first published in 1997. This book changed how I showed up in the world and I continue to share its wisdom with most all of my clients. In a nutshell, the four agreements are simply stated yet complicated to adhere to. They are:

1. Be impeccable with your word.

2. Don’t take things personally.

3. Don’t make assumptions.

4. Always do your best.

I wanted to talk about the month of September and focus on that last agreement. Always do your best. I, like many anxious people, am a perfectionist by nature. I sometimes care too much about how I am perceived in the world- and when I make a mistake or don’t ascend to some greater notion of myself, I exchange those shortcomings for intense self doubt. It can fuel an out of control imposter syndrome if I am not careful.

September is a hectic month full of appointments, birthdays, and responsibilities. This is why, I have not been able to write a blog post this month. I started the month by helping to organize a massive training for therapists and social workers here in Austin - and ended the month with celebrating both of my children’s birthdays. On top of that, I have a wonderfully busy private practice and physical therapy appointments for the humerus fracture I gave myself back in April.

When my children were very little, I would spend months planning birthday parties. Exquisitely curated Pinterest boards of pirate and mermaid themed parties, hand crafted invitations with original artwork, goody bags full of treasures purchased months in advance. I also want to add that this was when my anxiety was at its worst.

Since that time, I have survived cancer and made a decision to make some major changes around how I handle stress. I set boundaries around my time. And most importantly, I have exchanged the notion that self confidence means getting everything right with the idea that self confidence means that no matter what happens, I have the wisdom and heart to do what is needed, ask for support, and weather the storm.

Fast forward to today. My youngest told me four days before his birthday that he really wanted a slumber party. I sent out a quick text to see if any of his closest friends could come. They said yes. We decided to have the party Saturday night. Thursday night, I went out and bought a huge tent to put in the living room for all the boys to sleep in. Saturday morning, I ran to target and bought flashlights, thinking putty, sour worms, and glow sticks to put in their goody bags. I also bought some cupcakes. We ordered out for pizza. For entertainment, we went on a walk in the neighborhood with our flashlights in hand making shadow puppets on the fences. Now everyone is gone and the house is quiet. My son told me it was the best party ever before he fell fast asleep.

Always do your best doesn’t mean that you do “the best”… it means that you understand how your best changes in each moment. It means having self compassion. Doing your best involves mindfulness. It means being mindful of your resources, asking for help, and setting boundaries. It is recognizing that as long as you are trying and doing what you can - you can’t be asked to do more than that. In order to do my best, I had to stop setting unrealistic goals. I had to promise to love myself no matter how things turn out.

This week, I was rushing out the door to take my son to an early morning doctors appointment before school. I rushed through traffic and got there just in time. As we got out of the car, my son tells me, “I am only wearing one shoe.” How exactly that happens I am not sure. Old me might have been embarrassed beyond belief - concerned that this would reflect negatively about my ability to be a good parent. New me laughed and took a picture. Whatever. Glad you have socks on. This was our best today…. and that’s okay. We will stop off and get the other shoe before I drop you off at school.

What is a sand tray?

Many people might wonder why my office is filled with toys and figures. Maybe they think I am just quirky and just never stopped buying toys (Okay… maybe that would be kind of correct). They might think that these are meant for the children that they sometimes see leave my office. But unless they know about sand tray, they might be completely unaware of how this powerful tool can be used in their own therapy.

It is believed that the first person to use a sand tray in therapy was Margaret Lowenfeld, a British pediatrician in the early 1930s. Dora Kalff combined what she learned from Lowenfeld with her knowledge of Eastern philosophy and Jungian ideas of individuation to create a kind of therapy she called “Sandplay”. Whatever form of Sand tray gets utilized in therapy, at its core, it is the belief that we can use symbols and figures in the sand to create a deeper understanding of who we are, our past, our present, and what we want for our future. I have seen in my work with clients how the sand tray can make what is unconscious, conscious - and how that awareness can not only resonate through our whole system, but create changes in our life.

I was trained in the use of Sand Tray by Dr. Arnell Etherington, a brilliant art therapist and psychologist with a sand tray collection that I can only aspire to (but I am trying!). Sometimes, we have very personal reasons for choosing the figures that find their way into the sand tray. Some sand tray therapists are extremely non-directive and do not offer analysis, but rather listen to how the individual describes the tray and makes personal connections. Other sand tray therapists are much more active - asking questions and offering potential connections to patterns in the client’s life. I am a lover of stories and mythology and enjoy sharing the symbolism of the figures. As in all of my work with clients, I feel that we are in a collaborative partnership, working together to find meaning and uncover truths. I ask permission to share my thoughts and feelings with the understanding that in the end, my client is always the expert on their own life.

Why use sand? Sand is wonderful in how you can build up areas and leave other areas bare. It also allows the individual to expose the bottom of the tray to represent water. Sand can be used to both bury figures as well as to create mountains for others to sit atop. I have chosen to use kinetic sand in my tray because I love the tactile quality of the sand. It is both soothing and sculptural. I have some clients that just love talking while moving their hands around in the sand. Not all memories live in the prefrontal cortex, which is what is most accessible through verbal therapy. The textural nature of the sand lights up different areas of the brain and possibly allows the client to make associations that might not occur otherwise.

So, who can benefit from sand tray therapy? Children, adults, adolescents, families, couples… pretty much anyone open to the process. I often will take pictures of the tray and encourage my clients to also keep pictures. It isn’t uncommon to revisit a tray many sessions later. It gives us not only a visual picture but it also provides us with symbolic language that can be utilized throughout therapy. Why not give it a try?

For more information on Sand Tray therapy, check out these resources.

Texas Sand Tray Association

Good Therapy article on Sand Tray

Sand Play Therapists of America

Looking for What's Missing

I decided to try something new on my blog. I want to try sharing some of my favorite stories I use to illustrate ideas and concepts in therapy via a video blog. Maybe if it works out okay, I can make this a monthly feature… we will see.

And I am trying hard to not focus on all of the things wrong in this video! Do I really sound like that?

Let me know what you think!

DBT SKILLS: PLEASE MASTER, Reducing vulnerability to emotion mind

My clients know that I have two favorite DBT skills that I probably remind them of more often than any others. The first is DEAR MAN, which we discussed in an earlier blog post. The second, is PLEASE MASTER.

When do client’s hear me discuss the importance of PLEASE MASTER? Anytime it feels like life is becoming overwhelming and they are concerned about their emotional well-being. PLEASE MASTER, at it’s core, is all about self care. The notion being that if we are taking care of ourselves, we are more able to be in charge of our emotional reactions. But sometimes, our emotions can make self care difficult - all the more reason to take a moment and check in about how we are doing. Bringing mindfulness and awareness can often be the first step in making some important changes.

Marsha Linehan, the mother of Dialectical Behavior Therapy, loves a good Acronym… even though this one is stretching it a bit. Let’s just call it creative.

(PL) Physical Illness

(This is the part of the acronym that is taking some liberties.) Anyway, physical illness is all about taking care of our physical bodies. I often use one of my children as an example of how physical illness impacts our emotional well being. This particular child is super easy going and doesn’t ever really fuss about much… unless he is sick. When he becomes super grumpy, my partner and I have learned that we need to take his temperature. Nine times out of ten, we find out he is ill. It is easy to be irritable when you aren’t feeling well. When I used to work at a local mental hospital, I remember asking the patients about physical pain. Nearly every hand was raised. Depression can manifest in pain… but also pain can create depression. Taking care of our physical bodies is an important way to stay in control of our emotions. This includes seeing doctors regularly for check ups and taking our prescribed medications.

(E) Balanced Eating

Our body and brain needs sustenance in order to work effectively. “Hangry” is a real emotion for many people. When we don’t eat enough, we can feel lethargic, agitated, impatient, and have difficulty focusing. We can also not feel great when we overeat. The kinds of foods we eat can also impact us emotionally. Eating a ton of sugar feels great in the moment, but fifteen minutes later, I will often crash and find the easiest of tasks challenging. Unfortunately, this is one of the first things that becomes impacted when we are under stress. People forget to eat… or can’t stop eating. And this further exacerbates any negative emotional experience they are having.

(A) Avoid Mood Altering Drugs

Although reaching for alcohol or a mind altering substance seems like a good idea when we are feeling depressed or stressed, it often times will only escalate feelings of depression and anxiety. It lowers our inhibitions and it becomes easy to over-use. We might end up doing something that we will regret later, only making our situation that much worse. There are lots of great distress tolerance skills that you can use if you need a break from your emotional reality that won’t end up making you feel terrible later. Also important to note that overuse can impact our physical bodies which brings us back to that first part of the acronym.

(S) Balance Sleep

Making sure that you are getting between 7-9 hours of sleep each night is crucial in helping your body and brain perform optimally. Sleep deprivation is actually a very effective form of torture. But having an anxious brain can often mean that sleep is not easy. Without sleep, we can not focus, organize our thoughts, or understand our experiences. Because of this cognitive impairment, our brains become primed for more emotional reactions to life’s stimuli. For others, heightened emotional intensity might translate into hypersomnia. They have difficulty getting up out of bed and are sleepy all day. But this also doesn’t allow the brain and body to get what it needs to work effectively. Depression will often tell you that you should just stay in bed, call in sick, and pull the covers over your head… and although that might work as a short term solution, it can often only increase negative experiences and feed our depressive symptoms.

(E) Get Exercise

I have notice in my own life that on those mornings where I rally, walk the dog for a nice half hour walk before even taking a shower - I am more productive, in better spirits, have more patience, and just plain feel good. (Maybe it also has something to do with how happy my dog is too). Exercise increases endorphins and regulates cortisol production in our bodies. Check out that link to see all of the other amazing ways it can help us regulate our hormones. I know all of the excuses why not to exercise - I use them way more often than I should. But you and I both know that we feel better when we are taking care of our bodies.

(MASTER) Build Mastery

Marsha Linehan finishes off this acronym by asking that each and every day, you try to do one thing that makes you feel competent and in control. For me, that is making art. For many of my clients, it might be playing the guitar, reading, writing, or any other skill that you feel some mastery over. Sometimes, it might mean just doing one thing that makes you feel like you have accomplished something - like making your bed.

Disclaimer

I am not for one minute saying that any of these things are easy, especially when you are challenged with a major life crisis or a bout of depression. Do your best. Be kind to yourself. Maybe today, the only thing you can do is try to eat one good meal. That’s a start. It is best to try to work on these things when nothing terrible is happening at all, when life feels manageable. Because the more we practice these things when everything is okay, the better off we will be when life gives us a bunch of lemons. And no one is immune to getting lemons.

Time & Therapy or ... How many clocks are in a therapy office?

As I was setting up my new office, I laughed at how many clocks I have in 340 square feet of space. Each clock is incredibly necessary to both myself and my clients. My clients are aware of those clocks that face them… but they are also aware of the clocks that face me. They notice when my eyes look to see how we are doing on time. I notice when their eyes look to see how much time has passed. Time is an important concept in therapy. When I am at my best, I am very aware of the dynamics of therapy and how it works within the concept of time. How we begin with pleasantries and updates - how I hope that we have moved into deeper content by the half way point - and how I try to find ways to contain emotion and experience within the last ten minutes. Most of the time it works well… and sometimes it doesn’t.

Clock One: The waiting room

In my waiting room we have this nice big timepiece in my favorite color of light greenish turquoise… which incidentally is many of my client’s favorite color too since I am replacing that color constantly in my paint bin. Here is a picture of me on the waiting room couch.

Waiting room clocks help me to stay accountable. I know you are waiting - and I need to respect your time. Waiting room clocks also let you know if you are on time or not. (That may have to be another blog post). Waiting room clocks are helpful for parents who are waiting for their children or teens on the other side of the door. Waiting room clocks tell you how long you have been waiting and how much longer you need to wait.

Clock Two: Talk therapy client clock

When you are sitting on the couch, as shown, this is your clock. It is to the right of where my head would be. Some clients are hyper aware of the time. They have much to talk about and need to be sure to fit it all in… whereas others might save some of the most important discussion topics for that last fifteen minutes in the session. We call those “Door knob disclosures”… Just as you reach for the door knob and we are closing up the session, you disclose something like , “I decided to divorce my husband. Remind me to tell you about it next week.”

Those last minute disclosures are super important, and I for one appreciate them. They are telling me that you really do want to talk about this thing, but you might not want to talk about it at the moment. You are leaving it to me to assist you in broaching the subject at our next meeting. So, I might try to agree that it is a big topic - make sure you are taking good care of yourself - and promise that we will start there next week. Our hour is the container.

Clock 3: Talk therapy therapist clock

This clock helps me to stay on task and create the container. I must be careful to give enough time to process thoughts fully and allow for questions and insights. Every therapist has an experience of making a comment not realizing that it would trigger emotions and experiences that can not be processed in the time allotted. It is a terrible feeling. This is why being mindful of the questions and comments I make within the framework of time is crucial. Your therapist isn’t looking at the clock because they are bored. They are looking because the clock gives us information as to how we should proceed.

Clock 4: Art Therapy client clock

When you are sitting at the art table (as shown), this is your clock. Do you have enough time to add another color of paint to your art piece? Are you going to be able to finish before the end of the session? Should you thread that needle and add some more stitches to your hoop? This clock allows you to manage your time…. and of course, also manage your disclosures… just like your other clock.

Clock 5: Art Therapy therapist clock

I tried to do without this clock at first. I thought I could still kind of see Clock #2 from this vantage point… but my looking all the way to the other side of the room was too distracting. (I am looking at the other clock in this picture, just to give you an idea)… So, I had to buy clock #5.

I also help my clients manage their time with this clock. “Just wanted to let you know we have about ten minutes left, so you might want to find a good stopping place for now.” I don’t want anyone to feel rushed making art. Many of my clients know that some projects we finish in one session - and some projects we work on for months. It all depends upon the project. And of course, I am also watching this clock to help maintain the container of therapy.

5 clocks in 340 square feet of space. What is amazing is that with five clocks in 340 square feet of space… I don’t really hear any of them. I wonder if my clients do?

Top 10 Reasons to try Group Therapy! (Art & DBT in particular... of course.)

As I prepare to start another group cycle, I thought it would be a good time to talk a bit about why groups are so incredibly wonderful. This isn’t something that I just believe as a therapist, but also something that I understand as a participant of groups. When I recently broke my humerus bone, the first thing I did was look online to find a humerus fracture support group. I found not only people who understood what I was going through, but I also became educated in how bones heal, found questions to ask my physical therapist, and adjusted my own ideas about how the fracture might impact my daily life. One lovely woman even posted a video of how to put your hair in a ponytail with one hand! So yeah… I love my group.

Top 10 Reasons to Try Group Therapy!

1. Vicarious Learning: Sometimes in the process of a group, an individual will ask a question that you never even thought of - but realize once asked, that it is something that you could also use the answer to. Maybe you aren’t ready to ask a particular question, but another group member is. This happens more often than people can even imagine. In individual therapy, many of those questions never get asked.

2. Universality: Recognition that we are not alone in how we feel, can be extremely validating, even when those feelings are intensely negative. Understanding that given a situation, it is “normal” to feel sad, angry, scared, happy, resentful… helps us to feel less out of control and more able to recognize our emotions as a “normal” part of the healing process.

3. Support: Having a safe place to share our feelings and get the support of others is an invaluable experience. To have someone, other than your therapist, hear your story and give you empathy can be life affirming. It is also powerful to be able to offer support to someone who is struggling.

4. Perspective: Group members will come from a variety of backgrounds with a ton of both shared and divergent experiences. Through the sharing of stories and experiences, group members not only further connect with one another, they also can gain the perspective of someone outside of themselves.

5. Social Practice: Group therapy experiences allow us to practice social interactions. How do you ask meaningful questions? How do you apologize when you overstep a boundary? How do you set boundaries? With the help of a therapist, these awkward experiences can feel manageable - and group members can take this learning into their relationships outside of the group.

6. Role Models: In the group, we can often times witness how others manage relationships or issues in their daily lives. We might notice how “Mary” is able to set boundaries with her coworkers, and begin to emulate “Mary” in our own life.

7. Sharing Secrets: There is a saying often used in 12 step groups that goes, “You are only as sick as your secrets.” Many secrets can create anxiety, depression, and even panic. When we share our secrets and pain with others, it can feel like a weight has been lifted. We can get the support that we need and we can begin the process of healing that which was once in darkness.

8. Building Hope: Group members will often be in different parts of their own healing journey. In my humerus fracture support group, a man posted a video of himself raising his arm high above his head with a big smile on his face. “Eighteen weeks of physical therapy” he wrote. For myself, who was just beginning physical therapy and could barely lift my arm 20 degrees, this was hugely impactful. Yes… it might take some time, but I can do it too. We see others succeed and we can visualize our own success.

9. Group therapy is often economical. Whereas an individual session might cost you anywhere between 90 - 150 dollars for 45-60 minutes… Group therapy is generally much less expensive for more time in the office. The DBT/Art Therapy Group offered through Art & Therapy is only $200 for the entire group cycle! That’s four 90 minutes groups - which comes to just $50 per session!

10. Fun! It is not unusual that group therapy involves not only the sharing of challenging experiences, but also lots of laughter and camaraderie. Group members begin to care about one another and impact each other in positive ways.

So…. what are you waiting for? Join our group!

Click here for more information.

Factors Reducing Interpersonal Effectiveness - DBT

“But Deann…. I tried using Dear Man… and it just didn’t work!”

Unfortunately, sometimes, despite your best efforts, things go sideways, people act unfavorably, and you aren’t able to be effective in communicating your needs or wants. Many of my clients have heard me run through “Dear Man” (The tool we use in DBT to have more effective communication in relationships) for all types of situations… the band member who doesn’t come to rehearsals… the request for a parent to extend a curfew… asking a partner to clean the kitchen… It is a super effective tool (More on that later), but sometimes, it just doesn’t work. Luckily, DBT has an amazing worksheet just about those situations…

Lack of Skills

Sometimes, we just don’t know how to use the formula in a way to be effective. Maybe we don’t really know what we want or how to ask for it. Maybe we aren’t able to maintain our own self respect or preserve the relationship in the asking for what we need. Lack of skills can be a problem. But with practice, it gets easier and easier. I honestly wish that young children were taught DEAR MAN… it would make a massive difference in their lives. It has felt like magic in my own life.

Worry Thoughts

Sometimes, we can get so worried about asking for what we want that we aren’t able to sound confident. Maybe we are worried that others won’t like us… or maybe we are worried that we will sound needy or pushy. Worry thoughts create barriers to asking for and getting what we need in our relationships.

Emotions

Sometimes our negative emotions can be so extreme, that we are not able to use the tools that we know we have. When we are controlled by our emotion brain, we can sometimes make poor decisions or act out rashly. We don’t live our values and feel the pangs of regret later. Sometimes, I will write an email rather than speak to someone in person when I know my emotions are heated. This is to try to find ways to stay in wise mind - and not let my emotions stand in the way of communicating effectively.

Indecision

This goes back to the idea that we might not be clear about what we want or what we want to communicate in a given situation. Maybe in reality, we are ambivalent. Sometimes we ask for too much. Other times we set harsh boundaries that don’t make sense for the relationship. Either way, indecision can be a barrier to getting what you need.

The Environment

This is my favorite one. Sometimes the environment in which we are asking or making our assertion is just not one that will ever be conducive to us getting what we need. Other people may have too much power (think of the boss who feels that they do not have to bend), other times individuals are too jealous or threatened, and sometimes they are reacting to something that in all intents and purposes has nothing to do with you at all. Some people are set on not giving you what you need unless they can punish you first. It is important to recognize when this is happening, because if you don’t, you might extrapolate that it is the skills that aren’t working - when in fact, the environment was going to be one that would never let you be successful. Understanding this might help you to figure out how to hold better boundaries in the future.

So….

Keep trying DEAR MAN. Even if it feels like it isn’t working. You will get better and better at it. And the best thing about DEAR MAN is that being effective in how you communicate means that you don’t have to feel terrible later about that awful thing you said or did in order to get your needs met.

DEAR MAN - DBT Interpersonal Effectiveness

I probably mention DEAR MAN at least fifteen times a week in my practice. It is an amazing tool. It can help us to ask for what we need, assert the things that people need to know, and set boundaries to keep us safe. And it is a pretty simple formula. Granted, I am not super fan of the acronym… DEAR MAN… but it is easy to remember and I have never been able to think of a better acronym… so we will trust Marsha Linehan on this one.

DEAR MAN works because it is simple, easy to remember, and effective. It follows a very set guideline that even kids in elementary school could easily understand. So, I will use an example loosely based on a child I knew many years ago. Let’s pretend a child who suffers with anxiety wants a dog.

D- Describe

Describe the current situation. Don’t use judgment. Just the facts.

“Mom. The other day, Deann brought a therapy dog to the classroom. He was super sweet and cute. I was reading about how pets can often be really good for people with anxiety. He let me pet him. He was super soft.”

E- Emotions / Express

Express your feelings and emotions about the situation. Remember to use “I” statements. Don’t assume that people know how you feel. You have to tell them.

“I noticed that when I was petting the dog, I felt so happy and calm. I think I am generally pretty lonely at home. I don’t have a ton of friends and I am often pretty sad. I really felt so good around this dog.”

A- Assert/Ask

This is where you ask for what you need or assert a boundary. Be careful to not assume that others will know what you need or what you are asking for. Others might not even understand how hard it is for you to ask for what you need! Be concrete.

“I was thinking that I would like for us to adopt a small dog that I can use as a support animal.”

R- Reinforce/ Reward

Why should this person give you what you want? How can you make them feel good about giving you what you need?

“I really feel that having a dog would make a major difference to my mental health. I also think it would teach me to be responsible and keep me from feeling so lonely. I have been working really hard lately, and I really do believe that this would help me to achieve some of the goals we have talked about with Deann. Pets are really wonderful support."

The MAN in DEAR MAN, is all about how to do these first four steps.

M - Mindful

Sometimes when we are trying to set boundaries or ask for what we need, the person on the other end of the request will do all kinds of things to make us stop. They may change the subject, ignore us, say it isn’t important. Being mindful means sticking to the conversation points. Ignoring distractions and not responding to attacks.

A- Appear Confident

My clients and I always laugh at this one because of that word “Appear”… which really just means, it is okay if you are not confident, just pretend! Appear effective. Communicate clearly. No stammering or looking at your shoes. Stand up tall. You have every right to communicate your needs. Don’t start off with things like… “It’s okay if you say no.”… Ack! They will definitely say no if that is how you start.

N- Negotiate

Be willing to negotiate. Sometimes we may have to bend a little to get what we need. Focus on how both of you can get something you want. Sometimes, a clear no is just that - and there can be no negotiation. That’s okay. In my puppy story, the child’s mother did not agree to a dog. (Sad, I know)… but did agree to a guinea pig! Which was a super happy outcome!

I love DEAR MAN. Next time, I will talk about factors that can reduce interpersonal effectiveness.

So stay tuned!

Image by Katherine McAdoo @ Unsplash

Moving On Up

Transitions are hard. Even for therapists. But moving is something in my bones. I grew up as an Air Force Brat and was accustomed to moving every three years. I would pack up all of my things, say good bye to my friends, promise to keep in touch, and then be plopped into a totally new environment where I was too busy adjusting to mourn the losses from the previous address. It was indeed challenging. On the positive side, I learned early on that I am very good at adapting. I am a cat that lands on her feet. On the more negative side, I really missed having a consistent place to call my own and I have had to learn how to maintain long term relationships.

And here I am, in the midst of yet another move. This is my third private practice space since moving to Austin. Each of the spaces I have been in previously have been utterly wonderful. But I grew out of each of them and found that I wanted and needed more. That part of me that understands that I will land on my feet, allows me to take the jump necessary to check things out. So, when the space wasn’t working, I started looking around and luckily, I found something I loved right away.

So, to all of my lovely clients who have followed me from space to space… thank you. Please know that I choose these spaces not only for myself, but also with each of you in mind. I want a space that is extremely conducive to the work that we do. Providing you with a safe, comfortable, creative space that we can meet in consistently is one of the most important things I do as a therapist. I don’t take that responsibility lightly.

And you will be pleased to know that there is plenty of parking. More pictures to come as I start moving in…

Mindfulness Challenge

Mindfulness is the idea of how we can be present in this current moment, and it is very much a skill that one needs to practice. Our days are generally full of worries about the future, regrets about the past, judgments and criticisms of others and ourselves, hurts and transgressions... it is no wonder that we are overloaded and have difficulty with the idea of being present.

So what happens when we are present? Perhaps by giving our brains a much needed break from all of those previously mentioned challenges, it allows for a decrease in feelings of anxiety and stress. We are able in those moments of mindfulness to opt for more positive coping strategies to regulate difficult emotions. It has also been shown that having a practice of mindfulness improves our working memory and our ability to focus.

Art has always been for me a mindfulness practice. It is the way that I most easily transcend rumination, and move to a place of presence. Art engages my senses, my brain, as well as my physical being in a way that allows me to submerge myself in what psychologist Mihaly Csikszentmihalyi describes as "flow"... a place of optimal experience and creativity. It is the medicine my psyche needs when the world is too much.

This morning, I woke up, and wanted to do a mindfulness experiment outside. I had recently received a macro-camera lens for my phone, but still hadn't used it. So, I pulled it out of the box and decided to investigate my backyard. I breathed in the fresh air. I watched how light and shadow fell across my yard. I noticed each thing closely. I used visual observation and focus as a means of being present. And I took some photographs. And it felt wonderful.

The Challenge:

Go outside. Take a deep breath in through your nose and out through your mouth. Notice your stomach moving with each breath. Smell the air around you. Feel the temperature. Engage your senses.
Now look around. Take in your surroundings. What interests you? Where do your eyes focus? What can you see? Notice light and color. Notice your own shadow. Take some pictures.
​-Deann Acton LMFT ATR-BC

This blog post was originally posted on another site, but wanted to have my posts in one place. Stay tuned! I will very soon be returning with DBT Art Therapy and Mindfulness Groups this fall!