DBT Certification Training Day 2

Mindfulness Review

  • Quick touch base and review before starting mindfulness activity.

  • Review homework from the previous night.

  • Address questions from the prior day.

  • Tech questions: Use the chat to contact Sid or connect with each other.

  • Schedule:

    • Breaks at 10:00 AM and 3:00 PM (give or take a few minutes).

    • Lunch from 11:50 AM to 1:00 PM.

    • End at 4:40 PM.

    • Breaks may be adjusted based on the material (e.g., showing a video).

  • Start with a mindfulness exercise.

Mindfulness Activity

  • Comfortable and relaxed position.

  • Focus on breathing: slower, deeper breaths.

  • Inhale through the nose, exhale through the mouth.

  • Notice body sensations; relax areas of tension.

  • Acknowledge the body for its care.

  • Address mind wandering by gently returning attention to the breath.

  • Picture a happy or thankful event from the day.

  • Focus on a small, joyful activity planned for the day.

  • Experience joy and peace.

  • Take a few more deep breaths.

  • Return awareness to the present and open eyes.

Homework Review and Sharing

  • Share experiences with mindfulness practice.

  • Examples:

    • Being present with children.

    • Cooking dinner mindfully.

    • Eating oatmeal with blueberries, noticing flavors.

    • Mindful driving and enjoying food.

    • Beach walk and sunset.

    • Gardening and rediscovering enjoyment.

    • Mindful weightlifting.

    • Brushing teeth mindfully.

    • Sitting with pets outside.

  • Mindfulness of Pets:

    • Describing the feeling of their fur.

    • Following their breath to regulate your own.

Announcements and Updates

  • Link to "It's Not About the Nail" video shared in the chat.

  • Link to mindfulness videos to be provided later.

  • Free Grief Summit (PESI) on April 29th and 30th with 12 free CEs.

  • Pessy Grief Summit: Google Pessy Grief Summit for the link.

Reviewing Mindfulness Skills

  • Review of what skills: observe, describe, participate.

  • Review of how skills: non-judgmentally, one-mindfully, effectively.

  • Observing: sensing without words.

  • Describing: putting words to events, important for communication and self-control.

  • Putting labels helps to regulate emotions.

  • Differentiate between thought and feeling.

  • Participate: wholly stepping into an event without self-consciousness.

  • Focus on everyday experiences, not just big events.

  • Example: kids jumping in puddles.

  • Beginner's mind: experiencing each moment as new.

How Skills Details

  • Non-judgmentally:

    • Not judging as good or bad.

    • Stick to the facts.

    • Move away from labels.

  • One-mindfully:

    • Focus on the current moment.

    • Not on the past or future.

    • If you're going to worry, then worry.

  • Effectively:

    • Doing what works.

    • Letting go of what we think is right.

    • Being skillful to achieve goals, reduce suffering, increase happiness.

The Farmer and Horse Story for Non-judgmental Stance

  • Horses escape, farmer says, "We'll see."

  • Horses return with wild horses, farmer says, "We'll see."

  • Son breaks leg trying to ride a wild horse, farmer says, "We'll see."

  • Military doesn't recruit son due to broken leg.

Qualities that Enhance Mindfulness

  • Beginner's mind.

  • Compassion (for self and others).

  • Tolerance.

  • Trust.

  • Patience.

  • Not striving (just doing the process).

  • Practice.

  • Mindfulness creates distance from thoughts.

    • I'm not good enough (feeling).

    • I'm having the thought that I'm not good enough (labeling the thought).

Practicing Loving Kindness

  • Visualizing a person; sending positive phrases.

  • Goal: cultivate compassion and loving feelings.

  • Mantra Example: May you be happy. May you be healthy. May you be safe. May you live with ease.

Guided Loving Kindness Exercise

  • Comfortable position with relaxed posture.

  • Awareness of body and breath.

  • Cultivating loving kindness towards yourself.

  • Remembering your basic goodness, kindness, and generosity.

  • Acknowledging natural desire to be happy and free from suffering.

  • Extending words of loving kindness to yourself (e.g., May I be filled with loving kindness. May I accept myself just as I am).

  • Extending loving kindness to a dear one (e.g., May you be filled with loving kindness. May you feel my love now).

  • Extending loving kindness to a neutral person.

  • Extending loving kindness to a difficult person, attempting to let go of resentment.

  • Extending loving kindness to all beings, humans and animals.

  • Returning awareness to yourself, basking in the energy of loving kindness.

Benefits of Loving Kindness

  • Decreases negative emotions.

  • Reduces self-hate.

  • Improves relationships.

  • Increases daily experience of positive emotions.

Research on Loving Kindness

  • Increases daily experiences of positive emotions.

  • Increases in mindfulness, purpose in life, social support.

  • Decrease in illness symptoms.

  • Increase in life satisfaction.

  • Reduced depressive symptoms.

Introducing Mindfulness to Clients: Procedure

  • Mindful position: seated, straight but relaxed posture.

  • Practice name.

  • Content of practice.

  • Explanation of mindfulness practice: gently bringing mind back, non-judgmentally.

  • Ask if there are any questions before starting.

  • Eyes open or closed option.

  • Use a bell or chime to signify the start and the stop of the activity.

  • Opportunity to describe and process the exercise.

Recommended Handouts (Mindfulness)

  • Observing thoughts.

  • Thought records.

  • Walking the middle path.

  • Taking hold of your mind.

  • DBT mindfulness skills.

  • Loving Kindness meditation script (fresno.va.gov).

Interpersonal Effectiveness Skills: Overview

  • Building and maintaining healthy relationships.

  • Ending destructive relationships.

  • Resolving conflict.

  • Getting needs met effectively.

  • Building self-esteem.

  • Relationships are complex, clients need help practicing.

Mindfulness Activity: Mayonnaise Jar and Coffee

  • A professor fills a mayonnaise jar with golf balls, pebbles, and sand.

  • The golf balls represent the important things in life (friends, family, passions).

  • The pebbles represent other things that matter (food, clothes).

  • The sand represents the small stuff.

  • If you put the sand in first, there's no room for the important things.

  • The two cups of coffee signify that there's always room for a couple cups of coffee with a friend.

  • Focus on what's truly critical in life.

Core Interpersonal Skills

  • DEAR MAN skills: building self-respect by setting boundaries and asking for needs.

  • GIVE FAST skills: building relationships, ending destructive ones, maintaining self-respect, validating others.

  • Therapist's role: practice skills with clients and give feedback.

Goals

  • Be skillful in a healthy way for achieving objectives.

  • Reduce suffering, increase happiness.

  • Achieve balance when asking.

Importance of IA Skills

  • All have to interact and need relationships to survive.

  • Belonging is a basic need.

  • Change and assertiveness involve distress.

  • Skills must be used with present awareness and mindfulness.

  • Emotional and assumptions impair effectiveness.

    • Definition for self-respect is a willingness to be responsible for one's own life.

    • Lack of self-respect

      • Isolation

      • No boundaries

      • Feel used

      • Don't feel respect

      • Can't be effective

      • Easy quiz online to determine strengths and values, use it to determine self respect.

        • Grounded in priorities , goals or values

      • Foundations for skills in other relationships.

Goal Clarifications

  • To use skills must know the importance of achieving ourjective must know to maintain or ending the right relationship

  • Must maintain self-respect as well

Impediments

  • Shame

  • Myths around relationships and how they are supposed to be or should exist

  • Client comes to extremes

    • all or nothing

    • Clingy then nothing

  • Not balancing self needs with others needs.

Three Potential Interpersonal Goals

*Objective Effectiveness: What will change.
*Relationship Effectiveness: How to have interaction done.
*Self-Respect effectiveness: how to help a person think of themselves during/after interaction.
*Remember the keyword is effectivess.

Dear Man Give Fast Main Points

  • What we use for building self respect using boundaries: Dearman skills.

  • How to end and maintain destruction while using self-respect we use give and fast.* (Mainly what we will be focusing on.)

  • Use mindful skills to pause, practice for a feeling or experience and practice

    • able to make an informed decision

  • The Goals

    • Skillful manner/ health way to reach objectives

      • balance for ones's own wishes or goals that lead to favorable outcome and not relationship gets damaged
        DEAR MAN
        Describe
        Express
        Assert
        Reinforce
        Mindful
        Appear confidient
        Negotiate

  • Description:

    • Not evaluating what the person is like or labels but stating what really happened

    • Example i was for two years without a raise vs, I been with you for two years without positive reviews and staying over time
      MIND MAN tips: It's about what we WANT and SAY, our assertive Skill

Core Of Fast

*Skill is the way to maintain a relationship

  • It is self-respect and we must stay true to values.

BE FAIR
NO APOLOGIES
STICK TO VALUES
BE TRUTHFUL.

  • The use of this is knowing WHAT and WHEN things are said in relationship is most helpful

    • Goal: reduce harm

    • Need to know what WE want.

Quick Video On Humour

*Show a funny video or clip to relieve intensity and give time to discuss the process
Balancing: Dialectics with IT

Dialectic: Finding the Middle Path

  • Too focused on self = unmet needs and conflict.

  • Need to follow back and fourth so other person isn't feeling taken advantage of *Balance: What does the other person need in this situation( GIVE skill):

    • What I in this situation( Use Dear Man Skill)
      *What do i need in this situation to maintain self-respect/ use values: Use FAST skill.