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A Wise Mind

Nina Kaweblum

Ever get hijacked by your emotions? With the right skills, says therapist and DBT educator Nina Kaweblum, you can actually regain control of your emotions and respond with grace instead of impetuosity

Wednesday, April 26, 2017

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GOOD MOM, BAD MOM Thinking dialectically can improve your self-esteem because it turns your inner critic into an inner coach. How? By viewing two opposing ideas in your mind through the lens of “Both-And” instead of “Either-Or.” For example, instead of “Either I’m a perfectly calm mother or I’m a horrible mother,” your dialectical self-image can be: “I’m a loving mother and at the same time I have to stay calmer during the morning rush”

W e’ve all had the experience of acting from our emotions. We yell, we withdraw, we engage in harmful behaviors like overeating. Then we’re stuck with the resulting mess, like distanced relationships, loss of self-esteem, and guilty feelings — not to mention that we still haven’t dealt with the original problem. We resolve never to act that way again… until the next time, when, flooded with emotion, we revert back to our “go to” reaction.

In theory, we know we can grow, even transform ourselves — that’s the whole premise of teshuvah. But in practice, we’re often left wondering How do I get from here to there?

Dialectical behavior therapy (DBT) was created to help people do just that. It not only equips people with skills to break out of their old patterns and develop new ones, it also teaches people how to use these techniques even when they’re feeling a torrent of emotion.

And it works. Marsha Linehan, the creator of DBT, was just selected as the 2017 Grawemeyer Award winner for her contribution to psychology. Time magazine included DBT as one of the 100 New Scientific Discoveries in 2011, describing it as “a treatment with evidence of efficacy that works and gives hope for clients.”

Almost 25 years of research has shown DBT to be effective for previously untreatable conditions characterized by impulsivity, interpersonal problems, and self-destructive urges (such as borderline personality disorder) as well as eating disorders, anxiety, depression, substance disorders, and trauma. It’s also the “gold standard” therapy for suicide and self-harm. One of the most important developments in DBT over the past ten years is DBT-A (for adolescents), which helps teenagers stop risky and self-harm behaviors, as well as improve difficult relationships with parents and peers.

DBT isn’t just for problems; it’s also for prevention. Schools across the country — including Bet Yaakov of Jersey Shore in Deal, where I teach DBT Skills programs when I’m not running my private practice — are offering DBT Skills training as a regular class to all middle school and high school students, not only “problem” ones. In these classes, teens prepare to deal with stressful situations (for example, a fight with a best friend, too many assignments in too little time), and intense emotions (like anxiety, anger, shame). Instead of flipping out and then acting out (saying nasty things, cheating on a test, drinking, etc.), teens learn to problem-solve (for instance, finding a solution that both they and their friend are happy with, or learning how to organize their time better).

At first glance, issues like impulsivity, eating disorders, personality disorders, substance abuse, anxiety, and depression seem very different, some even opposites. But they all have a common thread: out-of-control emotions, which make a person either act imprudently, or shut down. The goal of DBT is to learn how to process intense, overwhelming feelings so we can respond in an emotionally healthy way instead of slipping into a downward spiral of destructive thoughts, feelings, and actions.

Amygdala Hijack

Even when we consciously want to act one way (stay calm, explain our point clearly, say no), we sometimes do the exact opposite (yelling, eating chocolate cake, caving in). What happens from point A to B that leads to the disconnect between what we want to do and what we actually do?

DBT teaches that your mind has three ways of operating: Emotion Mind (emotions control your thoughts and actions), Reasonable Mind (logic and facts control your thoughts and actions), and Wise Mind (emotions and logic work together to control your thoughts and actions).

When there are conflicting views or needs, ask yourself, “What am I missing?” or, “Why is my husband thinking so differently from me?” You don’t have to agree with him, but to reach a win-win solution, you need to at least understand his perspective

Let’s say, for instance, that your sister criticizes your housekeeping. Your experience of her comment first occurs in your brain’s emotion center, the amygdala. You then react emotionally, maybe with anger, as in “How dare she!” or with shame, as in “I’m a mess,” or with actions, as in eating half a chocolate cake, yelling at your sister, or responding in any other way to numb your pain. Afterward, you’re left with the same problem (a messy house, feelings of anger and shame), plus new ones (all of the above + fight with your sister + weight gain + guilt about your other actions + feeling bad about yourself).

When you’re stuck in this part of the brain, experts call it an “amygdala hijack,” or in DBT terms, you’re stuck in Emotion Mind, with your negative feelings, your impulsive actions, and all the resultant problems.

What if you don’t get stuck in your emotions? Then your brain sends messages to your prefrontal cortex, your brain’s logic center, which by definition reacts logically to the situation — e.g., “I have a bunch of pots soaking in the sink from Shabbos. My floors aren’t clean. I was too busy with other things — taking care of the kids and helping my husband — to get the house back in shape.”

Note the lack of emotion — it’s all about facts. If you act on only your Reasonable Mind and try to ignore or dismiss your Emotion Mind, you may not feel regret at the moment, but you’ll most likely be stuck with your negative emotions, festering under the surface, waiting to explode in the near future.

Ideally, your brain won’t stop at the Reasonable Mind — contrary to popular belief, pure logic and reason are not our ultimate goal. Instead, the prefrontal cortex and the amygdala need to communicate with each other. This is what DBT calls Wise Mind, because it combines the benefits of emotion with those of logic, and helps a person make wise, effective choices based on both parts of the mind. It’s the “Aha!” moment when we hit the balance between our emotions and our reason and we find a solution that our intuition tells us has a good chance of working.

For instance, your Wise Mind might tell you, “It feels bad that my house isn’t always perfectly clean and I don’t like my sister’s comments (emotion). At the same time, if I keep my house as clean as my sister’s, I’ll have less time with my children and husband (+ logic). I know I’ll find a moment when they don’t need my attention, and then I’ll work on those pots (= Wise Mind, a decision based on both emotions and the facts).”

Wise Mind can’t work without emotions — that’s because emotions serve a vital purpose: They give you information that your reasonable mind might miss. You’re also more motivated when you have an emotional stake in something. Additionally, if you say something in a nonemotional tone of voice, even if you say it’s urgent or really important to you, the listener won’t take you as seriously as they would if you’d said it with emotion. People read your tone of voice, facial expressions, and body language more than they listen to your exact words.

Let’s look at another scenario: Your 12-year-old daughter’s skirt is too short. She refuses to stop wearing it because it’s her absolute favorite and tries to convince you that if she sits and moves in a certain way, it’ll be okay. This is what your internal dialogue might look like:

Emotion Mind: “She needs to give away that skirt immediately! She has to follow halachah! She’s going off the derech — I have to stop her!”

Reasonable Mind: “Her skirt is too short. Getting into a power struggle will only make things worse.”

Emotion Mind (interrupting): “Who cares about not getting into power struggles? This is an emergency and I have to solve it — now!”

Imagine if the internal exchange stopped here and you responded impulsively. How effective would it be — and how much repair work would be required to fix all those hasty words and actions?

If you instead accessed your Wise Mind, it might sound something like this: “I need to teach my daughter why this is so important (emotions) and show her why her skirt needs to be longer, without anger or panicking (+ reason). I need to do this in a way that she’ll listen and it won’t hurt our relationship — I’ll first validate her feelings and recognize that it’s hard for her to give up a favorite skirt, then I’ll speak sincerely about why it’s so important to wear skirts that are an appropriate length, and then I’ll suggest adding on to her skirt or finding a new one she loves just as much” (= Wise Mind, where you take everything into consideration — your wanting your daughter to keep halachah, your daughter’s wanting to keep her skirt, and your wanting to maintain a good relationship).

Six Ways to Develop the Wise Mind

If you’re like many of my clients, you’re probably thinking, I’m supposed to think logically when my feelings are raging and I’m stuck in Emotion Mind? Really?? And the answer is, Yes, really!

To move from Emotion Mind to Wise Mind, DBT offers six mindfulness skills, divided into three What skills (what you do) and three How skills (how you do the What skills). (Excerpted from Family First, Issue 539)

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