DISTRESS TOLERANCE – AN INTRODUCTION TO A DIALECTICAL BEHAVIOUR THERAPY (DBT) PRINCIPLE

laura on 11/09/2024

There’s no question that feelings can be highly, highly unpleasant. For many people, emotions can become so overpowering that they can compel us to do things we mightn’t be proud of – we can yell, throw things, or binge drink.

Many clients we see at Your Mind Matters struggle with big emotions – some clients report feeling emotionally dysregulated when they’re upset, and struggle to bring themselves back to a baseline, neutral state. It’s a common problem, and can lead to all kinds of difficulties.

This blog is about Distress Tolerance, which is a host of psychological tools that can help us when we’re struggling with truly overwhelming feelings. The goal of Distress Tolerance is not to eliminate an emotion, or even significantly reduce its intensity – instead, it’s about teaching us to tolerate the emotion, and withstand the urges that can come with it. It belongs to a kind of therapy called Dialectical Behaviour Therapy (DBT).

DBT is an evidence-based therapy for multiple forms of mental health challenges, and contains plenty of ideas that can be great for anyone’s emotional wellbeing. DBT breaks itself up into lots of different bits and pieces – one of these is a Skills component, that has Distress Tolerance as a sub-school inside it. You can think of DBT as a big book – Skills is a chapter, and Distress Tolerance takes up a few pages in that chapter.

Distress Tolerance is about asking yourself what behaviours your emotions urge you toward, with a particular focus on the kind of behaviours that lead to greater distress later on – i.e., make the situation worse. For instance, if you were a tennis player whose emotions led to an urge to smash your racquet against the court, your Distress Tolerance goal could be to reduce your racquet-smashing – because this will make you feel embarrassed or guilty later on, and avoid the competitive consequences that come with it. Note the player’s goal wouldn’t be to feel less angry, although this would be nice… instead, Distress Tolerance asks you to ride that emotion more effectively, and not make the feeling worse.

Other behavioural goals can be:

Not binge-drinking alcohol.
Not texting people with threats, sarcasm, or aggressive themes.
Not using drugs.
Not self-harming.

Distress Tolerance asks clients to build a Distress Tolerance Toolkit – i.e., a set of skills that include self-soothing, distraction, connecting with others, and mindfulness. Again, we’d hope these tools reduce the intensity of your feelings; but more importantly, we’d hope they lead to you tolerating your distress without engaging in life-worsening behaviour.

There are lots of methods and strategies DBT uses in their Distress Tolerance framework – many of them are available for free from their official website: (https://dialecticalbehaviortherapy.com/distress-tolerance/).

Some questions for your reflection:

Why don’t I like unpleasant feelings? Aside from being viscerally uncomfortable, is there something I’m worried the feelings will do to me? I.e., that I’ll lose control, or not be able to recover?

How do I deal with highly unpleasant feelings? If I watched myself living with difficult feelings on CCTV, what would I see myself doing?

Do I do things that make my life worse, or increase a sense of shame or guilt? What sort of things are they? Do I want to change these typical responses, and why?
Lastly – am I being too hard on myself? Often, clients say they ‘respond badly’ to certain feelings… but there’s nothing necessarily wrong with eating more chocolate than usual, or scrolling on your phone for a few minutes. If you want to change those things, that’s great – but it’s certainly not compulsory for good mental health.

This blog was written by Patrick (Paddy) Carey – Clinical Psychologist at YMM.

Paddy works with adults presenting with anxiety disorders, mood disorders, trauma and stressor-related disorders, obsessive-compulsive disorders, substance and gambling issues, psychosis spectrum disorders, and grief and loss. He is trained in Cognitive Behaviour Therapy (CBT), Acceptance and Commitment Therapy (ACT), Cognitive Processing Therapy (CPT), Metacognitive Training (MCT), and mindfulness approaches.

Paddy is focused on developing warm, trusting, and strengths-based relationships with clients. He recognises that his clients are the foremost experts in the room, and unearthing their own expertise is crucial to applying his skills.

To learn more about Paddy, check out the “Our Team” page on our website! https://yourmindmatters.net.au/our-team/

Postpartum depression

laura on 06/01/2023

Photo by Aditya Romansa on Unsplash

Parenthood tends to be talked about in glowingly positive terms. It is described as a beautiful, natural part of life that is all sweetness and light. In this glowing description of parenthood, it is important to remember that having a baby is a big change in life and adapting to this change can be difficult. Having sad or difficult emotions during adapting to a new life does not make you a bad parent! You are not alone. Having a baby is a profoundly powerful experience, and intense experiences tend to create big emotional responses.

How are baby blues different to postpartum depression?

Postpartum Depression is not the same as the typical ‘baby blues’ that occur around day 4 post birth. Generally, the baby blues are due to the hormonal changes going on in your body after giving birth, but it does not tend to last more than a few days.

“Baby blues” may make you feel irritable, moody, weepy, restless, or unable to sleep – or all of the above. These feelings often tend to pass as you gain confidence and get into some routines. In postnatal depression, symptoms last longer than 2 weeks, may be more severe and often interfere with your ability to function normally. Unlike ‘baby blues’, postnatal depression doesn’t usually go away on its own. This can be especially tough to cope with when you are recovering from birth and have a new baby to look after.

Signs of postnatal depression

Postnatal depression, also known as postpartum depression, is a type of mood disorder associated with childbirth. There is no single cause of postnatal depression, but physical and emotional issues may play a role. Physical issues include hormonal changes after childbirth and sleep deprivation; while emotional issues include feeling overwhelmed/anxious and having money, work or relationship problems.

Some common symptoms of postnatal depression include:

Losing interest or lack of interest in your baby
Fatigue (a feeling of heaviness)
Hopelessness and sadness
Feeling overwhelmed
Sometimes extreme thoughts such as that of suicide or self-harm or harming your baby (if you are experiencing any of these symptoms or know of someone that might be, please seek help from a medical professional ASAP)

Who can I talk to for advice and support?

Talk to your partner, or someone else you trust.
Ask your GP, midwife or child healthcare nurse for advice.
Call one of these support services:
- PANDA (Perinatal Anxiety & Depression Australia) — 1300 726 306
- ForWhen — 1300 24 23 22 (Monday to Friday, 9.00am to 4.30pm)
- Gidget Foundation — online and telehealth support — 1300 851 758
- Beyond Blue — 1300 22 4636

If you are going through difficulties and need to find your inner strength, why not give us a call today? Our team of highly skilled and well-experienced Psychologists are here to help.

This blog was written by Aanchal Sood – Psychologist at YMM.

Aanchal completed studies in psychopharmacology and psychology in England, and is fluent in both Hindi and Punjabi.

Aanchal has experience assisting adolescents, adults and couples to address a variety of difficulties including anxiety and mood disorders, grief and loss, trauma and stress related disorders, adjustment issues (e.g. cultural adjustment), sleep difficulties, relationship difficulties, schizophrenia spectrum and other psychotic disorders, obsessive compulsive and related disorders.

To learn more about Aanchal, check out the “Our Team” page on our website! https://yourmindmatters.net.au/our-team/

Major Depression – More Than Just Feeling Blue

laura on 12/09/2022

Photo by Jack Lucas Smith on Unsplash

Nowadays, people may use the word depression to colloquially describe several different feelings. These may include sadness, feeling down or upset, lethargy, or even a loss of motivation or care. Unsurprisingly, many people make these complaints, as the literature suggests that 20% of people experience some period of significant low mood at some point in their life, whether that be once in their life, sporadically or regularly.

What is Depression?

In a clinical setting, the term depression can refer to several different disorders, some of which may sound more familiar than others – e.g., Major Depressive Disorder (aka. Major Depressive Episode), Persistent Depressive Disorder (aka. Dysthymia) or Premenstrual Dysphoric Disorder (PMDD). The common feature of all the disorders within this group include the presence of sad, empty or irritable mood, as well as physiological, somatic and cognitive changes, which have a significant impact on a person’s ability to function day-to-day.

This blog will take a closer look into Major Depressive Disorder and the symptoms that we may not have been aware of that were indicators of disordered mood.

Factors that Contribute to Depression

A common misconception about depression is that it is a choice – something that we can just ‘snap out of’ or ‘go for a walk’ to get rid of. However, many factors can increase a person’s vulnerability to experiencing depression, and it is often a combination of these factors that lead to depressive episodes.

Biological Factors:

Genetics: Some people may inherit genes that predispose them to experience low mood and increase their vulnerability to depression.

Hormones: The literature indicates that our brain undergoes changes throughout depressive episodes, which can lead to over- or under-production of certain hormones, accounting for some of the depressive symptoms.

Neurotransmitters: Neurotransmitters are how our brain cells communicate with one another to regulate and control our whole body – including sleep, appetite, mood, libido etc. Research indicates that throughout a depressive episode there are reduced neurotransmitters, leading to dysregulation of normal functioning.

Psychological Factors

Thinking: Throughout a depressive episode our way of thinking and perceiving information tends to change. We adopt a more negative pattern of thinking – overstressing the negatives, self-blame, ruminating on past events and having difficulty perceiving hope for the future.

Stressors: Significant events such as bereavement, separation, a break-up, loss of a job/promotion, failure to obtain a goal, interpersonal conflict, health concerns, financial strains etc. can all contribute to, perpetuate or increase depressive symptoms.

Symptoms of Depression

Given the name, many people are aware of the mood changes that are associated with depression, however, given the biological and psychological factors at play, individuals suffering from a depressive episode also experience somatic/physiological, cognitive and behavioural changes.

Somatic/Physiological Symptoms:

Disturbed Sleep: Depression can impact our sleeping patterns in many ways. Whether that be in difficulty falling asleep, frequently waking up throughout the night or earlier than intended or even overly sleeping and having difficulty staying awake.
Weight Changes: Individuals may find that they are unintentionally losing or gaining weight due to fluctuations in their appetite – eating or snacking more, or loss of interest in food.
Energy: People often complain of feeling constantly fatigued or lethargic, regardless of the amount of sleep or rest they are getting. People around them may also begin to point out that they are increasingly agitated or restless or more slowed down.

Cognitive Symptoms:

Negativity and Pessimism: Depressed individuals often perceive themselves and their choices in a negative light – often viewing themselves as ineffective, worthless or unlikeable or loveable – which impacts their self-esteem and can lead to excessive guilt.

Recurrent thoughts of Death: A common and distressing symptom of depression is recurrent thoughts of death. This can range from suicidal ideation such as “it’d be less of a burden if I wasn’t here” to a specific plan for committing suicide.

Behavioural Symptoms:

Withdrawn: The cognitive changes experienced throughout a depressive episode can lead to people being more withdrawn or isolating themselves due to beliefs that they are “stupid”, “dumb”, “broken”, “a burden”
Diminished Enjoyment: Individuals may find themselves losing interest or pleasure in all, or almost all, daily activities and usual hobbies nearly every day.

If you or anyone around you has experienced these symptoms, know that you are not alone. There are several services available to support you, including crisis lines, a GP, a school counsellor, or an Employment Assistance Program (EAP) through your workplace. To engage with one of our friendly psychologists at Your Mind Matters Psychology, feel free to reach out to our admin team for further information on 9802 4654.

Resources:

https://www.beyondblue.org.au/

Crisis Lines:

Beyond Blue: 1300 22 46 36

Suicide Call Back Service: 1300 659 467

Lifeline Text: 0477 13 11 14

This blog was written by Simone Chaochalakorn – Psychologist at YMM.

Simone has experience working in a variety of contexts, including working with young children in primary schools, as well as adolescents in clinics. Alongside this, Simone has also assisted adults and seniors with concerns such as work-related stress, relationship difficulties, anxiety and low mood. Simone uses a client-centered approach, in which she strives to understand each individual and their unique problem, in order to find the most effective strategies to help them.

To learn more about Simone, check out the “Our Team” page on our website! https://yourmindmatters.net.au/our-team/

So….what is CBT exactly? (Podcast Episode!)

laura on 01/05/2022

Understanding Your Thoughts

laura on 21/03/2022

Simply put, thoughts are our opinions and beliefs about ourselves, others and the world around us. Thoughts can be experienced in different ways. Some of us think in the form of ‘words’, images/pictures, or even both. We all have that ‘voice’ in our head that helps us process events that are unfolding around us. Sometimes our inner self-talk can be very positive, supportive and encouraging, almost like a cheerleader. However, at times it can be very critical. You may have heard of the term ‘the inner critic’; this is the part of you that scrutinises/judges you. It may, for example, tell you that you ‘should’ do better or that you’re failing in life.

A big part of therapy is to shift our thinking. Now we have all heard the term ‘positive thinking’. We might be going through a tough situation and in an attempt to help, a friend or loved one may tell us “STOP thinking so negatively and think more positively!!”. Easier said then done, right?! We first need to understand our thoughts, before we can start to shift them. Most importantly, we need to understand what has led us to form that interpretation of the situation/event at hand, ourselves, others or the world.

Let’s start at the beginning… First and foremost, you CAN NOT stop yourself from thinking! The more you tell yourself to ‘stop thinking’ the more you think that thought! Have you ever had a song stuck in your head? I bet the answer is YES! And your mind sings it over, and over, and over! It becomes annoying, right? And the more you try to ‘get rid of’ that song, the more your mind keeps replaying it. Eventually, you may decide to stop fighting it and allow your mind to ‘sing’, you allow the song to be there, and go on with your day, focusing on what is important to you. And alas… IT GOES AWAY!!

Above, I mentioned that thoughts are words/pictures/images. I want you to keep this in mind. Thoughts in and of themselves do not have any meaning; they are words/pictures/images formed in our mind about our interpretation of a situation. We are the ones who give our thoughts meaning…we think them and automatically believe them to be true. Just because you think something, it DOES NOT make it true. For example, if you had the thought “I’m not a good friend”, that does not make it a fact.

We can often get caught in ‘thinking traps’. These are also referred to as cognitive distortions. Thinking traps are inaccuracies in thinking which are often very unhelpful and get in the way of us viewing a situation more objectively. Here are some common thinking traps:

Mindreading – We believe we know what others are thinking, and they have a negative opinion of us. The truth is, we can’t possibly know what someone else is thinking as we are not mind readers.
Fortune telling – When you tell yourself that something won’t work out; almost like you are predicting the future.
Black and white thinking – Viewing situations/events in terms of extremes and not seeing the in-between. For example, seeing things as either good or bad, a success or a failure.
Catastrophising – Telling yourself that the worst thing imaginable will happen and you won’t be able to cope.
‘Should’ statements – Placing standards on how you ‘should’ or ‘must’ behave/think/feel.
Overgeneralisation – Thinking in terms of ‘always’ or ‘never’. For example, “I can never get anything right”.

Rather than refer to our thoughts as ‘positive’ or ‘negative’, I personally prefer to use the terms ‘helpful’ or ‘unhelpful’. Ask yourself, is it useful for me to think this way? Does this help me to live by my values and purse my goals? In the same way that we stop trying to ‘get rid of’ the songs stuck in our mind, we want to start making choices towards not engaging in our thoughts or getting stuck in the trap of ‘believing them’. Instead, we want to start noticing them more mindfully.

Our thoughts can be quite powerful and influence us in many ways. If you would like some support to shift your thinking to be more helpful and aligned with your values, our team of psychologists are here to help.

This blog was written by Maria Kampantais – Psychologist and Clinical Registrar at YMM.

Maria has been consulting at YMM for many years and enjoys working with clients through the use of evidence-based therapies such as Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), mindfulness techniques, Motivational Interviewing (MI), and Solution Focused Therapy (SFT).

To learn more about Maria, check out the “Our Team” page on our website! https://yourmindmatters.net.au/our-team/

Importance of Self-Compassion

laura on 26/07/2021

At some point in our lives, we all have heard the phrase that ‘charity begins at home’! Most of us accept it and even preach it to others when the opportunity for sharing wisdom arises (yeah, we are good at that!). The essence of the above phrase is seated in the value of compassion or kindness towards others. Compassion is empathy, kindness and understanding for others during suffering or challenging times.

So, I have a question for you – have you ever heard that ‘compassion starts with self?’ Probably, not, aside from that fact that I made the phrase up. Chances are that self-compassion is an alien concept and only comes into our lives through social media memes. So let me give you a brief snap shot and advocate the case for ‘self-compassion’ as an essential in our lives.

A simple google search will define ‘self-compassion’ along the lines of empathy, understanding and kindness towards one’s own self, when big or small life challenges happen. Kristen Neff, the world’s leading researcher on self-compassion, has identified three main components to it:

1. Self-kindness vs Self-judgement: treating ourselves with kindness and understanding when we fail, suffer or feel inadequate as opposed to ignoring our needs or belittling ourselves

2. Common-humanity vs Isolation: remembering that everyone fails and suffers at times and that we are not the only ones.

3. Mindfulness vs Over-identification: taking a balanced approach to our challenges and emotions, without over-identifying with heavy emotions or situations.

Kristen’s research has contributed significantly to understanding the importance of practicing self-compassion in daily life and more so when experiencing mental health challenges. Self-compassion also forms a crucial part of my own therapy model and aims at supporting and empowering clients, by helping them connect and understand their own emotions and situations. A simple activity that I encourage client’s to do is to treat themselves at the end of the day, each day. This can be as simple as listening to some music, having a cuppa or going for a walk. Practice makes one perfect!

So, I invite you to explore self-compassion for yourself and incorporate it in small ways within your daily life. Self-compassion will be the strongest script that you can have for yourself. If you would like to work on further developing your skills, our psychologists at Your Mind Matters will be happy to assist you.

Source: self-compassion.org

This blog was written by Prabha Mishr, psychologist at Your Mind Matters Psychology Services. She works with us 2 days per week (day sessions).

Prabha is passionate about building strong rapport with clients and establishing a collaborative relationship. As a practitioner, her belief is that ‘no one size fits all’ and so uses a combination of psychoeducation and research-based interventions such as Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT) and play-based therapy to help support clients to reach their goals.

Dealing with a diagnosis of bipolar disorder

laura on 01/10/2018

Bipolar Disorder is a mood disorder characterized by episodes of depression and mania. You may know this condition by its former title, “manic-depression”.

Like any physical health condition, sharing a diagnosis of a mental health condition with family and friends is of paramount importance. Given the nature of bipolar disorder, where depressive episodes may contribute to isolation and manic episodes may lead to impulsive decision making, open communication can not only help better manage your symptoms but also reduce stigma. Here are some suggestions to better communicate your diagnosis:

Educate family and friends: Important people in your life may have limited knowledge about bipolar disorder and are likely to have some misconceptions around the condition. Educating them will not only address any myths around the condition but will create a better support network. Remember to remain calm and avoid being defensive. As frustrating as it can be that you loved ones may not understand your illness, keep in mind that at first, it probably took you a while to understand it. Direct your friends and family to important websites where they can learn more and talk to them about your treatment plan. If you feel you need their support to cope with the condition, openly share these feelings with them. Your ability to educate them will normalise your diagnosis and open gates of further communication. Give them the official definition, and credit the source, rather than relying on misconceptions and myths, your family and friends will turn to you to clarify and ask questions.

Create a support team: Decide a list of people who you think will benefit from knowing and understanding the diagnosis. Openly share your symptoms with your support team and let them know what type of support you may need. Preparing them will only ease the process of receiving support.

Building acceptance & setting boundaries: Acceptance from others that you may not be able to make sound judgements during episodes of depression or mania can ease the process of asking for support. You could benefit from using your support network and have people looking out for you. But it’s equally important to set some boundaries so that you don’t feel that you are always being watched. Hence why openly talking about creating a plan around acceptance of your condition and setting boundaries with loved ones will help better manage your condition.

It’s important to remember that bipolar disorder can be a lifelong condition and therefore is likely to involve ongoing conversations. However remember that with better treatment, and learning new coping skills, the effects of bipolar disorder will diminish in your life. It’s best not to feel frustrated by constant questions about what it’s like to live with bipolar disorder, the ones that ask probably ask because they care. The more you embrace it, the easier it becomes to communicate about it.

If you are going through difficulties and need support, why not give us a call today? Our team of highly skilled and well-experienced Psychologists are here to help.

This blog was written by Aanchal Sood, Psychologist at Your Mind Matters.

Aanchal completed studies in psychopharmacology and psychology in England, and is fluent in both Hindi and Punjabi.

Aanchal works with us 1-2 evenings per week.

World Suicide Prevention Day

laura on 07/09/2016

World Suicide Prevention Day

10^th September 2016

The World Health Organization estimates that over 800,000 people in the world die by suicide each year – that’s one person every 40 seconds.

Facts about suicide in Australia

Suicide is the leading cause of death for men and women between the ages of 15-44
The population death rates are around 10/100,000 people every year
Annual number of deaths by suicide in Australia is around 2,500 each year
65,000 plan or attempt to take their life each year
400,000 people think about taking their life each year
The Global Burden of Disease Report cited 36 million years of healthy life were lost as a result of suicide in 2010

The tragic ripple effect means that there are many, many more people who have been bereaved by suicide or have been close to someone who have tried to take his or her own life, as well as those struggling to manage suicidal ideation.

World Suicide Prevention Day events occurred in local communities across Australia. Check out the Events page to see what’s happened near you. To find out about events planned across the globe, go to the International Association for Suicide Prevention (IASP) page: http://wspd.org.au/events/

IF YOU NEED HELP

Getting through difficulties on your own can be difficult. Talk to friends, family, your doctor, other health professionals or a telephone helpline about your substance use. The following will provide help and assistants and point you in the right direction if you need further help.

Suicide Call BACK 1300 659 467, support if you, or someone you know, is feeling suicidal.
Kids Help Line (age 2-5) 1800 551 800, to talk to someone about anything that’s going on in life.
Life Line 13 11 14, support and advise in as personal crisis.

Coping with Bereavement

laura on 04/08/2016

Bereavement affects people in different ways. There’s no right or wrong way to feel.

Experts generally accept that people usually move through four stages of bereavement:

accepting that your loss is real
experiencing the pain of grief
adjusting to life without the person who has died
putting less emotional energy into grieving and putting it into something new (in other words, moving on)

You may go through stages, but you won’t necessarily move smoothly from one to the next. You may even get stuck at a stage. Your grief might feel chaotic and out of control, but these feelings will eventually become less intense….with time How long you ask? Good question, and there is no answer; grief is experienced differently among individuals, and unique to each loss.

You might feel:

Shock and numbness (this is usually the first reaction to the death, and people often speak of being in a daze)
Overwhelming sadness, with lots of crying
Tiredness or exhaustion
Anger, for example towards the person who died, their illness or God
Guilt, for example guilt about feeling angry, about something you said or didn’t say, or about not being able to stop your loved one dying
Some people become forgetful and less able to concentrate.

Coping with grief

We all cope with grief differently, and what is helpful varies from person to person. You may try:

Talking and sharing your feelings with someone is often the most helpful thing you can do. You may speak with friends, family, colleagues, or a healthcare professional (e.g. psychologist, psychiatrist, GP).
For some people, relying on family and friends is the best way to cope, But if you don’t feel you can talk to them much (perhaps you aren’t close, or they’re grieving too), you may benefit from engaging in self-care activities. These may include: exercise, pampering, going for a long walk, visiting a much-loved place, reading a book, walking the dog. Self-care is all about you, and doing what you enjoy or find relaxing.
If distraction works well for you, get busy and productive!

If you’re out of ideas for self-care, head here: http://elishagoldstein.com/assets/183-pleasurable-activities-to-choose-from.pdf

Most importantly, be patient and compassionate, with yourself and others.

If you are having trouble with a loss, give our team a call and arrange a consultation with one of our psychologists.

World Suicide Prevention Day

10th September 2016

IF YOU NEED HELP

10^th September 2016