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Why DBT Skills Training?

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young people being used computer. education and technology concept.Dialectical Behavior Therapy (DBT) is a proven therapy for all mental health issues that include emotion dysregulation as a symptom.  Dysregulation is when someone is having difficulty managing their emotions.  Unrelenting depression and anxiety, bipolar disorder, borderline personality disorder and OCD are just a few of the disorders that respond well to DBT therapy.  However, anyone experiencing emotional dysregulation benefits from DBT skills training.

When someone is having suicidal thoughts or self-harming, that is a clear sign that they do not know how to manage their emotions and that they could benefit from DBT skills training.  It is also true that emotion dysregulation can be recognized when people develop ineffective coping mechanisms for dealing with emotions.  Those ineffective coping mechanisms include things like isolating, over/under eating, lashing out, self-medicating, avoiding, or self-invalidating instead of effectively recognizing and managing the emotions.  A goal of DBT is to recognize and manage our emotions effectively so we can ultimately “create a life worth living”.

DBT Skills Training covers four major themes.  They are Core Mindfulness Skills, Distress Tolerance Skills, Emotion Regulation Skills and Interpersonal Effectiveness Skills.  Core Mindfulness Skills are taught as the foundation to all DBT skills.  Mindfulness Skills teach us to “pay attention”.  If we are not paying attention to our emotions, our thoughts, our bodies, or what is going on around us it is impossible to effectively choose skills to manage the situation.  It often surprises people how little they are paying attention and they realize that is why it feels that their extreme emotions come out of nowhere.  Mindfulness Skills are taught throughout all DBT modules.

The first module in DBT Skills Training is Distress Tolerance.  Distress Tolerance Skills are skills that are used in a crisis, so we do not act on an urge that will make the situation worse.  These skills do not improve our situation they just help us get through the crisis.  This module is 8 weeks in length.

The second module is Emotion Regulation Skills.  These skills help us to recognize and name our emotions accurately, so we can respond appropriately to what those emotions are telling us.  We also learn how to decrease our vulnerability to heightened emotions and we learn how to change unwanted emotions or emotions that do not match the facts of a situation.  This module lasts for 9 weeks.

The final module is Interpersonal Effectiveness.  In this module we learn how to more effectively communicate our needs while maintaining relationships and our self-respect.  We learn how to find friends, get them to like us, and then build communication skills necessary to maintain those relationships.  This module lasts for 7 weeks.

If you or someone you know could benefit from DBT skills training, call the Summit to schedule an assessment to find out more and to see if you are a good candidate for the classes.

Parenting: Before You Fix It, Sit With It

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Mother and teenage daughter having an arguumentMuch like a wife desires a husband to hear about her day before coming up with solutions for her daily difficulties, our children desire the same from parents.

Too often we as parents accelerate past the consoling portion of the parenting process (because nothing is more painful for a parent than seeing the pain and anguish in our little loved one’s eyes…), but when we cheat this part of the process – underwhelming results occur.

To the chagrin of every work-smarter-not-harder person out there, a parent can come up with the most brilliant advice on the planet to a struggling son or depressed daughter, but it won’t land as well if that same child feels alone or sees him or herself as some problem to be fixed.  We must first sit in the trenches of our just-returning-from-school kid, open our ears, and quench our curiosity to each child’s uniquely daily experience.  That means being sad with them when they did poorly on a test, sharing in their frustration in being assigned too much homework, and getting angry with them when they feel slighted or unimportant with their group of so-called friends.

Joining our children in their pain gives a parent credibility in their eyes – credibility that they cared enough to sit with them through their ranting and raving, and credibility in not coming across as another know-it-all adult whom knows how to find a solution before the problem has a chance to be fully unpacked.

Make your children the expert on their crappy day, and they just might listen to your expertise on how to get through it next time.

10 Quotes That Give My Mind (and Mood) A Boost

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Woman climber success silhouette in mountains, ocean and sunsetJust like tiny particles of pollen that impair our physical health each spring, one intrusive thought can undermine our mental health no matter the season. A negative thought or judgment can leave our mind a little fuzzy and have us feeling low and disengaged. Through Cognitive-behavioral therapy (CBT), we can notice these unwanted thoughts and their effects on our mood or body. Then, we can choose to focus on another, more empowering idea to lift our mood and improve our mental clarity.

Wherever you are, and whatever you are going through I hope you find one of these ten quotes helpful as you journey through this moment and today.

Happiness can be found even in the darkest of times, if one only remembers to turn on the light. — Albus Dumbledore from “Harry Potter and the Prisoner of Azkaban”

There’s only us. There’s only this. Forget regret, or life is yours to miss. No other road. No other way, no day but today. — “No Day But Today,” Rent

Start by doing what’s necessary, then do what’s possible; and suddenly you are doing the impossible. — Saint Francis of Assisi

Even if we don’t have the power to choose where we come from, we can still choose where we go from there. — Charlie from “The Perks of Being a Wallflower”

Just keep swimming. — Dory from “Finding Nemo”

Be not afraid of life. Believe that life is worth living, and your belief will help create the fact. — William James

Peace is the result of retraining your mind to process life as it is, rather than as you think it should be. — Wayne W. Dyer

“I wish it need not have happened in my time,” said Frodo.
“So do I,” said Gandalf, “and so do all who live to see such times. But that is not for them to decide. All we have to decide is what to do with the time that is given us.” —  J.R.R. Tolkien from “The Fellowship of the Ring“

Smile, breathe and go slowly. — Thich Nhat Hanh

Unless someone like you cares a whole awful lot, nothing is going to get better. It’s not. — Dr. Seuss from “The Lorax”

There are far, far better things ahead than anything we leave behind. — C. S. Lewis

 

The Summit has a team of counselors who can help you identify and dispute unrealistic or unhelpful thoughts and develop problem-solving skills. This type of treatment is beneficial for most people who suffer with depression, anxiety, post-traumatic stress disorder, eating disorders, obsessive-compulsive disorders, and many others. To learn more or to schedule an appointment, call the front office at 678-893-5300 or visit us at www.summitcounseling.org.

DBT’s Guide to Self-Soothing

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Beautiful young woman at home drinking coffee reading a bookDialectical Behavior Therapy (DBT) is a specialized type of cognitive therapy that focuses on helping individuals regulate their emotions, tolerate painful emotions, and maintain relationships with others. One of the skills DBT focuses on is self-soothing. Self-soothing is your ability to cope through a situation without the help of others. It’s helpful and important to be able to self-regulate and soothe your own emotions related to a stressful or irritating event.  You can think of self-soothing skills like having your own tool kit to get through distressing situations that may trigger feelings of anxiety, depression, loneliness, sadness, boredom, stress, or anger. There are many ways you can self-soothe, but let’s talk about soothing with the 5 senses to get your started. You can even try putting together a self-soothing kit to use when you need it!

Taste – Try getting a cup of tea or a piece of your favorite candy. Notice what the tea or candy tastes like.

Touch – Wrap yourself in a warm, soft, fuzzy blanket or sweater. What does the blanket feel like on your body? What does the texture feel like? Is it soft on your skin?

Sight – Pick a picture of a happy memory. Observe the photo and notice what feelings or thought occur. Describe the memory to yourself or continuing observing the photo.

Hearing – Put on your favorite song by using your phone. Listen to the words or the instrumental parts of the song. Notice any feelings, thoughts, or physical sensations that come up.

Smell – Use your favorite perfume, cologne, scented lotion, or essential oil. Smell the scent and notice what thoughts or feelings come up for you. You might remember a happy memory or you might feel relaxed.

If you or a loved one are struggling to regulate your emotions, handle painful emotions, or maintain relationships please consider calling The Summit Counseling Center to schedule an appointment with an Intensively Trained DBT Therapist or get information about our DBT Skills Groups by calling 678-893-5300 or contacting us via our website www.summitcounseling.org.

Changes and Transitions Happen Faster than We Want!

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Father help his son ride a bicycleLet’s face it, children are always growing up too fast and going through different points of transition that may be harder than others. Sometimes during different times of change it can cause anxiety or sadness for kids because they do not know how to handle it. We want to be able to support our children but also foster the idea that they can handle the growth independently as well. With all these thoughts we hear a lot of questions from parents such as: What do we do with all these changes? How do we foster the independence at home, class, and with friends? I can tell my child is not handling the transition well and is anxious or sad about….​ but what do I do? How can I tell if the anxiety or sadness has become problematic or if it is just growing pains? ​ These can all be normal questions to ask, and now let’s talk about a few tips.

During periods of change, kids are experiencing a lot of “firsts” that may cause new worries or periods of sadness when things do not go the way it is planned. These feelings can be normal and by recognizing this can help validate what kids are experiencing. These feelings will more than likely decrease after the transition period is over and children feel more confident in what they are facing.  If you do not see worries or sad thoughts lower and even increase or spread, then it may be time to find extra support. By seeking support, children can learn tools to help their worries or problematic behaviors lessen.

Change can be a great period of learning and finding levels of independence for children. It can be hard to watch children struggle at points during transitions, but knowing they are in a safe and supportive environment can also help them learn from mistakes when they happen. This allows parents to resist the urge to “save the day” or fix the problem for the kids. By not fixing but coming alongside the children in their worries, can build self-esteem and allow kids to know they can handle their worries with confidence. When a problem does happen, it can be helpful for parents to “problem solve” the situation away. This can look like talking to kids and asking what they think went well or what they want to change next time to make the problem go away. This idea can give confidence to be able to handle the next experience with ease. When you notice your child is beginning to experience worries or sadness because they are going through a development change, change in friendships, or another transition continue to show support by practicing coping skills and monitoring if their feelings are decreasing as they adapt to their new surroundings.

The Mask of Anger

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Mother and daughter“Why is my teen so angry?” is a common question raised by parents as their previously even-tempered child’s mood starts to vacillate between apathy and moodiness. This period can be particularly challenging for parents who are resolved to believe their child is just being defiant or may take their child’s behavior personally. However, the following possibilities should be considered to inform next steps.

Is my teen depressed? When people think of depression they often think of crying spells and low mood. Although those are consistent with depression in teens, depression tends to present differently, as depressed teens often appear angry. Teens are much more prone to emotional outbursts, frustration and hostility than adults because they lack the emotional regulation skills to manage their feelings in healthier ways. Additionally, admitting to feelings of sadness can be particularly vulnerable for teens and they may view anger as a more appropriate expression of their feelings. Moreover, teens who experience bullying in addition to all the other challenges during this time are particularly at risk. Teens who are bullied can experience feelings of loneliness, low self-esteem, and fear, which can have significant impacts on their well-being. Furthermore, the hormonal changes teens experience may make them more susceptible to emotional wear-and-tear.  It can be challenging for parents to differentiate depression from typical teenage angst since irritability and moodiness tend to be features of normal adolescence. While anger is a normal emotion, when you start noticing marked differences in your teen’s attitude and behaviors professional help might be warranted. Be mindful of changes such as lashing out, making verbal threats, becoming destructive, and engaging in physical violence that cause significant distress and problems across settings (e.g. home, school social life).

Is my teen asserting their independence? Adolescence is characterized by a period of identity development and learning how to navigate the world independent of parents. For that reason, adolescence can be marked by feelings of frustration and confusion. It should come as no surprise that this can be a difficult period for the parent-child relationship as children are attempting to pull away from their parents and parents feel like they still have so much to teach their children. This push-and-pull dynamic is often seen as negative by parents, but perhaps reframing this stage as assertiveness building would be helpful. Parents should model and encourage assertiveness as a way for their child to express their feelings in an effective and non-threatening way. Assertiveness training can be beneficial in helping teens channel their frustrations into something that works for them instead of against them. Professional services can be an invaluable resource to help teens learn the assertiveness skills necessary to navigate the journey that lies ahead.

Is my child stressed? Adolescence can be a particularly tumultuous stage for teens when they are dealing with challenges such as graduating from high school, entering the workforce, starting college and being away from home for the first time. This stress and uncertainty can be overwhelming for teens which can manifest into anger.  Simply talking to teens and helping them brainstorm solutions to their problems can be helpful in this regard.

What can parents do?

  • Keep the lines of communication open. Having a safe, non-judgmental person that teens can talk to is critical. It provides them with someone they can express their frustrations with that will validate their experience.
  • Give teens space to assert their independence and form their identities. Identity formation is a huge part of adolescence and being given the latitude to figure out what kind of person they want to be is essential.
  • Give teens space to make mistakes. It is inevitable that with emotions and tensions running high, teens are going to make mistakes. However, each mistake is an opportunity for growth and making amends, a skill that will be useful in adulthood.
  • Seek professional services for your child if needed. Sometimes problems related to anger are beyond the scope of parents’ skill set. In these instances, it is best to rely on the expertise of professionals who can give your child the necessary skills to manage their emotions in healthy ways.

While anger is a normal emotional response to stress, it is imperative that teens learn healthy coping mechanisms before they reach adulthood. Most importantly, teens need to know that it is not wrong or bad to feel angry, but when that anger consumes them or controls their actions, it becomes problematic. Anger is rarely about defiance and almost always a mask for something else going on in the child’s ecosystem. Anger should not be dismissed as normal growing pains, but rather it should be used as an alert system that a child may be in need of something they are not getting, whether it be tools to cope with their emotions, social support, or both.

Helping Siblings Cope

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Supporting daughterWhen a child is first diagnosed with cancer, the parent’s focus is inevitably on getting their child the care and treatment they need.  This focus continues through treatment and can last months or even years.  It is a very natural and logical thing for parents to do and no one would argue that it is the right thing to do, including the siblings of the diagnosed child.  Parents also do everything they can to ensure that the siblings are taken care of but due to doctor’s visits, hospital stays, and inevitable emergencies, siblings are bound to get less attention and their own struggles to cope with their brother or sister’s illness may go unnoticed.  To help siblings cope, it is helpful for parents to know how children process major life events in the first place.

Children cope with major life events in bits and pieces.  Within a 20-minute period, they may go from crying with sadness to laughing hysterically at something they saw on TV.  Children rarely sit around and ruminate on difficult topics.  This behavior can seem erratic and even inappropriate at times, but it is what children do.  Children also process through play, not words.  It can be difficult to sit down and have a long conversation with your 5-year-old about their sister’s battle with cancer but playing with them will yield more information and understanding on their part.  Play is a child’s most natural and comfortable language, so we need to let them use it to process major changes.  Lastly, children tend to focus more on how they are going to be affected by their sibling’s diagnosis rather than how others are affected.  This isn’t selfishness.  It is developmentally appropriate.

So how can you tell if your child is struggling with their sibling’s illness?  Remember that children don’t often tell us their problems.  They show us.  The first sign that your child is struggling is behavior change.  Some children act out to get attention while others may withdraw.  Those that withdraw often do so because they don’t want to be more of a burden to their parents.  Losing focus and dropping grades at school are also a sign of struggle as well as changes in sleeping and eating habits.  Children are easily affected by their environment so when life gets disrupted by something as big as cancer, children are disrupted as well.  They mimic what is going on around them.  Another sign of struggle is when your attempts to comfort them never seem to be enough.  Lastly, children will often isolate themselves from friends or lose interest in things they use to enjoy.

Helping your children becomes the next challenge.  It can be exhausting trying to find time for everyone when you are running from one appointment to the next, going to work and trying to get dinner on the table.  However, here are a few tips to help them get through this difficult time.

  • Keep the rules the same. There will always be exceptions and special circumstances, but consistency should be a priority.
  • Keep to your routine as consistent as possible. Bed times, homework routines, etc. need to stay the same whenever possible.  Consistency makes life feel more stable and secure.
  • Be honest and age appropriate with the information that you share. Younger children obviously need less detailed information, but they do need to know how side effects may affect their sibling.  For example, they need to know that treatments will make their sibling more tired and less likely to feel like playing.  Allow them to ask questions and don’t be afraid to say “I don’t know.”  Remind them regularly that cancer is no one’s fault.
  • Set up regular family meetings to check in. Keep the conversation open.
  • Play with them when you can.
  • Utilize choices whenever possible. Children feel more in control of their world when they are able to make choices, even choices as simple as what snack to pack for school.
  • Keep your kids in as many of their regular activities as possible. They need to know that it’s okay to still have fun.

Coping with cancer is never an easy task, especially when a child is the one who is suffering.  Just remember, your whole family is in this together and all of your children need your attention more than anything else.  Cleaning and laundry can wait. So love on them, spend time with them, and give them all hugs for no reason whatsoever.

Cultivating Wholehearted Living

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Portrait of cheerful young african man with hat enjoying at the beach on summer day

Are you looking for more joy and happiness in your life?  Do you sometimes struggle looking for meaning and purpose?  Are you going through a transition and attempting to reevaluate priorities?  Do you want to create a life worth living but don’t know where to begin?  Then you may benefit from learning to live Wholeheartedly!

Over the past ten years there has been a lot of talk and research done around the concept of Wholehearted Living.  But what really does Wholehearted Living mean?  Bestselling author, researcher and professor at the University of Houston, Brene Brown, defines Wholehearted Living in the following way:

“Wholehearted Living is about engaging in our lives from a place of worthiness.  It means cultivating the Courage, Compassion, and Connection to wake up in the morning and think, no matter what gets done and how much is left undone, I am enough.”

In her book, The Gifts of imperfection, Dr. Brown identifies 10 Guideposts that she has identified as qualities held by people who are living Wholeheartedly.  In this blog we will explore the 1st Guidepost.  People who are living fully with Courage, Compassion and Connection know how to cultivate authenticity while letting go of what people think.

Living authentically means that we understand and embrace who we are, including our faults, failures and imperfections.  We must muster the courage to own imperfection, set boundaries and allow ourselves to be vulnerable while practicing self-compassion when we fall short.

There is no connection to others without vulnerability.  Ironically vulnerability is the first thing we look for in others, but it is the last thing we feel comfortable showing to others.  Many people view vulnerability as weakness and it is that attitude that interferes with deep meaningful relationships.

When we choose to cultivate authenticity while letting go of what others think, we can cultivate real connections in our lives.  People will see us for who we are, and we will feel accepted instead of the shallower feeling of “fitting in”.

If you are ready to embrace Wholehearted living and want to learn how to cultivate more joy and happiness into your life then look for Carleen’s Visual Journaling Group titled the Gifts of Imperfection offered at The Summit.

How To Talk To Your Kids About Going To Therapy

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A professional child education therapist having a meeting with a kid in a family support center.

There are many different ways a child becomes one of my clients: I’ve had kids google therapists, print out my profile, and ask their parent to schedule an appointment with me, often times families are referred, or maybe the front office staff directed them to me; either way, one thing I always want to know when I’m meeting with parents for an intake is, “Does your child want to come to therapy?” About 50% of my clients ask to come, for about 45% of my clients the parents stated that the client doesn’t know yet they will be coming to therapy but they think they will be okay with it even if it takes some time, and about 5% or less are completely opposed. A question I’m often asked by parents is, “How should talk to my child about coming to therapy?” This is truly one of my favorite questions to answer. Here are 4 main points to cover when talking to your kids about coming to therapy.

  • Health: Children are used to going to all kinds of doctors for checkups (pediatricians, dentists, eye exams, etc.). You can teach them that in your family you value keeping your head and your heart healthy too, and everyone in the family gets to see a therapist at some point.
  • It’s A Gift: Bringing your child to therapy is such a huge gift to them (even if they aren’t ready to see it that way yet). Therapy can be expensive for some families are you are willing to pay that so that they have a place they feel safe to talk and learn new skills. While in therapy, they learn effective communication, how to cope when things aren’t fair or easy, and self-control. How many adults do you know or work with that still lack those skills? They don’t teach these skills in school. You’re gifting your child with learning these skills now and therefore hopefully won’t struggle as much when they are older. Additionally, it is my personal belief that there is not one child in middle school that couldn’t benefit from seeing a counselor, even short term.
  • Don’t make them feel like the “Identified Problem” in your family: Often times kids are the most resistant to participate in therapy because they perceive that the reason they are there is because something is “wrong with them,” they are the cause of all the problems in their family, they are broken and I’m supposed to fix them. There is so much shame in those messages. It is okay to acknowledge that you see an issue though. It’s helpful to say something like, “We’ve noticed that you get really upset at times. We’ve even heard you say that you feel like you can’t control your body and your emotions and that sounds like a really hard thing to deal with all the time. It hurts our heart to see you hurting and we feel like we don’t have the skills the help you. We went to see a therapist and he/she is going to help us learn how to help/support you better and will talk with you about your feelings and teach you ways to help yourself.” This approach sends the message that you are in this together and that you are willing to learn more as well.

A Simple Fix to a Bad Day

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Young african american woman meditating in nature

Have you ever had one of those days where everything goes wrong? Or maybe you feel irritable for unknown reasons and you can’t shake the feeling.  Marsha Linehan, the founder of Dialectical Behavior Therapy, and her team created a skill called Opposite Action that can help turn a bad day around.

Opposite Action is exactly like it sounds: you’re doing the opposite of what your current emotion is telling you to do. With irritability for example, your tone of voice sounds different, your patience with every day inconveniences are shorter, and you feel on edge. Even the way we talk to ourselves sounds saltier than normal. Opposite action on those bad days can take many forms, but here’s a few things to try:

  1. Use a softer voice tone– imagine the way you talk to a close friend when they’re having a bad day and apply that to how you talk to yourself. When you’re kind and understanding to yourself, it’s easier to extend that same kindness to those around you.
  2. Pay attention to how your body feels– do you notice a tightness in your shoulders, neck, or face? Do a quick body scan throughout the day and relax those areas that are holding tension.
  3. Do a random act of kindness– on those bad days, it’s easy to feel angry at the world. Acknowledge that feeling for what it is and avoid trying to “should” it away (“I shouldn’t feel this way”). Once you’ve done that, use opposite action- send a thoughtful text to a friend, buy donuts for the office, or pay for someone’s order in the drive through. It feels good to do something nice for someone else.

Play around with opposite action to figure out what works best for you. Some days are harder than others, but optimism is a choice and a learned skill. We can’t control what life throws at us, but we can control how we respond to it. Opposite action is a learned skill that can help you bounce back quicker from those tough days.

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