As a therapist who has worked with children and adolescents who struggle with emotion dysregulation, anger management, and trauma, I found DBT (dialectical behavior therapy) helpful in conceptualizing the emotional challenges of my clients. DBT was also helpful in guiding my clients toward greater understanding, primarily when discussing the tendency to either rationalize or emotionally reason through challenges in life.
As a beginning therapist, I recognized that Wise Mind was a DBT concept that many of my clients (experienced and inexperienced) found practical and understandable. One of the most intimidating parts of psychotherapy can be the terminology and interpretation of emotions, behaviors, and symptoms. DBT keeps many of the concepts basic and doesn’t “ask for much” from clients who are suffering as it is. Although the acronyms used to explain some of the concepts can be overwhelming for some, DBT is a good start to building emotional awareness.
In The Mindfulness Solution For Intense Emotions: Taking control of borderline personality disorder with DBT, author Cedar R. Koons, MSW, LCSW, has written a clear guide to the use of mindfulness and DBT to treat borderline personality disorder (BPD). The book begins with a foreward by Marsha Linehan, a popular name often surrounding the topic of DBT and BPD. Linehan explains the usefulness of DBT and why she continues to support its theories and empirically based concepts and tool for those suffering from BPD.
Chapters 1 and 2 of the book focus on explaining emotion regulation and focusing on mindfulness and wise mind concepts. Chapter 3 focuses on identifying techniques or tools that can be used to support the learning of mindfulness and wise mind concepts. A few tips are listed at the end of Chapter 3 for individuals seeking concrete ways to increase the use of wise mind concepts to regulate emotions. Some suggested techniques include: keeping a gratitude journal (for at least one time per week to focus on the things that are going well), tracking worries (focusing on the top three worries of the week and examining their legitimacy), looking for ways to “make lemonade” (reflecting on things that appeared to be barriers at first, but then turned in to great learning experiences), and “inquiring into your wise mind values and working to live within them” (i.e., reflecting on your values and how you have come to feel the way you currently do).
Many of my clients, primarily the clients who enjoy writing songs, poetry, or journal entries, appreciate the activity of writing and tracking progress. Even as a therapist, I find myself religiously engaging in the activity of reflecting on challenges, triumphs, and things I am grateful for by using writing and journaling. In fact, we all could benefit from the activity of “actively” reflecting on where we once were, where we are now, and how to get to the places we hope to be. Not only does the book focus on mindfulness as the foundation for DBT skill building, but also wise mind. Wise mind concepts can help clients (and even professionals) examine when they are reasoning in a black or white fashion (in absolutes) and how to move away from this destructive pattern of thinking.
Chapter 4 focuses on observing and accepting reality as it is. I have learned that there is a component of mindfulness in the process of observing. Observing allows us to examine our feelings without judging them or allowing a “voice” to say things such as “you shouldn’t feel that way, you know that is wrong” or “you shouldn’t think like that, that’s bad.” When client’s observe, they are making themselves aware of their thoughts and feelings (as they do when using mindfulness techniques) without having a reaction to it (which is something we, as humans, are conditioned to do). Chapter 4 lists a few things readers should observe, such as sensations, thoughts, and emotions. The author points out the importance of observing by highlighting that:
“Whenever you feel angry, sad, or afraid, your attention dwells on what is prompting those feelings (Ratey 2001). It seems like your mind will focus only on how bad you feel or how much you want to escape that feeling. Your attention is taken hostage while crucial things going on around you go unnoticed.”
Koons breaks down the steps of observing sensations, thoughts, and emotions and offers tips on how to experience “observing.” When we become more mindful and aware of things within our environment and within ourselves, we develop an incredible ability to monitor ourselves, especially when we are in “crisis” emotionally and psychologically. The remaining chapters focus on furthering the concepts of mindfulness and encouraging full awareness of emotional states.
If you are a parent, family member, or mental health professional, this book is a great start to learning more about and teaching DBT skills, primarily mindfulness. The key, from my perspective, to benefiting from this book is to choose a few suggestions provided by the author and try them for an extended period of time. Mindfulness skills can take a while to adjust to and integrate into daily life. As a result, this book may not be like other books in which you can read each chapter and complete the book. This book seems more like a personal guide that may require you to revisit concepts and chapters to master them or be reminded of certain skills. For clients or families, this is a nice companion to supplement therapy sessions or personal exploration and development. For mental health professionals, this book can help guide therapy sessions. Either way, Koons does a nice job at structuring the topic and focusing on necessary skills for helping the individual with BPD control and regulate emotions.
The Mindfulness Solution for Intense Emotions: Take Control of Borderline Personality Disorder with DBT
New Harbinger Publications, April 2016
Paperback, 288 pages