Counseling, Coaching, Psychology, Therapy

Mindfulness and DBT: “What” Skills

Dr. Kathleen Young: Treating Trauma in Tucson

As promised yesterday, I am writing today more about the specifics about the use of mindfulness in trauma treatment. If you think about it, mindfulness is really the antithesis of dissociation, with its focus on being present in this moment and “training your mind to pay attention to what you choose to pay attention to instead of letting your mind hijack you.” (Cindy Sanderson, Ph.D., Mindfulness for Clients, their Friends, and Family Members). Although dissociation was a life-saver for you as a child living amidst trauma, we’ve talked before about understanding how it may be getting in your way as an adult.

In Dialectical Behavioral Therapy (DBT), mindfulness is broken down into six specific types of skills. The first three are referred to as “what” skills in Marsha Linehan’s Skills Training Manual for Treating Borderline Personality Disorder (1993). So you want to practice mindfulness, what exactly do you…

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Avoidance and Trauma Therapy

Dr. Kathleen Young: Treating Trauma in Tucson

What does avoidance have to do with trauma therapy? Avoidance is a common coping strategy. In psychotherapy, when we talk about avoidance we mean strategies for avoiding unwanted or uncomfortable feelings. Avoidance is a natural and understandable response to a traumatic event. Who wouldn’t want to avoid reminders of a painful and overwhelming experience? Or attempt to avoid situations because you fear something similar could occur again?

The problem is, avoidance doesn’t really work. In fact, avoidance strengthens the fear and anxiety response! The more we avoid a place, person, or even feeling, the more likely we will continue to feel anxious about it and continue avoiding it. A vicious cycle!

Ongoing avoidance is one criteria required for a diagnosis of PTSD in the DSM V:

Criterion C: avoidance

Persistent effortful avoidance of distressing trauma-related stimuli after the event:(one required)

  1. Trauma-related thoughts or feelings.
  2. Trauma-related external reminders (e.g., people, places…

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Breaking Silence: Talking about Trauma

Dr. Kathleen Young: Treating Trauma in Tucson

Breaking SIlence: Talking About TraumaHave you heard any of the following: break the silence, stop the silence, speak out? In activist and healing circles, survivors are often encouraged to talk about their traumatic experiences. Why is this the case?  Should you talk about your abuse?

As is so often the case in healing, it is a matter of when, how and to whom.

Some survivors have spent years keeping their abuse secret, or they have disclosed to someone who responded poorly, perhaps expressing disbelief or victim blaming. Not telling anyone about your abuse can be a form of avoidance coping.  Avoidance can worsen post traumatic symptoms in the long run. It can even prevent you from fully understanding your experience.

Some trauma survivors may go to the other extreme and feel compelled to tell their story indiscriminately. This form of talking is often somewhat dissociative in nature, and does not reap the healing benefits…

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Dissociative Identity Disorder

Dr. Kathleen Young: Treating Trauma in Tucson

Dissociative identity disorder Image via Wikipedia

I am finally completing my series on understanding dissociation with  Dissociative Identity Disorder (DID). Although DID (or Multiple Personality Disorder, the earlier term) is perhaps the most well-know dissociative disorder it is also complex and often misunderstood. Due to its complexity, I am going to discuss it over the course of several posts.

I want to start by stressing that all dissociation serves a protective and coping function. In the face of  repetitive and overwhelming experiences a young child’s capacity to “not know” or compartmentalize is life saving. So as you read this, if this is an issue for you, keep in mind that your dissociation has helped you survive. That is important to acknowledge and honor indeed!

The following are the DSM-5 diagnostic criteria for dissociative identity disorder. All five of the following are true for someone with DID:

  • Disruption of identity characterized by two or more distinct personality…

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