- Boston DBT Groups

Whose fault is it anyway? What if relationships mattered more than being “right” and what you can do about it

We live in a society in which persons tend to dichotomize responsibility, resulting in blaming, scapegoating, and finding fault. When and if persons are at fault, there needs to be a process in place to make changes, resurrect one’s place in society, do repair work, and find a way to prevent further harm from happening in the future.

Figuring out whose fault it is often results in a person feeling guilty or bad. The value of having a sense of shame or guilt about what a person has done is that the person has the opportunity for corrective action. But blaming or shaming a person without opportunity for corrective action doesn’t help people know what to do that can prevent, fix, or change things in the future. In my experience helping people with anger problems, there is a false sense of having fixed a problem by figuring out who is at fault. Figuring out whose fault it is (“not me”) creates a sense of separateness, polarity, relationship rupture, and inattentiveness to what needs to happen next. Shame can create further problems when people actively avoid being blamed or don’t have clear direction for what to do next.

A less dichotomous (and dialectical) approach involves one in which people are impacted by each other; people all have roles in how conflicts happen in relationships. While it is possible that one person did something hurtful to cause a problem in a relationship, it does not necessarily negate roles in identifying how people influence each other, what can be done to fix or solve it, or what could be done to ameliorate the situation.

The next time you figure out that it wasn’t “your fault” consider the following:

What was your role in the series of events that led the other person to behave they way they did?

How is the other person impacted by your behavior?

What impact do you intend or want to have on the other person?

What is at stake in terms of your self respect, your ability to keep the relationship, and your ability to be effective in addressing the problem?

Even if you did not cause the issue, relationship rupture, or problem; what can you do to fix or change it?

Are you doing anything to make the situation worse (or making the other person feel worse about the situation than they already do)?

What solutions or proposals do you bring to the table to work on preventing the problem from happening in the future?

What impact does blaming or shaming another person have on your short and long term relationship with them?

What difficulty emotions are you being asked to tolerate or bear given the complexity of the situation? Is an unwillingness to tolerate discomfort making the situation worse?

What specific nonjudgmental feedback can you take give the person “at fault”? (In other words, how can you be part of the solution?)

If it was “your fault”, and you are not sure that shaming and blaming yourself does any good, consider the following suggestions for repair work:

Start with a succinct, matter-of-fact nonjudgmental description of what happened that includes a very brief summary and an acknowledgement of the situation. Use the following prompts to fill in the details of your own situation:

The consequences for my actions are (or may have been)…

My intention was…

My intention was not…

When I behave this way people sometimes react by…or think that…

I regret that…

I am sad that…

I would like for…

In order to prevent this from occurring again, I am going to commit to the following…

In order to make up for what I did, I will…

What I appreciate about you is…

What I value about this relationship is…

I hope that in the future…

Even if you are overwhelmed by overwhelming problems such as homelessness, drug use, or abortion rights, remember that people have more influence and power when they work hard to maintain relationships, help people in society do better, or provide solutions. Pointing fingers is never helpful unless you are prepared to give clear and specific feedback and are willing to be proactive in working towards solutions.

What are Dialectics and Dialectical Behavioral Therapy Skills?

What is Dialectics?

Dialectics is based on the idea that two opposing concepts can both be equally true. One truth does not trump or rule out another, which undercuts the dichotomy of a “I am right you are wrong” type of relationship. A common dialectic is that you are perfect as you are (acceptance), and that in order for things to turn out differently in your life, you need to do things differently (change). One is not more true than the other, and one truth does not rule out the other truth. Sometimes people need acceptance, and sometimes people need to be challenged. Both belonging and growth are an inherent part of being in relationship.

Dialectics challenges the idea that one person is always “right”, because when you take into account diversity of perspective, other truths often arise. Being “right” often fails to take into account effective communication and the value of the relationship. Experience and emotions get ignored. A set agenda of being “right” often gets people stuck in a very rigid, dichotomous, black and white, non-dialectical stance. Dialectics are important in that sometimes you can find the one thing you have in common with your enemy instead of focusing in ways you are different. Relationships exist in context of conflicting truths, yet relationships are the glue that carries us through life.

What are the four Dialectical Behavior Therapy Skills?

DBT is a complex treatment that has confusing origins in terms of how it was developed and who it was for, and has been tailored to a wide range of populations and settings. The DBT skills are universally applicable materials that help people with extreme and painful emotions, intolerable life situations, and relationships. The four skills sets are as follows:

Core Mindfulness: Mindfulness is a skill that helps people focus attention, regulate arousal, calm the brain, quiet the mind, and settle in. Being mindful is a way to steady and anchor oneself in order to observe quietly and not “react” to what is going on. It is inherent in all of the other skills in that it requires a steady, quiet, secure stance in the face of demanding life situations. It takes spaciousness to know what is going in with your body, your self-experience, your wants and desires, and your life. If you don’t pause the moment and check in with yourself, it is easier to get “caught up” in the banging and thrashing of what life throws in your direction. Mindfulness can be a spiritual practice of quiet contemplation, a way to press the pause button, and way to regroup. Core mindfulness skills taught from the DBT material include skills of observing and describing without judgement. Other traditions, spiritual practices, health care services, and therapies teach mindfulness, so it is not “new” nor is it confined to just DBT skills; its roots are actually in Zen Buddhism. There are multiple ways of accessing mindfulness including mindfulness based programs, meditation groups, trainings, and apps. DBT groups are known for implementing a mindful practice or exercise in every group, and like many spiritual traditions are simply considered part of a daily practice.

Emotion Regulation: This is a set of skills that helps people to observe and describe what they feel (you can see the overlap with mindfulness) in order to help regulate arousal, understand what they feel, and know the reasons why they feel the way they feel. Skills cover ways to reduce emotional suffering through mindfulness and opposite action, and ways to reduce vulnerability to emotional suffering. Skills are quite complex and take practice, feedback, and validation. Since emotions can be tricky, elusive, (and just plain unbearable at times) the emotion regulation content is not something you could “quick learn” and be done with it. Sometimes people are not always aware of how or what they feel in general, and there is nothing pathological about this. It is a process! Knowing oneself and knowing one’s emotions is a lifelong task not subjected to any particular type of disorder, and does not end just because you have had a first exposure to all of the skill content. That is why working together on ways to regulate arousal given varying life circumstances can best be done over time in small group settings that promote cohesion and intimacy.

Distress Tolerance: In order to regulate emotional arousal, finding ways to endure the “I-can’t-stand-it-itis” of painful and extreme emotions is critical. Surviving painful life circumstances well means doing so in a way where people do not lose self-respect, forget their values, give up what is important to them, or react in such a way that makes things worse. Sitting in the fire and not reacting is often harder than picking a fight, poking the fire, making others suffer in order to prove a point, exacerbating pain to let others know how bad things are, undermining a person where it hurts, forcing the university to prove its point, perseverating on being “right”, asking “why me”, or engaging in self-defeating or relationship destroying behaviors. Being willing to tolerate the unknown, be zen with the universe, stop fighting reality, and do what works is skillful practice. We all want things to do our way or to turn out for the best. In reality, a lot of people are suffering a great deal and need everything they can to survive well. Distress tolerance skills encompass not only change strategies (if you can do one thing make it better, why wouldn’t you?), but acceptance and willingness skills. Anyone who has successfully undergone any type of exposure treatment for anxiety knows that the benefit to tolerating anxiety is a decrease in overall anxiety. There is an inherent truth that reality is easier to face once you stop fighting it, thus freeing you up to do what is needed to effectively solve problems.

Interpersonal effectiveness: True to the concept of the dialectical philosophy of DBT, it is better to be effective than it is to be right. The interpersonal skill content encourages readers to identify objectives in situations (what exactly it is you want or don’t want), how the relationship may be impacted, and if self-respect is at stake. Balancing the three helps people to look at natural barriers and consequences of interacting, and enables readers to problem solve the cost/ benefit of ignoring each. For instance, you can ask for what you want at the expense of the relationship, or you can give into a relationship but sacrifice self-respect. The balancing act of relationships is an ongoing challenge for everyone, and some give and take is part of how people stick together, find intimacy, and keep people close. Interpersonal skills also include ways to get out of or decrease contact with toxic or unwanted relationships, set limits, say no, and to identify barriers to doing so. Direct rehearsal in terms of “what to say and how to say it” benefits group members in that they can try out and receive feedback in both verbal and non-verbal forms.

A book of all the DBT skills is available for purchase via this link: https://tinyurl.com/y2qad6sk

Here is a short video of me on YouTube with an overview of the skills: What Are the DBT Skills? DBT Skills with DrReneeHoekstra

What if I’m wrong?

Here are a couple of thoughts on the business of being “wrong.” First, the question itself begs a certain dichotomy to form in a relationship. It implies a one-up, one-down position. It can make one person more powerful, keep another at a distance, or in extreme circumstances serve as an opportunity to belittle or berate. What does being “wrong” imply about the relationship, the importance of keeping a relationship, or the way that people will continue to relate to each other? Is it worth it to damage or hurt a relationship to be “right”? If one person is “wrong”, then how is the relationship handled in the future? How do people move forward?

Next, being “wrong” might be rephrased as being technically inaccurate. If you are responding in a way to that does not match reality in a reasonable sort of way, you may be considered “wrong.” However, in some circumstances this begs the question of differences in opinion, perception, feelings, and agendas. A person can have a valid point of view, see things differently, or see aspects of a situation that another person is not able to see. This can prevent communities from being rigid, thinking “inside-the-box”, refusing to consider alternatives, or being racist or non-diverse in their thinking. Trying to understand the validity in where others come from can help us be more understanding, have better relationships, be more forgiving, and become less “stuck” in the right/wrong dichotomy. If you are technically “wrong”, this also might be your opportunity for self-correction, learning, or growth. Consider teasing out the differences of being “wrong” vs. being technically accurate, and if being “wrong” has anything to do with conflict around perspective, perception, intention, or emotion.

In addition, there is a certain cost to being “wrong.” Everyone at some point in their life has probably had an experience in which they thought something to be true, accurate, or reasonable but found this to not be the case. The cost to being “wrong” is often related to embarrassment, shame, humiliation, or perhaps the loss of trust or leadership. Are you able to correct your actions based on what happened? Can you tolerate the pain of your own humiliation and consider what really matters? If the inability to bear the cost of being “wrong” results in isolation, criticism, withdrawal, and becoming more adamant that you were “right”; you may want to give some thought to what it is costing you in terms of your relationships.

Here are some final questions for you to consider:

What are your intentions? Sometimes we are in long term work, romantic, or family relationships that must be giving careful consideration.
What are the intentions of the other person? (Are you sure, or are you assuming? What evidence do you have?)
What is the true cost of being told you are “wrong”? What do you have to gain by making sure others know you are “right”?
If you are “wrong,” can you tolerate your embarrassment enough to grow, learn, regroup, or reconsider how you will handle future situations?
Is it more important to be right than to be effective? (Consider what the relationship means to you and if your own self-respect in handling the situation is on the line).
Are you unforgiving of other people when they are “wrong”, thus unable to forgive yourself? Is your own criticism preventing you from moving on, getting unstuck, or responding in a way that is potentially painful but perhaps necessary?

When Things Fall Apart by Pam Chordron

Here are some paragraphs from this book:

“When the bottom falls out and we can’t find anything to grasp, it hurts a lot. It’s like the Naropa Institute motto, ‘Love of the truth puts you on the spot.” We might have some romantic view of what that means, but when we are nailed with the truth, we suffer. We look in the bathroom mirror, and there we are with our pimples, our aging face, or lack of kindness, our aggression and all that timidity– all that stuff.

This is where the tenderness comes in. When things are shaky and nothing is working, we might realize that we are on the verge of something. We might realize that this is a very honorable and tender place, and tenderness could go either way. We can shut down and feel resentful or we can touch and I met throbbing quality. There is definitely something tender and throbbing about that groundlessness.

Things falling apart as a kind of testing and also a kind of healing. We think that the point is to pass the test or to overcome the problem, but the truth is that things don’t really get solved. They come together and they fall apart. Then they come together again and fall apart again. It’s just like that. The healing comes from letting there be room for all of this to happen: Room for grief, for relief, for misery, for joy.”

(pages 7-8).

Have you been told to change your “bad mood”?

Here are some steps to figuring out your mood- and what to do if, indeed, you want to change it.

Our moods- or our feelings- can be extremely important in helping us understand ourselves, organize our behavior, know what matters, and have better relationships. One of the first steps to figuring out feelings is to be able to describe, understand, and put words on experience. Think beyond just being in a “bad mood”: Try figuring out what, exactly, you are feeling. Instead of thinking about your mood as bad or good, try approaching this task with curiosity. Are you down, flat, depressed, lethargic, or disinterested? Are you irritable, angry, frustrated or impatient? Are you struggling with loss or sadness? Remember that feelings give us information about ourselves, our situations, and the people around us.

Next, consider what is valid, relevant, and sensible about what you are feeling. Some reasons that others tell us to stop being in a “bad mood” is because they want us to behave a certain way. Consider this: If the person telling you to stop being in a “bad mood” got what they wanted, what specific action would that entail? If you stopped being in a “bad mood”, would you stop avoiding conflict, go to work, keep a relationship, participate fully in an activity, or attend a social event or function? We may know and understand our mood, and have a good reason to feel the way we feel, but our mood gets in the way of rising to the occasion and meeting an obligation.

Expressing negative feelings frequently or pervasively can hurt relationships; on the other hand never being to share our innermost pain can prevent us from having more meaningful and connected relationships. In other words, ranting, venting, or complaining can join people in their beef against the universe, while expressing vulnerability can increase caring and intimacy. Consider how acting or expressing how you feel works or doesn’t work for you. Does it bring you closer to the people you care about, or does it tend to push them away?

Next, consider if you want to change how you feel. Is someone else trying to get you to change how you feel? If so, trying to change how you feel can be much less effective.

One way to change how you feel is to act in ways that are incompatible with how you feel. In some situations, acting on how we feel can enable us to feel congruent and genuine with what is going on for us on a more personal level. However, sometimes moods are so pervasive that they interfere with our lives. If your “mood” is interfering with your ability to organize action, meet obligations, make deeper connections with others, keep relationships, or engage in meaningful activity, it might be time to experiment with alternative behaviors to shift gears, engage your brain differently, or do something you wouldn’t typically do.

Here are some suggestions: Express appreciations to other people, talk about what you value in the relationships you have, avoid “complaining”, practice not talking about anything negative, shift gears by doing an activity that demands your attention, shift gears by doing a something physical (washing dishes, raking leaves, taking care of a child), become invested in someone else’s problem or dilemma, try generating compassionate reasons for why people behave the way they do, soften your body and facial expression, wish other people well, do something that challenges you, do an activity you like or enjoy, or do an activity for someone else that they like or enjoy. Doing these things even if you don’t feel like it– may help you change your mood all by yourself.

Is everything really going to be okay?

When people tell you that everything is going to be okay, sometimes it is helpful to hear. Sometimes it is soothing, and can give you a sense of hopefulness and shared understanding. There are many ways in which other people try to soothe us, and which we find help and assurance in cases of extreme distress.

However, people sometimes use this statement in a way that is unhelpful. For instance, the statement that everything is going to be okay may be an attempt to avoid the subject, offer a platitude, or inhibit communication of distress. Sometimes it is more helpful to obtain some acknowledgment or understanding of how you really feel. Sometimes worries, fears, or concerns about the future just need to be openly expressed. In addition, it is hard to know that things are going to be okay when you don’t have a way to solve the current problem.

The statement that everything is going to be okay is a statement of expressed hope. It can be offered to the person who is going through the most severe of all crises, and even though there may be some irony to it, there is some truth to it as well. Sometimes when we feel very hopeless it is hard for us to hear the usefulness of this statement. Sometimes in the worst of moments we can find and create experiences of hope and joy- despite significant loss. Being able to find and participate in these moments help people survive.

Thinking about the ways in which this statement is both helpful and not helpful at the same time can help us to create space for different perspectives. When we can see things from different angles, we have more flexibility in addressing situations, responding to our environment, and finding help that may actually be helpful. There is always some element of truth to things turning out okay, but there are also moments when hopelessness prevails. Sometimes it is nice to consider the kindness of another person’s intentions, even if their attempts to be helpful aren’t always exactly what we need to hear in our moment of our pain.

10 Reasons why you need The Emotional Extremist’s Guide to Handling Cartoon Elephants book this holiday season

1. The Cartoon Elephant book, after being temporarily unavailable through Amazon, is now back on the market. The retail price is $26.95, but sometimes Amazon will let it go for a bit less.

2. Cartoon Elephants approach painful emotions with humor. If there is an elephant in the room in your family, this book is the starting point for approaching avoided conversations. You will recognize yourself and others in this book. There is no finger pointing or blaming.

3. Cartoon Elephants is something you can put on your coffee table. Because it is a graphic book with pictures and fun fonts, it is an easy read. The elephants will fit nicely next to big picture books about Africa and Asia.

4. The Cartoon Elephant book is being used to teach people in Dialectical Behavior Therapy skills groups about emotions. Loaded with psycho-educational material and teaching points, it cleverly accomplishes the task of making people think they are reading something fun yet giving them something valuable.

5. This book is not hard to read. There is no “plugging away” at chapters. If you want to bring something to someone’s attention in a way that is universally applicable, this book will do the trick. You don’t need to have painful emotions to appreciate elephants- you just need to have emotions.

6. If you are going to buy someone a self-help book for Christmas, this is safe bet.
Whether they believe it or not, everyone has cartoon elephants. The research proving this to be true is cited in the back of the book.

7. This book can be used and re-used, read and re-read. You can share it with family members, friends, or long lost relatives. It won’t go out of style. Emotions, as a rule, will be with you as long as you live.

8. You will get some food for thought about how and where you see yourself in relationship to your elephants. This is great for discussion groups, weekend retreats, and writing workshops.

9. This book is great for people of all ages. If you’re trying to get your kid to read something important, heavy, and deep, you can give them this book. It won’t take long to read and it is much more fun with illustrations.

10. The book will be the perfect introduction for my live series on emotions starting January 20, 2014. Of course you don’t need the book to sign up, but if you have the book you will have a better appreciation for cartoon elephants in general.

When two different concepts can both be true: A tip for handling and understanding your emotions

Two different concepts that often come up for handling emotions might at first appear contradictory:

1) In order to handle emotions effectively, a person has to be able to step back and notice what they feel (observe).

2) In order to survive strong emotions, a person needs to fully experience the nuances and physiological discomfort that arises when emotion is present (enter into the experience).

Can you see how both of these concepts make sense?

Being able to step back and observe emotions is effective because it increases options and awareness for how to respond to emotional material. Without the ability to “stand by”, a person might immediately act on their emotion. When a person always acts on their emotions, he/ she might regret it later. For instance, if you become really angry at someone you care about, you might lash out. The ability to “step back” and observe what you are feeling can help you organize a thoughtful response in which you maintain integrity, speak clearly, and feel better about yourself later. Sometimes refraining from taking immediate action is very effective.

On the other had, a willingness to experience strong emotions when they arise is a critical element to being human and being alive. Emotions give us very important information that we can’t always ignore. When we experience emotions fully, we are in touch with what matters. When we suppress, hide, ignore, or push away strong feelings they may become worse or “blow up” on us down the road.

In some ways, a person can both experience and observe emotion. A willingness to get in touch with what hurts and to hold off on any immediate reactions can increases options for the best response.

On being “right”: Demystifying the “stiff and rigid” cartoon person from The Emotional Extremist’s Guide to Handling Cartoon elephants.

Sometimes being “right” has to do with maintaining a sense of justification, power, or virtue. Sometimes being “right” has to do with feeling valued or heard, or even finding others to support your point of view. Sometimes it has to do with taking sides, feeling validated, or knowing that you have something important to add that is being left out of the equation. Sometimes being “right” has to do with not sacrificing a point of view, a perspective, or an observation.

Sometimes, when people feel emotionally threatened, they focus on the “right”-ness of where they are coming from. When threatened, attention is often narrowed and constricted to the threat- thus making it difficult to shift perspective, see things from different points of view, or understand the person who is identified as a threat. Sometimes being “right” has a certain quality, characteristic, or experience that feels guarded, shut down, or even restricted. It’s a way of being that builds walls, doesn’t let other people in, and sends a strong message. It builds a dichotomy in which one person has the upper hand, and the other person doesn’t.

Sometimes people need to be “right” to gain a sense of influence, power, or importance in a relationship or situation. Being “right” may have to do with making a statement, communicating something strongly or clearly, or not yielding to an expectation. It may have to do with mattering.

Sometimes being “right” means sacrificing a relationship, failing to get along with someone, or being seen as someone who is approachable. This can create difficulties in important and unavoidable relationships.

Sometimes being “right” isn’t so much about being non-negotiable as much as it is about trying to define values, being clear about how much you can take, knowing that you can no longer make the sacrifices you are making, or suddenly realizing the demand that someone is placing on you. Sometimes it is difficult to define the “right”-ness of your experience and keep important relationships.

Here are some ways in which you might re-consider being “right”:

Even if you are “right”, consider the impact that communicating being “right” has on the relationship.
Stop thinking about one person being “right” and the other person being “wrong.” Start thinking about it as “this is my experience” and “this is the experience of the other person.” Make space for them to be different.
Sometimes it makes sense to simply stop bringing it up. Refraining from pointing out your point of view can challenge you to tolerate differences, anxiety, or some other threat in order to make for better relationships. Making strong overtures in which you are constantly proving your point can exhaust any conversation.
If you are in the middle of one of those conversations that bring out the “I have to be right” in you, consider having the conversation while practicing loose and floppy (refer to the cartoon elephant book for more specific guidelines!).
Consider what you would lose if you found out conflicting information that challenges your “right”-ness. What’s the threat?

PS- Want to get a free Cartoon Elephant book? Make sure you check out the last blog post for details…

How to change the behavior of someone you care about deeply

First, acknowledge what you cannot control. When others do things that are destructive, hurtful, irritating, annoying, or have painful consequences, the acknowledgement itself is simply a way in which you are looking and seeing what is actually going on. Not wanting something to be true, ignoring the fact that it is happening, attacking the person for the behavior, and making threats often reflects an inability to accept and acknowledge what is there. Often people don’t want to accept reality because it means something very painful. The acceptance of what is and the acknowledgement of what you cannot control can lessen the drama around the fight. It can also get people unstuck from repetitive impasses. However, it often means grieving what has been lost.

Next, do something for the relationship itself. Having a strong relationship will make you much more powerful and influential than having a rocky or weak relationship. One way to do this is to focus on what you appreciate, value, or like about the other person. Make it a point to express this directly. Another way to do this is to create time together in which you actively listen to what the other person has to say. Don’t interrupt or disagree- instead, just see if you can focus on understanding how they see things. Pay attention carefully to thoughts, experiences, feelings, and opinions. See if you acknowledge how they see things- even if you don’t see them that way. You may want to simply reflect and summarize what they are saying, and use statements like “If I understand you correctly…” Try to be gentle, warm, and receptive. Temporarily suspend efforts to fix or control their behavior.

Finally- if you desperately want them to stop doing something that is hurtful- focus on naturally occurring consequences of their behavior. When you try to control or change someone’s behaviors by threatening, being coercive, or being cold and withholding, it could really damage the relationship. Be direct in expressing your own feelings and reactions about their behavior- without making threats. You will be more powerful and influential when the relationship is strong, spending time with the person is a pleasant experience, and you are liked. Therefore, treat the other person as capable of choosing. Treat them as an equal. When they are fully aware of the realistic, natural, unwanted and painful consequences of their actions, their options for choosing increase. Consider your role as an ally who helps them think through their actions. There will be a big difference between (you) trying to control the outcome through threat or coercion vs. (them) having to face what they are doing and figure out what they want to do about it.

Repeat the steps. Sometimes you will be able to accept and sometimes you will not. Practice acknowledgment of what you cannot control over and over again. Build the relationship. You don’t have to ignore to deny what they are doing. You just have to have a way to address it in such a way that your voice matters, you don’t lose your own self-respect, and you don’t lose sight of what is important.