Editor’s Note: Broadly speaking, a dialectic is a tension between two contradictory viewpoints, where a greater truth emerges from their interplay.1
As I write this, I’m sitting upstairs in my son’s room. I hear my one son in his room listening to a webinar, while my other son is watching television downstairs. My husband’s voice and the echoes of his Zoom meeting with colleagues can be heard outside the closed doors of our home office.
This is apparently the new ‘norm.’ What was initially supposed to be ‘temporary’ has now been our life for almost a year. My kids, who once thought it was ‘fun,’ staying home and having Mommy and Daddy supplement their schoolwork, now find the at-home experience dull, unexciting, even frustrating. I assure you that my degree is not in teaching elementary school-aged children, though I have far more respect for teachers than I ever had before (and it was already high to start with). To acknowledge that I have only two and teachers have upwards of 20 students per class is truly amazing, awe-inspiring, and exhausting (at least from my own perspective). What I have learned from these past several months is that families are truly resilient if we rely on each other, provide each other some room and flexibility, and allow both inter-personal and intra-personal growth to occur.
As a psychologist, I am reminded that I became a psychologist to help people. And, surely, when I went to school, I had not considered that part of helping others would occur in the midst of a pandemic. This whole experience has been new to all of us and has created widespread panic, anxiety, angst, even ‘numbness.’
Some patients have told me they have a tendency to laugh at everything at this point, writing it off as, “It’s 2020. What do you expect?” We all cope differently though these experiences and yet, with flexibility and kindness, we can help one another. I remind my students (who are in graduate school to become psychotherapists) that, while they are providing therapy to their patients, their patients will remember them as helping to shape their resilience in the process. While we may be ‘small’ in scope, we are nonetheless powerful in our impact.
I am reminded of a personal experience at an emergency veterinary hospital. My poor kitten, Rascal, was extremely ill with, what I later learned, was diabetes. The doctors told me that he would not likely make it through the night but asked that I stay for a few minutes as they attempted to revive him. As I sat in the waiting room sobbing, a stranger saw me. She gently asked if she could sit with me and expressed that she, too, had been through something similar. She put her arm around me, a comfort, and told me that my feelings of sadness and loss were perfectly appropriate. With loss, there was (and is) also love. While a pandemic is certainly not akin to my personal experience, what stays with me is the caring gestures of a stranger; I never even learned her name. What I recall, in that dark moment, was the care and connection that helped me get through such a lonesome and painful moment. In retrospect, I can see that caring and connection were both occurring at the same time as loss and pain.
I was asked to write this article to explain how to understand that working with situations of opposing feelings/thoughts can lead to a better, third option. Right now, we are all suffering with anxiety, loss, and grief. At the same time, we all share a common reality (i.e., “We’re all in this together,” which can provide some comfort when we use it). Without a concrete end in sight, the greatest gift we can give each other is hope and comfort.
Several years ago, I attended a week-long course in Dialectical Behavioral Therapy (DBT), by Dr. Marsha Linehan.2 I have since attended numerous other trainings in the same modality of therapy. One thing I love about DBT is that it truly can be applied to such a variety of individuals and has shown efficacy in a wide variety of populations. I also find that, as a clinician, I often turn to many of the principles that are taught by Dr. Linehan, not solely with self-care, but also with helping teach my own children some of the interpersonal skills, emotion dysregulation,3 tactics, coping mechanisms, and learning how to tolerate distress. Most importantly (at least in this very moment), I also find that the emphasis on mindfulness is even more important than ever.
What does this mean for us? It means that by practicing some of these skills, we can begin to experience better self-awareness and grounding. We can cultivate relaxation, growth, and ease. We can learn to be better communicators and, quite possibly, better versions of ourselves. One of the hallmark tenets of DBT is the recognition that, in life, there are dialectical ‘tensions,’ in which multiple opinions can be simultaneously true. As we know, at any given moment, we are doing the best that we can, but we also know that we can strive to do better: dialects that we experience all the time and those that are especially important at this time.
Here are some of the basic components of DBT:
Mindfulness: Mindfulness is being present, fully present, in the moment. Not wishing for things to rush forward and not fixating on the past—after all, there is nothing that we can do to change it. But, we can learn from it, right? So, what are some ideas for mindfulness—ones that we can do in the safety of our own homes?
- Cook.
- Play board games.
- Write a book (and have your kids ‘animate’ it)
- Make s’mores outside.
- Take a bubble bath.
- Read together.
- Rollerblade (we have brought this back from the 90s, and I can certainly say that my skills are not nearly as good as they used to be—but, let’s not judge).
- Color.
- Paint.
- Eat dinner—and really sit and talk (no electronics).
Learn how to better communicate your wants, desires, and goals. We are particularly good at saying yes to everything and anything. But, what about if we don’t want to actually do everything?
We have learned to be a distracted society (always doing a million different things). Stop being on autopilot and check back into your lives. Your kids will thank you! And, you will, too. It is common to become distracted. Try not to judge yourself; simply check back into the activity you’re doing. It is OK. Even those of us who have been practicing for years can become easily distracted!
Interpersonal Skills: Learn how to better communicate your wants, desires, and goals. We are particularly good at saying yes to everything and anything. But, what about if we don’t want to actually do everything? We’re just saying yes to be the people-pleasers that we have learned to be? When we’re sitting at your computer at 9 pm and the kids are asking for the millionth time, “Mom! Come tuck me in!” It’s easy to really begin hating what you’re doing because you’re tired. Exhausted. Overwhelmed. Every part of you wants to cuddle in bed and listen to lullabies, putting your kiddos to bed.
So, resentment builds. But, who is the real source of our anger? The boss? Sure. How do you justify anger if you are your own boss? But, really, we need to learn to say no to the things that don’t enrich our lives and say yes more to the things that we really want to do. Trust me, you will want to make time and be more motivated to do those things that really mean yes to you. We need to learn how to self advocate. We need to learn the art of negotiation. We need to teach our kids that it is okay to be selfish at times, as long as we are selfless at other times.
Emotion Dysregulation: I love this term: dys—not; regulation—maintaining stability. Think of a toddler. You’re in a grocery store and your toddler asks for the M&M’s in the check-out line. Oh no. You politely and quietly say no. Then you try to reason with them (bad idea). Then you get louder (stand your ground—another bad idea). Then they’re shouting and you are shouting and turning beet red. You are not happy and your toddler is not happy. And, your first instinct is to bolt.
Second scenario. As a psychologist, teacher, or parent, perhaps you’ve been asked to speak with a young person who seems to have serious behavioral issues. Your task is to try to help ‘problem solve.’ You provide him with a possible scenario that “someone takes your jello at lunch.” How do you feel and what do you do? Truth be told, the “appropriate” answer is to “speak to the adult monitoring the cafeteria.” The answers I have been given include:
“punch them in the face, steal it back, kill them.” Clearly, these are not appropriate responses, but it tells us a lot about how this particular person has ‘learned’ to function. A different person given a similar scenario, might internalize and binge eat ice cream (another problem, albeit a form of ineffective coping). Some have learned (appropriately so) to share how that makes them feel. But, what about when the tension escalates? What tools can we use to respond to this feedback?
- Learn to understand our emotions. Fear=concerns that something will be taken from us; anxiety=us not having control over what we know or desire to be ‘true.’ Anger=feeling unheard, feeling belittled, being treated in a manner that we don’t feel is right. Let’s learn to identify what we are feeling and and what happened that led us to these feelings. Once we uncover the real ‘feeling,’ not the surface, we can start to treat it appropriately.
- Learn how to accumulate positive experiences by building in little things that we know we enjoy or expect to enjoy. For example, after working for three hours, I’m going to give myself a little reward (e.g., coffee, walk around the block, play with the dog).
- Build mastery. Learn a new talent and master it. A dear friend of mine in her 60s just decided that she is going to learn to play the guitar. She has learned one song thus far in the last six months. I think that’s awesome; we can all learn and get lost in it. You do you!
- Anticipate a coping strategy. if you know you will be in a stressful situation, what will (and can) make it better and more manageable? Bring a book, listen to a podcast, plan something fun after.
- Finally, Distress Tolerance: This is a hard one and should not be considered “tolerance /acceptance.” We are all going to experience distress, and we can all learn how to cope to the best of our abilities. Tolerance does not mean that we have to like it, either; however, given that there is much of life that is out of our control, we must do with it what we can. This reminds me of the film Life is Beautiful. This movie reminds us that, even if the midst of horrible situations, much can be changed by how we perceive it and what we make of it. (This, by no means, suggests that what is happening is not deplorable.) So, what are out options?
- Improve the moment: If the electricity goes out (and it is temporary), let’s have a flashlight read-along. If things are stressful, let’s pause and figure out what (in this moment) can make things a little, even if is just a tiny a morsel better? If I have to wait longer at a doctor’s appointment than anticipated, can I read a book that I’ve been wanting to read for a while? If I get, oh, let’s see—locked into my house with my kids for ten months—can I be grateful to have this time with my safe, rambunctious kids? And, then, play games? Rollerblade? Read? Give them time to be kids while I get my time adulting? Learn how to cook something? Learn knitting with them or making a million friendship bracelets?
- Radical acceptance: I am not only going to accept what is happening, but I am going to put my all into it. So, if I’m going to stay in my house for this amount of time, I am going to redesign my living room. I am going to give back to others if possible. I am going to accomplish all of these things that I have wanted to do for some time. I am going to allow my feelings to upset me for only a short period of time and then I’m going to bounce back. Further. And, higher.
- Change of atmosphere: If I’m really feeling deflated and as though I am going to crumble, I might change my atmosphere drastically. I will go running and increase my adrenaline and give myself a runner’s high. I will go shower in ice cold water (hey, it will take your mind off things). I will hold a piece of ice in my hand (which we have done in psychiatric hospitals) and I promise, you will feel different things. Sometimes we have to, quite literally, change our physiological response to stop ourselves in our spiral. Hit the ‘reset’ button, if you will.
- Self-soothing: I will relax in a bath. I will make cookies and smell the aroma. I will wrap myself in a cozy fleece blanket. I will go outside to fresh air. I will listen to quiet, beautiful music.
- Practice gratitude: It’s human nature to compare ourselves to others. But, is it really helpful? The reality is that the more that we try to grow into who we want to be and give it time, patience, and respect, we will become that person. Our past helps to shape us. Often, the very things we perceived as being ‘bad’ were huge growth opportunities that eventually helped us to feel better. Ask yourself: In five years, will I be proud of what I did or how I acted? The reality is, we could all use a little more appreciation, kindness, and flexibility (even applied to ourselves).
I have used some of these DBT skills on a variety of individuals, myself included. I have seen the beauty of DBT and how people benefit so greatly from it. There is a philosophy that you cannot and should not ‘make’ people, who are willful (i.e,. stubborn, unwilling, non-motivated) do things that they do not want to do. However, with time and exposure, seeing others feeling content—even happy, people often learn that they, too, want to be happy. So, as Dr. Linehan would say, “Let me know when you’re ready, and let’s go together.”
Remember, you are not alone… For more on DBT, consider reading Dr. Linehan’s books (see below). They just might change your perspective.
1 Reidbord M.D., S. (September, 13, 2019) “Dialectics in Psychotherapy,” psychologytoday.com
2 Marsha M. Linehan (born May 5, 1943) is an American psychologist and author. She is the creator of dialectical behavior therapy (DBT), a type of psychotherapy that combines behavioral science with Buddhist concepts, such as acceptance and mindfulness. en.wikipedia.org/wiki/Marsha_M._Linehan.
3 Emotional dysregulation is the clinical term used to describe an emotional state that is difficult to control, including unhealthy patterns of emotional coping, a predilection toward outbursts of emotions, and an inability to or a struggle with expressing emotions effectively (if at all). (August 28, 2020) www.betterhelp.com.
