Tag Archives: Blogging201

Dialectical Behavior Therapy (DBT)

Posted on by Gertie

Happy Friday!!! It being Friday, that means it is time for me to do my educational feature. I have decided to do the topic of Dialectical Behavior Therapy (DBT). The reason being is because I did the topic of Borderline Personality Disorder (BPD). I got the following information off of the  Linehan Institute; Behavior Tech at:   http://behavioraltech.org/resources/whatisdbt.cfm

What is DBT?

Overview

Dialectical Behavior Therapy (DBT) is a cognitive behavioral treatment that was originally developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD) and it is now recognized as the gold standard psychological treatment for this population. In addition, research has shown that it is effective in treating a wide range of other disorders such as substance dependence, depression, post-traumatic stress disorder (PTSD), and eating disorders.

What are the components of DBT?

In its standard form, there are four components of DBT: skills training group, individual treatment, DBT phone coaching, and consultation team.

  1. DBT skills training group is focused on enhancing clients’ capabilities by teaching them behavioral skills. The group is run like a class where the group leader teaches the skills and assigns homework for clients to practice using the skills in their everyday lives. Groups meet on a weekly basis for approximately 2.5 hours and it takes 24 weeks to get through the full skills curriculum, which is often repeated to create a 1-year program. Briefer schedules that teach only a subset of the skills have also been developed for particular populations and settings.
  2. DBT individual therapy is focused on enhancing client motivation and helping clients to apply the skills to specific challenges and events in their lives. In the standard DBT model, individual therapy takes place once a week for as long as the client is in therapy and runs concurrently with skills groups.
  3. DBT phone coaching is focused on providing clients with in-the-moment coaching on how to use skills to effectively cope with difficult situations that arise in their everyday lives. Clients can call their individual therapist between sessions to receive coaching at the times when they need help the most.
  4. DBT therapist consultation team is intended to be therapy for the therapists and to support DBT providers in their work with people who often have severe, complex, difficult-to-treat disorders. The consultation team is designed to help therapists stay motivated and competent so they can provide the best treatment possible. Teams typically meet weekly and are composed of individual therapists and group leaders who share responsibility for each client’s care.

What skills are taught in DBT?

DBT includes four sets of behavioral skills.

  • Mindfulness: the practice of being fully aware and present in this one moment
  • Distress Tolerance: how to tolerate pain in difficult situations, not change it
  • Interpersonal Effectiveness: how to ask for what you want and say no while maintaining self-respect and relationships with others
  • Emotion Regulation: how to change emotions that you want to change

There is increasing evidence that DBT skills training alone is a promising intervention for a wide variety of both clinical and nonclinical populations and across settings.

What does “dialectical” mean?

The term “dialectical” means a synthesis or integration of opposites. The primary dialectic within DBT is between the seemingly opposite strategies of acceptance and change. For example, DBT therapists accept clients as they are while also acknowledging that they need to change in order to reach their goals. In addition, all of the skills and strategies taught in DBT are balanced in terms of acceptance and change. For example, the four skills modules include two sets of acceptance-oriented skills (mindfulness and distress tolerance) and two sets of change-oriented skills (emotion regulation and interpersonal effectiveness).

How does DBT prioritize treatment targets?

Clients who receive DBT typically have multiple problems that require treatment. DBT uses a hierarchy of treatment targets to help the therapist determine the order in which problems should be addressed. The treatment targets in order of priority are:

  1. Life-threatening behaviors: First and foremost, behaviors that could lead to the client’s death are targeted, including all forms of suicidal and non-suicidal self-injury, suicidal ideation, suicide communications, and other behaviors engaged in for the purpose of causing bodily harm.
  2. Therapy-interfering behaviors: This includes any behavior that interferes with the client receiving effective treatment. These behaviors can be on the part of the client and/or the therapist, such as coming late to sessions, cancelling appointments, and being non-collaborative in working towards treatment goals.
  3. Quality of life behaviors: This category includes any other type of behavior that interferes with clients having a reasonable quality of life, such as mental disorders, relationship problems, and financial or housing crises.
  4. Skills acquisition: This refers to the need for clients to learn new skillful behaviors to replace ineffective behaviors and help them achieve their goals.

Within a session, presenting problems are addressed in the above order. For example, if the client is expressing a wish to commit suicide and reports recurrent binge eating, the therapist will target the suicidal behaviors first. The underlying assumption is that DBT will be ineffective if the client is dead or refuses to attend treatment sessions.

What are the stages of treatment in DBT?

DBT is divided into four stages of treatment. Stages are defined by the severity of the client’s behaviors, and therapists work with their clients to reach the goals of each stage in their progress toward having a life that they experience as worth living.

  1. In Stage 1, the client is miserable and their behavior is out of control: they may be trying to kill themselves, self-harming, using drugs and alcohol, and/or engaging in other types of self-destructive behaviors. When clients first start DBT treatment, they often describe their experience of their mental illness as “being in hell.” The goal of Stage 1 is for the client to move from being out of control to achieving behavioral control.
  2. In Stage 2, they’re living a life of quiet desperation: their behavior is under control but they continue to suffer, often due to past trauma and invalidation. Their emotional experience is inhibited. The goal of Stage 2 is to help the client move from a state of quiet desperation to one of full emotional experiencing. This is the stage in which post-traumatic stress disorder (PTSD) would be treated.
  3. In Stage 3, the challenge is to learn to live: to define life goals, build self-respect, and find peace and happiness. The goal is that the client leads a life of ordinary happiness and unhappiness.
  4. For some people, a fourth stage is needed: finding a deeper meaning through a spiritual existence. Linehan has posited a Stage 4 specifically for those clients for whom a life of ordinary happiness and unhappiness fails to meet a further goal of spiritual fulfillment or a sense of connectedness of a greater whole. In this stage, the goal of treatment is for the client to move from a sense of incompleteness towards a life that involves an ongoing capacity for experiences of joy and freedom.

How effective is DBT?

Research has shown DBT to be effective in reducing suicidal behavior, non-suicidal self-injury, psychiatric hospitalization, treatment dropout, substance use, anger, and depression and improving social and global functioning. For a review of the research on DBT, click here. In this video, DBT Developer and Behavioral Tech founder Dr. Marsha Linehan describes the amazing changes she’s seen in people who have received DBT and gotten out of hell.

Dive Deeper

Philosophy and Principles of DBT

DBT is based on three philosophical positions. Behavioral science underpins the DBT bio-social model of the development of BPD, as well as the DBT behavioral change strategies and protocols. Zen and contemplative practices underpin DBT mindfulness skills and acceptance practices for both therapists and clients. DBT was the first psychotherapy to incorporate mindfulness as a core component, and the Mindfulness skills in DBT are a behavioral translation of Zen practice. The dialectical synthesis of a “technology” of acceptance with a “technology” of change was what distinguished DBT from the behavioral interventions of the 1970s and 1980s. Dialectics furthermore keeps the entire treatment focused on a synthesis of opposites, primarily on acceptance and change, but also on the whole as well as the parts, and maintains an emphasis on flexibility, movement, speed, and flow in the treatment.

True to dialectics, DBT strategies are designed in pairs representing acceptance (validation, reciprocal communication, environmental intervention on behalf of the client) and change (problem solving, irreverence, consultation-to-the-patients about how they can change their own environment). Strategies are further divided into procedures; a set of principles guides the selection of strategies and procedures depending on the needs of the individual client. Clients are also taught a series of behavioral skills designed to promote both acceptance and change. A focus on replacing dysfunctional behaviors with skillful behaviors is woven throughout DBT.

DBT is a principle-based treatment that includes protocols. As a principle-based treatment, DBT is quite flexible due to its modular construction. Not only are strategies and procedures individualized, but various aspects of the treatment, such as disorder-specific protocols, can be included or withdrawn from the treatment as needed. To guide therapists in individualizing priorities for targeting disorders and behavioral problems, DBT incorporates a concept of levels of disorder (based on severity, risk, disability, pervasiveness, and complexity) that in turn guides stages of treatment and provides a hierarchy of what to treat when for a particular patient. In contrast, skills training is protocol based. Once a skills curriculum is determined, what is taught in a session is guided by the curriculum, not by the needs of a single client during that session.

The Development of DBT

In the late 1970s, Marsha M. Linehan attempted to apply standard Cognitive Behavior Therapy (CBT) to the problems of adult women with histories of chronic suicide attempts, suicidal ideation, and non-suicidal injury. Trained as a behaviorist, she was interested in treating these and other discrete behaviors. Through consultation with colleagues, however, she concluded that she was treating women who met criteria for Borderline Personality Disorder (BPD). In the late 1970s, CBT had gained prominence as an effective psychotherapy for a range of serious problems. Dr. Linehan was keenly interested in investigating whether or not it would prove helpful for individuals whose suicidality was in response to extremely painful problems. As she and her research team applied standard CBT, they encountered numerous problems with its use. Three were particularly troublesome:

  1. Clients receiving CBT found the unrelenting focus on change inherent to CBT to be invalidating. Clients responded by withdrawing from treatment, by becoming angry, or by vacillating between the two. This resulted in a high drop-out rate. If clients do not attend treatment, they cannot benefit from treatment.
  2. Clients unintentionally positively reinforced their therapists for ineffective treatment while punishing their therapists for effective therapy. For example, the research team noticed through its review of taped sessions that therapists would “back off” pushing for change of behavior when the client’s response was one of anger, emotional withdrawal, shame, or threats of self-harm. Similarly, clients would reward the therapist with interpersonal warmth or engagement if the therapist allowed them to change the topic of the session from one they did not want to discuss to one they did want to discuss.
  3. The sheer volume and severity of problems presented by clients made it impossible to use the standard CBT format. Individual therapists simply did not have time to both address the problems presented by clients (suicide attempts, self-harm, urges to quit treatment, noncompliance with homework assignments, untreated depression, anxiety disorders, and more) and have session time devoted to helping the client learn and apply more adaptive skills.

In response to these key problems with standard CBT, Linehan and her research team made significant modifications to standard CBT.

They added acceptance-based or validation strategies to the change-based strategies of CBT. Adding these communicated to the clients that they were both acceptable as they were and that their behaviors, including those that were self-harming, made real sense in some way. Further, therapists learned to highlight for clients when their thoughts, feelings, and behaviors were “perfectly normal,” helping clients discover that they had sound judgment and that they were capable of learning how and when to trust themselves. The new emphasis on acceptance did not occur to the exclusion of the emphasis on change: clients must change if they want to build a life worth living.

In the course of weaving in acceptance with change, Linehan noticed that another set of strategies – dialectics – came into play. Dialectical strategies give the therapist a means to balance acceptance and change in each session. They also serve to prevent both therapist and client from becoming stuck in the rigid thoughts, feelings, and behaviors that can occur when emotions run high, as they often do in the treatment of clients diagnosed with BPD. Dialectical strategies and a dialectical world view, with its emphasis on holism and synthesis, enable the therapist to blend acceptance and change in a manner that results in movement, speed, and flow in individual sessions and across the entire treatment. This counters the tendency, found in treatment with clients diagnosed with BPD, to become entrenched in arguments and polarizing or extreme positions.

Significant changes were also made to the structure of treatment in order to solve the problems encountered in the application of standard CBT.

In her original treatment manual, Cognitive-Behavioral Treatment of Borderline Personality Disorder (1993), Linehan hypothesizes that any comprehensive psychotherapy must meet five critical functions. The therapy must:

  1. Enhance and maintain the client’s motivation to change
  2. Enhance the client’s capabilities
  3. Ensure that the client’s new capabilities are generalized to all relevant environments
  4. Enhance the therapist’s motivation to treat clients while also enhancing the therapist’s capabilities
  5. Structure the environment so that treatment can take place

As already described, the structure of DBT includes four components: skills group, individual treatment, DBT phone coaching, and consultation team. These components meet the five critical functions of a comprehensive psychotherapy in the following ways:

  1. It is typically the individual therapist who maintains the client’s motivation for treatment, since the individual therapist is the most prominent individual working with the client.
  2. Skills are acquired and strengthened, and generalized through the combination of skills groups and homework assignments.
  3. Clients capabilities are generalized through phone coaching (clients are instructed to call therapists for coaching prior to engaging in self harm), in vivo coaching, and homework assignments.
  4. Therapists’ capabilities are enhanced and burnout is prevented through weekly consultation team meetings. The consultation team helps the therapist stay balanced in his or her approach to the client, while supporting and cheerleading the therapist in applying effective interventions.
  5. The environment can be structured in a variety of ways. For example, the home environment could be structured by the client and therapist meeting with family members to ensure that the client is not being reinforced for maladaptive behaviors or punished for effective behaviors in the home

True to dialectics, DBT strategies are designed in pairs representing acceptance (validation, reciprocal communication, environmental intervention on behalf of the client) and change (problem solving, irreverence, consultation-to-the-patients about how they can change their own environment). Strategies are further divided into procedures; a set of principles guides the selection of strategies and procedures depending on the needs of the individual client. Clients are also taught a series of behavioral skills designed to promote both acceptance and change. A focus on replacing dysfunctional behaviors with skillful behaviors is woven throughout DBT.

DBT is a principle-based treatment that includes protocols. As a principle-based treatment, DBT is quite flexible due to its modular construction. Not only are strategies and procedures individualized, but various aspects of the treatment, such as disorder-specific protocols, can be included or withdrawn from the treatment as needed. To guide therapists in individualizing priorities for targeting disorders and behavioral problems, DBT incorporates a concept of levels of disorder (based on severity, risk, disability, pervasiveness, and complexity) that in turn guides stages of treatment and provides a hierarchy of what to treat when for a particular patient. In contrast, skills training is protocol based. Once a skills curriculum is determined, what is taught in a session is guided by the curriculum, not by the needs of a single client during that session.

  1. Clients receiving CBT found the unrelenting focus on change inherent to CBT to be invalidating. Clients responded by withdrawing from treatment, by becoming angry, or by vacillating between the two. This resulted in a high drop-out rate. If clients do not attend treatment, they cannot benefit from treatment.
  2. Clients unintentionally positively reinforced their therapists for ineffective treatment while punishing their therapists for effective therapy. For example, the research team noticed through its review of taped sessions that therapists would “back off” pushing for change of behavior when the client’s response was one of anger, emotional withdrawal, shame, or threats of self-harm. Similarly, clients would reward the therapist with interpersonal warmth or engagement if the therapist allowed them to change the topic of the session from one they did not want to discuss to one they did want to discuss.
  3. The sheer volume and severity of problems presented by clients made it impossible to use the standard CBT format. Individual therapists simply did not have time to both address the problems presented by clients (suicide attempts, self-harm, urges to quit treatment, noncompliance with homework assignments, untreated depression, anxiety disorders, and more) and have session time devoted to helping the client learn and apply more adaptive skills.
  4. In response to these key problems with standard CBT, Linehan and her research team made significant modifications to standard CBT.

They added acceptance-based or validation strategies to the change-based strategies of CBT. Adding these communicated to the clients that they were both acceptable as they were and that their behaviors, including those that were self-harming, made real sense in some way. Further, therapists learned to highlight for clients when their thoughts, feelings, and behaviors were “perfectly normal,” helping clients discover that they had sound judgment and that they were capable of learning how and when to trust themselves. The new emphasis on acceptance did not occur to the exclusion of the emphasis on change: clients must change if they want to build a life worth living.

In the course of weaving in acceptance with change, Linehan noticed that another set of strategies – dialectics – came into play. Dialectical strategies give the therapist a means to balance acceptance and change in each session. They also serve to prevent both therapist and client from becoming stuck in the rigid thoughts, feelings, and behaviors that can occur when emotions run high, as they often do in the treatment of clients diagnosed with BPD. Dialectical strategies and a dialectical world view, with its emphasis on holism and synthesis, enable the therapist to blend acceptance and change in a manner that results in movement, speed, and flow in individual sessions and across the entire treatment. This counters the tendency, found in treatment with clients diagnosed with BPD, to become entrenched in arguments and polarizing or extreme positions.

Significant changes were also made to the structure of treatment in order to solve the problems encountered in the application of standard CBT.

In her original treatment manual, Cognitive-Behavioral Treatment of Borderline Personality Disorder (1993), Linehan hypothesizes that any comprehensive psychotherapy must meet five critical functions. The therapy must:

  1. Enhance and maintain the client’s motivation to change
  2. Enhance the client’s capabilities
  3. Ensure that the client’s new capabilities are generalized to all relevant environments
  4. Enhance the therapist’s motivation to treat clients while also enhancing the therapist’s capabilities
  5. Structure the environment so that treatment can take place

As already described, the structure of DBT includes four components: skills group, individual treatment, DBT phone coaching, and consultation team. These components meet the five critical functions of a comprehensive psychotherapy in the following ways:

  1. It is typically the individual therapist who maintains the client’s motivation for treatment, since the individual therapist is the most prominent individual working with the client.
  2. Skills are acquired and strengthened, and generalized through the combination of skills groups and homework assignments.
  3. Clients capabilities are generalized through phone coaching (clients are instructed to call therapists for coaching prior to engaging in self harm), in vivo coaching, and homework assignments.
  4. Therapists’ capabilities are enhanced and burnout is prevented through weekly consultation team meetings. The consultation team helps the therapist stay balanced in his or her approach to the client, while supporting and cheerleading the therapist in applying effective interventions.
  5. The environment can be structured in a variety of ways. For example, the home environment could be structured by the client and therapist meeting with family members to ensure that the client is not being reinforced for maladaptive behaviors or punished for effective behaviors in the home.

DBT has personally saved my life and am grateful to have had the opportunity to take an intensive outpatient DBT program. DBT is awesome and it is one of the best decisions I have made in my life. Have an awesome Friday and Peace Out!!

Writting 201: Poetry; Day Four: Imperfect, Limerick, Enjambment

Posted on by Gertie

UNTITLED POEM

(For Now)

by Gertie

All you seem to care about are my scars,

You don’t care about me wanting to jump in front of the moving cars.

Suicide is on my mind,

Wish you could be kind.

Please tell me a corny joke about being in a bar.

(Side Note: I wrote this poem back in February when I was feeling extremely suicidal. I AM NOT FEELING SUIDAL NOW)

Writing 201: Poetry; Day Three: Skin, Prose Poem, Internal Rhyme

Posted on by Gertie

You Know Me Not, You See Me Not

by Gertie

You know my name

Not my story

You see my smile

Not my pain

You see my cuts

Not my scars

You can read my lips

Not my mind

Writing 201: Poetry; Day Two: Gift, Acrostic, Simile

Posted on by Gertie

R.E.C.O.V.E.R.Y

by Gertie

Recovery is a gift. A gift not everyone chooses to open,

Eagerly trying to open it, to see what it has to offer.

Consciously striving,

One must not forget where they once were.

Valleys so deep,

Earnestly grasping the cliffs that surround the valley.

Recovery is just a grasp a way.

Yes, the gift of recovery one chooses to open is a gift one must work for

Daily Prompt: If I Could Turn Back Time

Posted on by Gertie

In response to The Daily Post’s writing prompt: “If I Could Turn Back Time.” If you could return to the past to relive a part of your life, either to experience the wonderful bits again, or to do something over, which part of you life would you return to? Why?

I personally think we all have moments where we could turn back time to do over or even re-experience something good or joyous in our life. Who wouldn’t want to do an embarrassing day they experienced in junior high / middle school? Who wouldn’t want to experience a time in their life where it was a joyous or wonderful? I know for me that there are plenty of embarrassing moments from junior high I would love to do over again. I also know I would love to re-experience all the wonderful experiences I have had.

But truthfully, I don’t know if there is a time I would want to turn back. I say this because if we go back and change things then it would change the course of our lives. Despite all the pain and suffering I have experienced in my life; it has made me the person I am today. Granted if I could turn back time; I wouldn’t want to struggle with a mental illness. Then again, my mental health diagnosis has helped shaped on who I am as a person. I’m not my mental illness but it has shaped me and for the better. Don’t get me wrong I wouldn’t wish a mental illness on anyone but its helped make me realize who I am as a person and what direction my life is going. It’s just like I wouldn’t wish anyone to get hurt like I did as a child (including those who abused me) nor would I want to re-experience being hurt again but its helped me be the person I am today. As much as I don’t like some of the aspects of what I experienced in my life I am grateful that it has made me who I am today. Yes, the positive experiences have made me who I am today as well and I still wouldn’t want to relive them for the same reason as the negative experiences. Turning back time would just make me a different person and that is why I wouldn’t want to do it at all. I’ve learned that as much as I want to turn back time at times that there is no going back. Enjoy what you have in the moment.

For me enjoying what I have in the moment is the best way to live my life and not turn back time. I hope everyone takes the time today to enjoy the moment that they are living in. Life is too short to not enjoy the current moment. Have a wonderful day and peace out!!

Writing 201: Poetry; Day One: Screen, Haiku, Alliteration

Posted on by Gertie

An Untitled Haiku

(For now)

by Gertie

One size fits all doesn’t work.

Recovery is a unique process.

As unique as you and I.

Weekly Goals

Posted on by Gertie

Happy Monday!!! It is the start of another work week and like always I was looking forward to going to work today but still not feeling all that well so I called into work sick. I love the fact that I look forward to going to work each day even when I am unable to do so. It being Monday, it also means it is time to do my weekly goals. Like always I will start with how I did with my last weeks goals.

1)  Read Speaker of the Dead by Orson Scott Card. I only read a total of three pages but I read. I ended up starting to read another book that highly encouraged for those of us who work in the mental health field to read.

2)  Work on jigsaw puzzle. I spent a great deal of time work on the puzzle this week since I haven’t been feeling all that well.

3)  Color. Another thing I spent a great deal of time doing this week since I wasn’t feeling all that well.

4)  Writing 101: Finding Your Inspiration. I finishing up Writing 101. I learned a great deal from it and hope to continue finding inspiration in everything.

5)  Update my résumé. Yup, I update my résumé. I was even able to update my references with both my previous and current supervisor  of my current employer.

6)  Work on cover letter. I updated my cover letter. I find it difficult to look at my strengths but was able to do so.

7)  Apply for a least one job. Yup, I applied for a job. It was only one job but it is the job I most want.

8)  Work on a self-help workbook; The Dialectical Behavior Therapy Skills Workbook by Matthew McKay, PhD., Jeffery C. Wood, PSY.D., and Jeffrey Brantley, MD. I managed to do a couple of pages. It was difficult to do since I haven’t been feeling all that well.

9)  See my therapist on Wednesday. Yup, I saw my therapist despite not feeling well. We discussed how I need to focus on what my body is trying to tell me. I find it difficult sometimes.

Despite not feeling well this past week, I managed to accomplish every goal. Now it is time to share with you my goals for this week.

1)  Read Speaker of the Dead by Orson Scott Card.  I am bound and determined to finish this book. I am loving the book, it just seem to be taking longer than usual to read.

2)  Work on jigsaw puzzle. I am loving how the puzzle is slowly progressing.

3)  Color. The various coloring pages or posters I am working on are finally showing some progress.

4)  Start Writing 201: Poetry. I am taking another course that WordPress puts on to help improve ones blogging skills. I am looking forward this particular course because I love poetry.

5)  Work on a self-help workbook; The Dialectical Behavior Therapy Skills Workbook by Matthew McKay, PhD., Jeffery C. Wood, PSY.D., and Jeffrey Brantley, MD. I am actually grateful that I have decided to do this workbook. It has helped me remember how much I have improved with DBT skills over the years.

6)  See my therapist on Wednesday. Yes, I see my therapist again on Wednesday. I’m thinking it is a great thing because I have been feeling a little on the downside. Don’t worry I am pretty sure it is just because I haven’t been feeling well.

Well, it seems like I have been having some of the same goals for awhile now. I am thinking that next week I will have to change things up a little when it comes to my goals. I am greatly appreciative of the blogging event over at: http://greenembe.rs/2015/10/05/building-rome-week-40-for-2015/ Have a wonderful week. Peace Out!!

Beautiful, Sunny Yet Crisp Sunday

Posted on by Gertie

It is a beautiful, sunny yet crisp Sunday where I live. To make this day even more beautiful than it already is, is when Junior came home from work this morning and made me breakfast in bed. Junior is so romantic. After breakfast in bed, we had some intimate moments and then took a nap.

After the nap, Junior and myself went to a local park with a lake and walked around the lake holding hands. We held hand and talked. We talked about everything. When we walked around the lake twice, we decided to have lunch a nearby restaurant. As we ate we discussed how our love continues to grow for each other and how cool (and romantic) it is to do spontaneous things that we were doing.

Now that we are home and it is three o’clock in the afternoon, Junior and I are relaxing and taking it easy. Junior is reading a book as I sit here at my laptop blogging. Junior just started a book called Into The Storm by Taylor Anderson. So far he says it is a good book. The book is a Science Fiction book that is based on a Navy Ship in World War II. After I am done blogging I tend to read. Not sure if it will be Speaker of the Dead by Orson Scott Card or Trauma Stewardship; An Everyday Guide for Self While Caring for Others by Laura van Dernoot Lipsky with Connie Burk. I will probably read the latter of the two books.

I love days like today where I can be with the person I love. Most importantly, I love the fact that I can be at peace and be content with who I am despite still not feeling well. I am content with how my life is going and the people I have in my life.

With all that being said, I am going to end the post. Have a wonderful Sunday and Peace Out!!

Can I Have Just One Night Without Nightmares

Posted on by Gertie

I woke up about an hour ago with a nightmare. A nightmare that could have possibly turned into a screaming nightmare if Junior didn’t gently wake me up. The above picture is not me but that’s how I tend to end up after a horrific nightmare like the one I had tonight.

Like the loving partner, Junior is, he comforted me. As I was curled up in the fetal position, Junior asked if it was okay to rub my back and I shook my yes. As Junior rubbed my back I slowly felt safe enough to get out of the fetal position to allow myself to be held by Junior. As Junior held me I cried. I cried out the emotions that have haunted me for years.

After a nice long, good cry with Junior, we are now up. Junior put in a movie and decided to bake some chocolate cupcakes as I blog and watch the movie. I know it is going to take some time to recover from the nightmare I had tonight and I am radically accepting that moment.

For those who are not familiar with Dialectical Behavior Therapy (DBT), radical acceptance is a skill. A skill that is defined as: complete and total acceptance of something; accepting reality. Radical acceptance is one of the key components of Dialectical Behavior Therapy (DBT).

Radical acceptance is not the easiest of skills to master. I am speaking from experience. It is something that I will need to continue to practice so I can master it or at least come close to. It is a skill that I find difficult for many reason that I hope to explain at a later date.

I know I am needing to go so I can continue to radically accept the nightmare. I also want to focus on the movie and spend time with Junior. I hope everyone has a wonderful Saturday. Have a great weekend and peace out!!

Writing 101: Finding Your Inspiration; Day Twenty: The Future

Posted on by Gertie

Today is the last day of Writing 101: Finding Your Inspiration. I am a wee bit sad that it is the last day. I have learned a great deal from this course. One of the many things I have learned from this course is the many ways I am able to find inspiration to write, weather it is for my blog or personal writings.

Speaking of writing, todays assignment is to write about the future. We were given many different prompts to choose from to write about the future. I am choosing to not pick one of those prompts to discuss the future. I have chosen my own topic to discuss in regards to the future. I have chosen to discuss about my career and its future.

As many of you know I work in the mental health field as a Consumer Aide. I have had this position for the last year. Part of the reason why I am a Consumer Aide is because I was unable to get a job as a Peer Specialist last year (2014) due to the fact that I didn’t have enough paid experience. Don’t get me wrong I love my job with a passion. I just really want to be a Peer Specialist.

Now that I have worked a year in the mental health field, I figure that I have enough paid experience. Plus it looks better on a résumé the longer you are at an employer. I have been thinking a great deal about my future in regards to my career the last several years and the last year has confirmed that I am meant to work in the mental health field. I love being able to help people.

Yesterday, I took another step in making my dream come true in regards to moving up in the mental health field. I applied for a Peer Specialist job yesterday with my supervisors “blessing.” She said that she would be more than willing to be a reference for me “even if it is for a different agency.” In fact my previous supervisor said something similar in an email. It feels good knowing that I am good at what I do and that I have the “blessings” of both my current and previous supervisors. Unfortunately, the agency I currently work for, don’t have any Peer Specialist openings at the moment. If they did I would have applied to them first instead of a different agency. I really want the job as a Peer Specialist and hope I get the job but at this moment in time, I just want a call saying that I got an interview.

The one thing I have learned about applying for jobs is to not put your life on hold waiting for a call to see if you got a interview much less the job especially the interview. I have found out from experience that if employers like your résumé  and/or your cover letter they will call you within two weeks to set up an interview. In most cases, employers will let you know if you got the job or not within two weeks. I did have one agency interview me last year that never got back to me even when I emailed them inquiring weather or not I got the job. That’s okay because I now realize maybe its not an agency I want to work for anyway and for a multitude of reasons. I am happy with the experience I have gotten with how various agencies work in regards to their hiring process.

As I end this last assignment of Writing 101: Finding Your Inspiration can you all please send out positive energy and vibes that I get an interview. It will be much appreciated. Have a Happy Friday and Peace Out!!