Common Cognitive Distortions: Negative Filtering

Negative Filtering is a common cognitive distortion, and most of us do it from time to time. Simply, it is filtering out all of the positive information about a specific situation and only allowing in the negative information. In other words, negative filtering is focusing on negative things and discounting positive things. For instance, negative filtering occurs if you’re usually on time with deadlines but are late once and have thoughts about being incompetent. Or, if you generally make A’s and B’s in a class but make a lower grade on one assignment, having thoughts about being stupid or a poor student is evidence of negative filtering.

Negative filtering often accompanies unrealistically high expectations. Unrealistic expectations involve anticipating always doing something well or doing something perfectly. Perfection is the standard against which all effort is judged. If you reach it, it’s merely doing what is expected. But if you fall short occasionally, it is easy to ignore all of your past successes and focus entirely on the few instances that were not as successful.

Negative filtering can be harmful, as only focusing on negative things can result in a depressed mood, poor self-esteem, and unhealthy pessimism. Many people get caught in a cycle of negative filtering that results in poor mood, resulting in more negative filtering, etc. Negative filtering is one of the primary cognitive distortions in people with depression. As such, identifying negative filtering is one of the primary treatment targets in cognitive behavioral therapy for depression.

The key thing to do when you suspect you may be engaging in negative filtering is to examine the actual evidence. Look around to find instances in which things are not all bad and, more importantly, things to be grateful for. Ask yourself if other people you know would come to the same conclusion given the circumstances and if not, what would they be focusing on that you’re not? Is the evidence really all bad, or are there varying degrees? Try making the opposite case, for instance, that you will be able to pass the class or that you’re not incompetent. Is there more evidence for that argument? By probing and systematically looking at the way we think about things, we can come to more rational, less mood-dependent conclusions.

Being vigilant to negative filtering can help us learn to take on more effective, less pessimistic perspectives and consequently feel better about our situation. The next time you suspect you may be engaging in filtering, try taking on an alternate perspective by more closely examining your thoughts. 

All material provided on this website is for informational purposes only. Direct consultation with a qualified provider should be sought for any specific questions or problems.  Use of this website in no way constitutes professional service or advice. 

Cognitive Distortions: Labeling

Labeling is a cognitive distortion in which we generalize by taking one characteristic of a person and applying it to the whole person. Because I failed a test, I am a failure. Because she is frequently late to work, she is irresponsible.  If someone responds in a brusque way, he is a jerk. Rather than more objectively thinking about the behavior, when we engage in labeling, we globally describe the whole person. As a result, we view the entire person through the label, such as jerk, and filter out any information that doesn’t fit under the umbrella of the label. This results in the label feeling more apt as a descriptor of the person, and we believe it more.

So what’s wrong with labeling? Well, as it is a cognitive distortion, it is necessarily a distorted way of thinking about things. The person who spoke to us curtly may not be “a jerk” but instead could be in a hurry. Or they may be a very kind and generous person who speaks directly and to the point. Making one broad assumption about someone based on one isolated data point or just a few data points is almost always inaccurate.

Labeling as a cognitive distortion, in addition to causing inaccurate thinking, can fuel and maintain painful emotions. If you fail a test and come to the conclusion that this means you’re a failure, it will likely trigger feelings of sadness, despair, hopelessness, etc. Whereas recognizing that you merely failed a test would most probably result in more mild disappointment. Furthermore, if you believe the label, identifying as a failure, you won’t know what to do to solve the problem. Failing a test means you need to study more. Problem solved. Failing in life, however… What do you do to solve that?

Labeling also causes problems when we apply it to others. Labeling your husband as uncaring because he appears not to listen to you when you talk about your day can feel miserable. You’re married to an uncaring person. But if you consider the behavior as the problem rather than the person, it becomes easier to discuss with him and potentially solve it. For instance, it may be that he needs time to unwind at the end of the day or has difficulty concentrating in general.

When we notice ourselves engaging in the cognitive distortion of labeling, there is one simple solution: objectively describe the behavior we notice. That person is late to work. I failed the test. She spoke to me brusquely. You may find that fewer negative feelings are stirred by this more objective, more accurate language. Even better, problems that have felt unsolvable, or people who seem impossible, may become much more manageable. 

All material provided on this website is for informational purposes only. Direct consultation with a qualified provider should be sought for any specific questions or problems.  Use of this website in no way constitutes professional service or advice. 

Achieve Your Goals by Countering Automatic Thoughts

Many people who have anxiety and depression often feel hopeless about getting what they want in life. It’s not that they haven’t tried to achieve their goals. The problem is that what they have tried hasn’t worked as well as they would have liked. Over time, they conclude it is not worth the continued effort. As a result, they feel they are off track in their lives, and this feeling fuels and maintains their anxiety and depression.  The more depressed they become, the less effective their efforts seem. It can be a devastating cycle.

There is a technique from a form of CBT called Cognitive Behavioral Assessment System of Psychotherapy (CBASP) designed specifically for this dilemma. It involves looking at your goal and working backward to determine what has gotten in the way of achieving it. This may sound like something that most people do automatically. However, what is different about this technique is that it does not just require that you examine the actions you took to obtain your desired outcome. It also requires that you examine your interpretations of the situation as well. In other words, this model emphasizes that how you think about your goal is just as important strategically as the steps you take in going after it.

For example, let’s say that your goal is to get a raise at work. You go into your boss’ office, highlight your achievements, ask for the increase, and… rejected. After several instances of this, you might feel it is hopeless and give up. You did all the right things, right? Well, your interpretations of the situation might have weakened your strategy. While you were talking to your boss, did you have thoughts like “I don’t really deserve a raise” or “I’m not worth it?” How about, “I know she’s just going to say no anyway.” If these are the thoughts running through your mind, how do you think they impacted your body language or how assertively you went after the raise? How do you think these thoughts affected your commitment to the goal, i.e. your willingness to compromise? What about the impact of these thoughts on your nonverbal communication, such as eye contact, posture, etc.? Or the other extreme may be the case: Did you go in thinking, “I’ve worked here for so long they owe me a raise,” because how do you think this might come across?

Yes, our ineffective automatic thoughts can get in the way even when we have a solid strategy for getting what we want. In CBASP, the solution involves comparing your interpretations to your desired outcome, and deciding whether the interpretations moved you closer to your goal or further from it. If the thoughts were obstacles to your objective, you need to tweak them so they become assets. What would you have to think to get what you wanted? Or, what would someone else who consistently achieves their goals think in this situation? By identifying a more helpful mindset, you allow your thoughts to work for you rather than against you. This technique is akin to cognitive restructuring on traditional CBT. And like cognitive restructuring, it is more difficult than people first assume, mainly because you actually have to believe the alternate perspective.  Click here for more information about cognitive restructuring in CBT.

So, the next time you feel like your bulletproof strategy has fallen short, stop and consider whether you included your thoughts as part of your strategy. 

All material provided on this website is for informational purposes only. Direct consultation with a qualified provider should be sought for any specific questions or problems.  Use of this website in no way constitutes professional service or advice. 

Get Back to Sleep!

There is much information on the internet about healthy sleeping habits, commonly called sleep hygiene. Behaviors such as maintaining a regular bedtime, making the bedroom comfortable, not watching TV in bed, etc. – all of these can be very helpful for helping people go to sleep. However, if you have difficulty waking up in the middle of the night, these tried-and-true interventions are probably not terribly helpful. You may, however, find the following techniques to get back to sleep helpful:

Once you realize you are awake, try to get back to sleep immediately. The lights stay off, and your head on the pillow. Rather than think about your day or plan the next day, go to sleep. There will be plenty of time to deliberate or plan tomorrow. If you find it difficult to turn off your mind once it gets going, try one of the other techniques mentioned below.

Let it go. Tell yourself to let it go and that if what you are thinking about is truly important, you will surely resume thinking about whatever it is tomorrow.

Do your planning before bedtime. If you have a good idea of what you will worry about once you are in bed, worry about it beforehand. Write out the source of the worry, and next to each worry, write the solution or the next step. When the worry occurs to you while you’re in bed, remember that you’ve already identified a solution, and postpone the worry until tomorrow. You may even find it helpful to have the piece of paper on your nightstand to use as a visual reminder that you’ve already done all the thinking you need about that topic.

Count your breaths as a way to distract your mind. Imagine you are becoming increasingly sleepy with each exhalation.

One mistake people make is staying in bed for hours when they are unable to fall back asleep. When you stay in bed while you are not sleeping, you are essentially training yourself to be awake, alert, and frustrated in bed, all of which are moving you in the opposite direction from sleep. The more you toss and turn, the more you teach yourself that this is what you do in bed, not sleep. You can undo this cycle by getting out of bed once you’ve been awake for 15 minutes. Stand beside the bed in the dark, counting your breaths, imagining that you’re feeling sleepier and heavier with each breath. Once you feel drowsier, return to bed.

You may find these exercises helpful the next time you have difficulty falling back asleep. They come from a cognitive behavioral treatment for insomnia. For severe insomnia, it is recommended you consult a mental health professional. 

All material provided on this website is for informational purposes only. Direct consultation with a qualified provider should be sought for any specific questions or problems.  Use of this website in no way constitutes professional service or advice. 

CBT Self-Help Books

People often ask me for recommendations for good, evidence-based books based on cognitive behavioral therapy and mindfulness. There are quite a number of good ones out there. Unfortunately, they are vastly outnumbered by self-help books that are poorly written, vague, unhelpful, and sometimes even harmful. The following is a list of self-help books based on contemporary psychological research and that my clients have found helpful through the years.

Feeling Good by David Burns An easy-to-read best-selling self-help guide using CBT principles. Well-researched interventions such as cognitive restructuring and behavioral activation are explained and discussed.

Mind Over Mood by Greenberger and Padesky: A self-help guide using primarily cognitive therapy techniques, it contains helpful interventions to assess the thought patterns that may be getting in the way of achieving your goals and provides clinically proven ways of addressing these patterns.

Get Out of Your Mind and Into Your Life by Stephen Hayes is A mindfulness-based self-help book using principles of Acceptance and Commitment Therapy. This is a good book for learning how to work toward big life goals while overcoming the emotional obstacles that generally get in the way.

Dialectical Behavior Therapy Skills Workbook by McKay, Wood, & Brantley A workbook providing instruction and exercises for people who have difficulty regulating intense emotions. This workbook contains exercises designed to teach mindfulness skills, distress tolerance, emotion regulation, and interpersonal effectiveness.

Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness by Jon Kabat-Zinn: A self-help guide to mindfulness for a variety of problems.

The Mindful Way through Depression by Williams, Teasdale, Segal, and Kabat-Zinn: A self-help guide for using mindfulness-based cognitive therapy to cope with depression and stop a relapse before it starts.

These books can provide helpful guidance on dealing with difficult emotional problems. They are, however, no substitute for working with a licensed psychologist. If you have a significant psychological problem or are in significant distress, seeking treatment with a mental health professional is important.

Acceptance Techniques to Reduce Anxiety and Worry

People who have difficulty controlling their anxiety generally worry a lot about a lot of things. This is known as generalized anxiety. One factor that often fuels generalized anxiety is difficulty accepting the absence of certainty. For most people, uncertainty about important areas of life is unpleasant. It may seem as though life would be easier if you knew how everything would turn out in advance. Unfortunately, this is not a realistic expectation. With life comes uncertainty. People who struggle with this often end up needlessly worrying about things they have very little control over, causing undue anxiety and stress. 

The solution to fighting uncertainty is accepting uncertainty. By choosing to tolerate not knowing how situations will turn out willingly, we expend less energy fighting unnecessary battles, getting tied up in knots about things in unhelpful ways. Acceptance does not necessarily mean enjoying uncertainty. It merely means acknowledging that there is a degree of the unknown in everything we do and letting go of the fight with reality. Following are ways you can learn to turn your mind toward acceptance of uncertainty:

Weigh the pros and cons of accepting uncertainty: Identify the reasons fighting uncertainty feels helpful or safe, as well as the ways in which it is ineffective. Chances are the cons outweigh the pros. Being mindful of this can help you drop the struggle and embrace the unknown. 

Identify areas of your life in which you’re already accepting of uncertainty: You’re already doing this in some situations, either with traffic jams along your commute, visiting a new restaurant, or meeting new people. Take a moment to consider how accepting some degree of uncertainty is helpful in these situations, and take the same attitude with more difficult areas of your life. 

Analyze what underlying meaning uncertainty has for you: Sometimes, without awareness, we automatically associate uncertainty with a negative outcome. If you do this, take a step back from this thinking pattern and ascertain whether there’s any evidence. Take another moment and identify the evidence against this assumption. Chances are by thinking about uncertainty from this new perspective, it may seem less threatening. 

Imagine what life would look like without uncertainty: Although a sense of certainty may be helpful for planning, it’s likely that too much certainty would make life pretty dull. How enjoyable would movies be if you knew exactly what was going to happen every step of the way? And with absolute certainty, there would be no pleasant surprises. Envisioning what would happen if we really got our wish and everything was more certain may cause us to think twice and consider that uncertainty comes with some benefits we normally overlook. 

The next time you tense up when you encounter a feeling of uncertainty, bring to mind these different ways of relating to the situation and see what happens. You may find that you can more calmly handle whatever it is that’s on your plate, and you may just be able to appreciate some of the benefits of uncertainty. 

This technique for reducing anxiety comes from a cognitive behavioral treatment for anxiety disorders that has been shown to be highly effective (see effectiveness rates for CBT) in significantly reducing symptoms of anxiety in 70-80% of patients. Compared that to traditional talk therapy, which helps about 30% of patients with generalized anxiety. Click here for more information about cognitive behavioral therapy for anxiety disorders. 

All material provided on this website is for informational purposes only. Direct consultation with a qualified provider should be sought for any specific questions or problems.  Use of this website in no way constitutes professional service or advice. 

Mindfulness Skills: How You Do It

Mindfulness How Skills

What you are supposed to do to be mindful has already been explained in a previous post. Observe, describe, and participate are three different ways of engaging in life in a mindful way. To make those experiences more powerful, you need the “How Skills” or instructions on how/the way you are to practice the “what skills.”

One-Mindfully

One-Mindfully is the opposite of multi-tasking. For most of us, the majority of the day, we do several things at once. Our culture seems to value this “skill,” and many of our jobs require that we do this at least a portion of the time. Although it feels like we are getting more accomplished when we are doing more things simultaneously, what is happening is that we are doing many things poorly. Having our attention splayed in this way, our mind bounces from task to task, from topic to topic. This is problematic for a number of reasons. When we train our minds to bounce around this way, it is harder to recognize when distracted. If one of the places your mind goes when you are distracted is worries about the future or past painful experiences, you are more vulnerable to a negative shift in your mood. Doing one thing at a time with deliberate, focused attention makes recognizing when our minds have wandered easier. We can then turn it back toward the task at hand.

 
Making a practice of doing only one thing and doing it fully can be transformative. Many people notice the time they spend worrying or ruminating is significantly reduced by trying to do one thing at a time. Often, people find that activities they used to find frustrating take on a different quality and are sometimes even enjoyable. For instance, most people do not enjoy sitting in traffic. For them, listening to the radio seems like an essential distraction. For others, checking email, eating breakfast, and putting on makeup all make traffic time seem more tolerable. However, if you experimented with turning off the radio and limiting all distractions, sitting in silence, bringing the mind to sitting or breathing, you might find all of these distractions are not necessary. You may even discover that the silence and simplicity of sitting in your car is a welcome respite from the busyness of modern life. By deliberately choosing to do just this one activity mindfully, you will recognize when your mind wanders to an unpleasant responsibility at work or a stressful situation you anticipate later in the day. Rather than priming yourself for stress and anxiety all the way to work, you can use the opportunity to rest and recuperate. Doing things one-mindfully allows you to set the tone for what you are doing and engage in it in a way that is therapeutic. 

Non-judgmentally

Non-judgmentally refers to the way in which you describe things in your mind when practicing mindfulness. It has been found, through extensive research, to be one of the most important components of dialectical behavior therapy. Judgment refers to thinking about something in value terms or thinking in terms of either good or bad. Judgments can be a helpful shorthand when making quick decisions, such as whether to buy a spoiled or ripe banana. Judgments are helpful in this case because we know a bad banana is one that would be unpleasant to eat or make us sick. However, there is nothing that is inherently “bad” in the banana, so in a sense, there is no “badness” we can point to in the banana itself. The judgment really only exists in the mind. We can point to the spoiled parts, the discoloration, the mushy pieces. But there is nothing we can point to as inherently “bad.” Someone else might judge the same banana to be “good” if the goal is to find fertilizer without wasting edible food. Or if you are making banana bread, a soft, brown banana is a “good” banana to use. Good and bad really only exist in the mind of the beholder. 

So, how does judgment enter into our discussion of mindfulness? Well, if part of being mindful is connecting to reality rather than our thoughts about reality, holding judgments gets us further from this goal. One of the goals of mindfulness is to help us move closer to what is actually happening rather than merely connecting to the thoughts we have about what is happening. As judgments really only exist in our minds, they do not move us toward a mindful experience. Because emotion dysregulation is usually triggered by the meanings people make of situations rather than the actual situations themselves, the non-judgmental component of mindfulness helps people regulate their emotions by putting them back in contact with the situation. 

For instance, if you have a fear of experiencing anxiety, the moment you sense a symptom of anxiety, you probably place all sorts of judgments on the experience. “This is horrible.” “I can’t stand this.” “I am weak for feeling this.” All of these value statements serve to increase negative emotions about the anxiety, probably causing increased anxiety, as well as shame, anger, etc. Instead of buying into all of these judgments, if you were to instead mindfully describe them non-judgmentally, you might avoid this downward spiral. “Noticing tightness in my chest. I notice I’m having thoughts about not being able to handle anxiety. I notice my heart beating.” You won’t necessarily immediately eliminate the anxiety, but by actually describing what is happening without judgment, you contact the emotion without all of the undue suffering you might normally experience when fixating on the judgments instead of the actual situation. Taking this objective perspective, describing “just the facts” allows us to increase our willingness to tolerate difficult moments and as a result, prove to ourselves that we can handle them. 

Effectively

Effectively means to be willing to do what works to achieve your objective. Rather than focusing on what is “right” or what you “deserve,” effectiveness is about playing by the rules dictated by the situation. If you feel you are unjustly pulled over on the freeway, you can assert your rights, instruct the police officer on where he/she is wrong, and threaten litigation. Those are all ways of reacting to the situation. And if your only objective is one of social justice and defending the Constitution, those behaviors may be the effective ones. However, if your objective is more to get out of paying a ticket, the effective thing to do in this situation would probably be to be polite, apologize, validate the officer’s point, etc. It may not be the “fair” thing, but it is the effective thing. 

Being effective is a mindfulness skill because it requires a mindful mode of operating. It is a stance of willingness and one that accepts the current situation in order to maneuver through it effectively. One definition of mindfulness is acceptance of the present moment. Effectiveness captures the spirit of both accepting the present moment and reacting to it in a fluid way to reach your goals. Effectiveness is about achieving your objective not in spite of the current situation, but because of the current situation. 

That is not to say that you should sacrifice your values in the service of doing what works. That isn’t effective. What effectiveness is, is being willing to do what works when the cost is tolerable, rather than rigidly holding to some ideal that is “right.” There is an old expression that you can “right” yourself “right” out of a relationship. Being right is nice, but if you sacrifice everything in the service of being right, you end up losing a lot. It is captured by the analogy of being on the freeway where the speed limit is 65, and the person in front of you is going 45. You can refuse to accept this situation, honking, riding the person’s tail, hurling insults and fingers, and even insisting on continuing to drive 65 as you plow into the car. Or you can take a deep breath, change lanes, and move on. What seems more effective?

All material provided on this website is for informational purposes only.  Direct consultation with a qualified provider should be sought for any specific questions or problems.  Use of this website in no way constitutes professional service or advice. 

Mindfulness Skills: What You Do

There are many roads that lead to Rome when mindfulness is concerned. Numerous techniques and instructions have been developed to help people contact their present experience.  There is no one right way of teaching or developing mindfulness. Any approach that helps us move out of our heads and into our lives is valid. DBT has traditionally focused on three skills to this end: observe, describe, and participate. These are referred to as the “what skills,” as these skills are what you do when you are practicing mindfulness. 

The Observe Skill

The observe skill is about developing awareness of the present. It is just noticing what is happening. Noticing external events, thoughts, sensations, whatever arises in your awareness, you watch it. Developing this skill helps with regulating emotions in a number of important ways. First of all, to observe your experience rather than get caught up in it requires a sort of mental distancing. When people describe their experience of observing, they talk about it as though they were a third party or watching it like a movie. This distance is helpful in giving people space to step back and think rather than impulsively act. It slows down the process of impulsive behavior by providing space between the urge to act and the action. 

Using the observe skill also helps us to face whatever is happening in the present moment, no matter how distressing it may be. People who have problems regulating their emotions tend to avoid even the smallest negative emotions. This usually results in poor decision-making and, paradoxically, more intense emotion. Practicing observe with painful feelings can be a tool to break the cycle of emotional avoidance that fuels emotion dysregulation. By willingly experiencing emotional pain, we learn that although it is unpleasant, it passes, and we survive it. It is similar to the exposure treatment for phobias. If you fear spiders, the most powerful way to get over your fear is to spend time with spiders. In time, you learn the anticipation was more problematic than the actual experience. Observe allows us to accept whatever we feel in the present moment. 

The Describe Skill

The describe skill is a tool designed to bring us to the present by putting words to our experience. Powerful associations with emotions or negative life events can be created over time. Some people believe that it would be the end of the world if we experienced intense shame. Others think they could not bear to be rejected by someone. The more we believe this to be the case, the more catastrophic negative experiences feel. As a result, we get caught up in the meaning we make of unpleasant events rather than being able to access the event itself. An example of this is being nervous about giving a presentation in class. Feeling the anticipatory anxiety and taking it to mean you are a failure, or because you are nervous, you will be rejected, and that you would “fall apart” were that to happen, have you pretty far removed from the reality of the situation. But that’s hard to see when you’re spending most of your mental energy on the stories you’re telling rather than the actual experience.

So, what would the describe skill look like as applied to this example? You might begin by describing in your mind the sensations in your body: “I notice warmth in my face. I feel discomfort in my abdomen. Tight chest. Heart pounding.” Although a simple intervention, it functions to help you contact what is actually happening rather than the worst-case scenario you’ve created. You might go on to describe your thoughts about the situation: “Noticing thoughts about failure. I notice I’m having thoughts of running out of the room. I notice that I’m merely thinking about worst-case scenarios.” Again, you’re naming what is happening in the present moment in a way that is free of hyperbole or mental constructs that are not really present. Such an exercise won’t necessarily eliminate anxiety, but it can help make the experience tolerable by helping you recognize what is actually happening rather than putting you face to face with the worst possible scenario, which is really just a fiction that exists nowhere but in your own mind. 

The Participate Skill

The final skill is participate. Participating is being fully engaged in whatever you are doing, in the moment, without second-guessing or over-thinking. We all engage in participating from time to time. There are certain behaviors that require it, such as learning to play a musical instrument. Take, for example, the guitar. When you’re playing a song, you may find that you can do it well if you are just engaging in the behavior in a fluid, natural way. However, the moment you begin thinking about how to get your fingers from one chord to the other, the song falls apart. Participating is sometimes referred to as the slipstream. It is that mode of behavior and mental activity when we are only doing what we are doing. 

So how do you get here? Well, it’s easier to explain than to practice. Imagine dancing alone in your room in a way that is free of self-consciousness. Do you think you might naturally do this without overthinking it or free of negative judgment? Now, imagine that you’ve gotten feedback in the past that you’re a terrible dancer. Probably harder to participate now. How about if you’re no longer in your room but in a crowded dance hall? How about on stage? Lots of factors can make it difficult to keep our mind on what we’re doing, fully engaged, diving in. However, although we may not have total control over our minds, we have more influence over our own minds than we usually give ourselves credit for. Participating requires acknowledging that you have the power to bring your mind back to what you’re doing and to do so once you notice it’s wandered. Again and again and again… To participate is to repeatedly make the decision to throw yourself into whatever it is you’re doing with focus and commitment. When you do this, there is little room for the internal critic or the storyteller in your mind to ruin your experience. 

All material provided on this website is for informational purposes only.  Direct consultation with a qualified provider should be sought for any specific questions or problems.  Use of this website in no way constitutes professional service or advice. 

Mindfulness from a DBT Perspective

There is a great deal of research into mindfulness meditation and its benefits. In Dialectical Behavior Therapy (DBT), mindfulness skills are considered the core component of improved emotion regulation. DBT mindfulness is taught and reviewed throughout the treatment, and mindfulness begins each skills training session. This is because all of the other emotion regulation skills in DBT hinge on being able to practice DBT mindfulness. Despite this central position of DBT mindfulness among DBT skills, its function to reduce emotional sensitivity and regulate emotions is often misunderstood.

What Is DBT Mindfulness?

In a nutshell, the term mindfulness refers to the practice of bringing one’s mind to the present moment. Put another way, mindfulness is the technique of recognizing when the mind is caught up in a thought and drawing it back to the present experience. DBT mindfulness adds another dimension to the traditional practice of mindfulness: mindfulness without judgment. By practicing non-judgmental present-focused awareness, you are able to attend to thoughts, feelings, and behaviors without engaging in the self-invalidation responsible for persistent emotion dysregulation.

It sounds simple, but most people spend a very small portion of their day mindfully engaged in their lives. We usually tune out our actual experience and get distracted by thoughts about our experience. Most of us get so conditioned to engaging with our thoughts rather than with reality, it is very easy for us to lose sight of what is actually happening to us and, consequently, how best to handle what is happening to us.

How Does Mindfulness fit into DBT and CBT?

Dialectical Behavior Therapy is a treatment that targets emotion dysregulation. Often, people get emotionally dysregulated by seemingly insignificant or trivial events, not because of the events themselves but by the judgments people have about the events. For example, you may have a job that you are reasonably happy in. Let’s say it’s working at a clothing store. You like clothes, and you like interacting with people, so it seems like a good fit. What you don’t like, however, is folding clothes. You find it boring. Now, you may only have to fold clothes for about 30 minutes of a six-hour shift, which is really just a small portion of the job. You may find that as you fold clothes, your mind starts to make all kinds of negative judgments about folding clothes. “This is terrible.” “What a waste of time.” “This is stupid.” “This job is awful.” Rather than spending the time focusing on folding the clothes, your mind is busy telling all kinds of disturbing stories about this task and will likely trigger emotions such as anger, resentment, and even despair. What’s worse, these emotions have a way of coloring the rest of your day. Now, instead of tolerating 30 minutes of an unpleasant chore, you spend the whole day in a foul mood, judging all aspects of your job negatively, feeling worse every minute. Because being in a bad mood for most of the day, more days than not, is very unpleasant, you start having judgments about your mood, thinking, “I can’t take this anymore.” So, what started out as a relatively insignificant thing has caused a lot of suffering.

A mindful approach to this dilemma would be to approach the unpleasant task in the spirit of acceptance, willing to engage in it without engaging in a lot of judgments about it. The moment you notice a judgment, you turn your mind to folding the clothes, aware of the sensation of the fabric against your fingertips. Noticing the movement of your arms. Describing the smell of the new fabric as it reaches your nose in waves. By fully engaging in the task and repeatedly turning the mind to it, there is little room for negative attributions. You may now even find it to be a calming, soothing activity. This is one way mindfulness can help avert an emotional downward spiral.

Mindfulness can also be effective in helping us make the best decisions. People with pervasive emotion dysregulation often have histories full of others invalidating their wants, needs, thoughts, and feelings. Over time, persistent invalidation from the outside nourishes invalidation on the inside. After a while, people with emotion dysregulation learn to invalidate their own experience, having learned it was wrong, bad, or dangerous for some reason. People who get good at invalidating themselves tend to lose touch with their own experience. They no longer consider their own opinions. They no longer know where to find their own intuition. Consequently, self-invalidators live lives inconsistent with their own values and dreams. They don’t find it important when their needs are being sacrificed for those of someone else. All of this results in people who do not do what is best for themselves, which is a hard way to live life. As a result, they are unhappier and thus more prone to becoming emotionally dysregulated.

Finally, mindfulness can help with emotional dysregulation by way of helping to relinquish the struggle with painful emotions. One of the reasons people develop emotion dysregulation is because they try to quash or control their emotional responses to things. Trying to control an emotion is kind of like trying to grab tightly onto jello. The more you try, the more of a mess it makes. With emotions, the more we try to control them, the more intense they become, and the longer they persist. Unfortunately, due to an environment plagued by invalidation from others, there is pressure from the outside to control the emotions, leading to more intense emotions, leading to more invalidation, etc. This tends to become a self-perpetuating feedback loop.

Mindfully experiencing emotions is the opposite of the control strategy. With mindfulness, you simply observe what comes up with the emotion. You notice a feeling of your face flushed. You notice a lump in your throat. You notice all of the experiences that are the emotion, and you do so not with the intention of suppressing them, but in the service of accepting each and every one of them unconditionally. There is an old expression that you can’t argue with an emotion. This is because the emotion is there for a reason, so the best one can do is tolerate it without holding on or pushing away. It is a paradoxical approach, but the end result is emotional experiences that are less disturbing and of shorter duration. The emotions naturally go just as they came. Giving them permission to be there lets emotions take their natural course as fleeting, changing, dynamic sensations.

These are some of the main reasons mindfulness is relied on so heavily in Dialectical Behavior Therapy. There are many other uses of mindfulness in the treatment. In fact, as mentioned earlier, every skill relies on a foundation of mindfulness, so there are as many uses of mindfulness as there are skills, and then some.

One of the most important points about mindfulness practice is that it is very difficult. Our brains are hardwired to make judgments, time travel, and create stories. In a way, working to be mindful is working against the biology of our brains. No one is perfect at this. Luckily, there is no need to be perfect at it. We can experience the real benefit of mindfulness when we notice we are not being mindful and choose to turn our minds back to the now. That is the power of mindfulness: recognizing when we are not mindful. If we get distracted a thousand times, we have a thousand opportunities to notice and shift our attention. It’s a bit like fly fishing. Your mind casts its line to far-flung places when you are distracted, and then you reel it back in when you reorient your mind to the present. And like fly fishing, this process occurs again and again. Numerous times in the course of one minute. And the more we practice, the easier it becomes to recognize when the mind has left the building. And with each time we practice, we gain a little more clarity and control. 

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