Staying Afloat Amidst Life’s Floods

 by Bernadette Dougherty, Psy.D

Storytelling has always been a large part of my life and family culture. I grew up an avid reader, rushing home from school to be immersed in a book until long past bedtime. 

Throughout my childhood and early adulthood, I was fortunate to spend a great deal of time with my grandparents every week. They often shared stories of their lives and journey with me, my father’s parents having grown up in war-torn Ukraine, living in labor and refugee camps across Europe. My mother’s family immigrated from Italy, and they were separated for decades before they were all able to come to the United States. 

As a child, my family’s stories fit well with the fairytales and fantasy books I read, tales of overcoming adversity and good eventually winning over evil. When I became older, I realized that these were not simply stories, but real and very painful events that occurred to the people I loved. This realization was the initial catalyst for my curiosity with risk and resilience: 

What allows some individuals to survive and even thrive in spite of painful events and trauma?

Recent world events and devastation by hurricanes throughout the southeastern United States brought this question into sharp focus again. Whether we are directly impacted by large-scale disasters or not, it is heartbreaking to see how lives can be turned upside down in an instant.  

None of us are strangers to pain and adversity. At times it can feel like wherever we look there are horrible events occurring in our lives and in the world more broadly, yet we’re expected to continue functioning through it all. In times such as these, it can feel like any additional stressor threatens to pull us under the flood of stress and emotions. In addition, our brains are naturally constructed to prioritize negative information over the positive, often making it exceedingly difficult to think of anything other than the stressful event we are experiencing. 

Moments such as these, when painful situations occur repeatedly and it’s difficult to keep my head above the emotional flood, I have found that the first part of one of the Dialectical Behavior Therapy (DBT) skills is particularly helpful in staying afloat: Accumulating Positives in any and every way we can. Through purposely directing our attention to things we find enjoyable, we strengthen neural connections for positivity, increase much needed dopamine in the brain, and decrease our vulnerability to emotional stress. Focusing even on small things like beauty in our environment, a song we enjoy, or a soothing sensation works; we essentially boost ourselves above the emotional flood. Stringing along these positives during transition moments — like car rides and minutes in between meetings — can be a small and time-friendly way to accumulate positives despite many of our busy schedules. Allowing small positives to be present along with the pain can help us to feel more balanced and less emotionally flooded. As we experience changes throughout our lives, I encourage you to set aside time and space throughout your day and week, no matter how much or little, to accumulate positives and stay afloat. 

Bernadette Dougherty, Psy.D. is a Licensed Psychologist providing therapy for teens and adults. Her approach is collaborative and individualized to help clients create meaningful change. Specialties include anxiety, depression, emotion regulation, trauma, suicide, self-injury, stress, chronic pain/illness, LGBTQIA+ care, and insomnia. To learn more about her work and to schedule an initial consultation, reach out to her at bernadette.dougherty.psyd@gmail.com and 215-770-1845. 

Maintaining Emotional Health and Hope during the Holidays with Your Teen

by Katie May

You’re a parent with a teen who’s struggling emotionally. Maybe they are anxious and full-on panic at the thought of a crowded room (even with familiar faces and family members in it.) Maybe they are depressed and withdrawn, and the concept of joy and laughter are so far off from their everyday that it feels cruel to ask them to smile for yet another picture when you know that it will be fake and plastered or trigger them to burst into tears.

You’re sitting back silently like an elf-on-the-shelf to avoid saying or doing something that will set your teen off or cause them to act out impulsively or self-destructively.

At this point you may be thinking, “Aren’t the holidays supposed to be fun?”

But from past experience you know that holidays and families can bring up baggage that causes way more stress than the everyday routine.

Many parents white-knuckle the winter break and repeatedly mutter the mantra “Just one week” until school resumes.  (Oh yeah… there’s another transition and yet another opportunity for your teen’s symptoms to increase… and for everything to fall apart again.).

Or, they spend the holiday season putting out fires and managing conflicts and crises as they arise with no clear plan for how to cope ahead and make the necessary changes that make the holidays run smoothly.  In fact, many therapists work this way too!  And if we’re being honest here, it’s just not working anymore.

When I work with teens in my teen groups we practice a Dialectical Behavior Therapy (DBT) skill called Cope Ahead.  This idea is that we can begin to prepare for difficult situations by being mindful of how we may think, feel and behave in them and making a plan for how we will manage this in the moment.

One fun example of this is if you know that grandma is going to ask you twenty questions about why you’re not on the cheerleading squad and why you don’t like wearing pink, then you can make a game of it.  Create a bingo board for yourself on an index card to keep in your pocket and every time grandma makes a critical comment, check one off the board until you’ve “won” the game.  You can’t change grandma, but you CAN shift your reactions to be more effective.  I guarantee this game will have you laughing at your own personal inside joke rather than sulking sullenly in the corner!

Another example may be recognizing that a holiday will make you feel sad or empty because you lost a loved one and you miss them.  You can cope ahead by creating a memory jar or journal where you can record everything you remember about the holidays you shared together.  You can lead a discussion at the dinner table and ask others their favorite holiday memory of the loved one you lost.

Or, if being around people makes you nervous because you don’t know who will be there or what to say to them, you can do some prep work.  Make a list of everyone who will attend the gathering or party and decide on at least one topic that you can ask them about.  Also, write down three to five topics you like to talk about, such as what TV shows you’re watching or what’s new in your life that you’d be willing to share.  Having a set plan for what to say and who to say it to creates a structure for talking to people that takes some of the pressure off when you may freeze in the moment.

Coping ahead isn’t about making the feelings go away; it’s about using the knowledge you have about those feelings to change your experience into one that works for you instead of against you.

It’s time to have a plan for this holiday season!  I’ve called together a group of amazing therapists to help you prepare for how to manage an angry, sad or self-hating teen this winter.  (And they are ready and prepared to support your teen in Winter Coping Skills Camp too!  More at www.creativehealingphilly.com/winter-coping-skills-camp)

Take some time for you and tune in to this video series for parenting teens.  In just a few short videos you’ll be equipped with the tools you need to cope ahead with holiday triggers that your teen may experience.  And you’ll likely learn at least a thing or two about how to create a stronger bond with your teen and help them manage their emotions on an ongoing basis too!

As a teen therapist, I know that adolescence can be a challenging time for my clients.  I support six groups of teens who all share similar struggles with anxiety, depression and/or self-harm behaviors.  And I want you as a parent to feel supported too.  

In this parenting support video series, you will learn:

·       How to peacefully communicate with your teen in a way that helps them make choices that are aligned with your family values

·       How to help your teen manage anger and disappointment in healthy ways that build self-esteem

·       How to help your teen go from self-loathing and critical to feeling strong and empowered

·       How to use self-soothing skills to help your teen manage anxiety and dis-ease

·       Why encouraging your teen to use the arts as a creative outlet is beneficial for both of you

To learn more about Winter Coping Skills Camp and to watch the parenting support video series, click here:  www.creativehealingphilly.com/winter-coping-skills-camp-for-parents

Practicing Radical Acceptance to Reduce Life’s Suffering

by Katie K. May

With warm weather in full swing and fun in the sun at the pool, I’m reminded of two summers ago when my son broke his arm. He was six years old and had just learned to swim. He loved splashing around in the water and swimming to each end of the pool. Then, a camp monkey bar accident and a full arm cast put a stop to his pool fun for the rest of the summer.

           

I can remember others’ remarks like, “That’s awful!” and my son’s tearful plea, “Why did this have to happen?” Not only was he in physical pain, but he also experienced emotional anguish every time we drove past the placid blue water of our pool.

           

An important idea in Dialectical Behavior Therapy (DBT) is pain vs. suffering. When you don’t accept reality as it is, it leads to greater suffering. Alternatively, when you can accept reality, or what is, you may still feel pain, but you can avoid suffering. As a DBT therapist, I call this concept Radical Acceptance.

           

Radical Acceptance means accepting what you can’t change so you can spend your time and energy on what makes your life worth living. It means understanding reality for what it is. Once you understand what you can and can’t change in your life, you can accept reality for what it is.

If we look at my son’s experience in the context of Radical Acceptance, we can understand exactly why it happened. Understanding the logistics is the first step to Radical Acceptance: He was climbing across the monkey bars, which put him in a precarious situation. He fell mid-way across and kept his arms too stiff as his body made impact with the earth.

Next, consider what you can’t change in the situation. My son was not allowed to get that cast wet. Period. So…swimming was not an option for the summer. It was something we could not change. Continuing to focus on the “can’t” in the situation would have led to greater suffering. If we talked about NOT swimming every day, it would remind him of something he loved that he could not have.

Finally, you CAN choose to use skills and act effectively or focus your attention on ideas and events that serve you. Well let me tell you, with water not being an option, we went to every museum and park that summer and changed our summer vacation from the beach to Washington D.C., and it was all amazing!

It’s important to remember that acceptance does NOT mean that you’re giving up or agreeing with a situation or incident that is difficult. It doesn’t mean putting up with a situation or relationship that is harmful for you. It means focusing your energy and taking action on what will help you move forward in your life.

When you practice Radical Acceptance, you shift your focus from “Why did this happen?” to “What can I do now?” It’s this shift that allows you to take ownership of your personal experiences and begin making choices about how to create your path to happiness.

Katie K. May is a Licensed Teen Therapist who specializes in offering groups. A new session of Teen DBT Skills Group will begin in August. Contact Katie@creativehealingphilly.com to explore whether this group will best support your teen.

Using Creativity to Effectively Manage a Crisis

by Katie K. May

“We are all broken and wounded in this world.  Some choose to grow strong at the broken places.”

~Harold J. Duarte-Bernhardt

Everyone has a creative side and you don’t need to be a skilled artist to engage in the arts.  There are many ways to be creative including drawing, writing, playing an instrument, dancing, designing fashion, woodworking, knitting, cooking, coloring and painting.  Using art as an outlet helps you to put your emotional energy into creativity rather than getting stuck in difficult emotions.

In Dialectical Behavioral Therapy (DBT), “Creative Outlet” is a skill that is taught to help participants manage a difficult situation or intense feeling.  DBT is a skills-based approach designed to help its participants abstain from self-destructive thoughts and behaviors, act less impulsively and improve their emotions and relationships.  For individuals who struggle with safety issues like suicidal thoughts and self-harm, DBT is the recommended treatment.

DBT is about being mindful of the balance between extremes.  In the case of using Creative Outlet, this is a crisis survival skill meant to be planned and temporary.  This means it is important to mindfully take a break from the situation that is triggering extreme emotions and use your creative outlet  to cope with distress and express difficult feelings in a healthy way.

Taking a break when you are overwhelmed with emotion will help you regroup and decompress so that you can be more effective when you approach the problem. To maintain balance, it is essential that you return to and deal with the crisis once you feel more in control of your emotions.  Trying to avoid a difficult situation forever may make it worse or create more long-term problems.  

The Creative Outlet skill is part of the Distress Tolerance module in DBT.  DBT includes four different modules including Mindfulness, Distress Tolerance, Emotion Regulation and Interpersonal Effectiveness.  Beginning this September, Licensed Therapist, Katie K. May will offer a DBT Skills Group for High School Teens and a DBT Skills Group for young adults, ages 18 through 24.  See here [insert link to: http://www.creativehealingphilly.com/dbt/