Discussion Piece - Resiliency & DBT

Today, in DBT group we looked at resilience - and it's relationship with DBT
To me, DBT seems to sit between Resilience and CBT. We cannot always control the factors for resiliency in our life and life is much broader than cbt and emotional regulation. Its seems to me that DBT gives us a way to cope even when we might not have the resiliency factors in place. That is what DBT means to me in my life - because I don't have the resiliency factors but I have survived great trauma and hardship. That is just my take on it - How do YOU see the relationship between DBT???

Definition
"Resilience in psychology refers to the idea of an individual's tendency to cope with stress and adversity. This coping may result in the individual "bouncing back" to a previous state of normal functioning, or using the experience of exposure to adversity to produce a "steeling effect" and function better than expected (much like an inoculation gives one the capacity to cope well with future exposure to disease). Resilience is most commonly understood as a process, and not a trait of an individual."

Resilience Factors
"Many studies show that the primary factor is to have relationships that provide care and support, create love and trust, and offer encouragement, both within and outside the family. Additional factors are also associated with resilience, like the capacity to make realistic plans, having self-confidence and a positive self image, developing communications skills, and the capacity to manage strong feelings and impulses. Another protective factor is related to moderating the negative effects of environmental hazards or a stressful situation in order to direct vulnerable individuals to optimistic paths, such as external social support. More specifically, Werner (1995) distinguished three contexts for protective factors: (1) personal attributes, including outgoing, bright, and positive self-concepts; (2) the family, such as having close bonds with at least one family member or an emotionally stable parent; and (3) the community, like receiving support or counsel from peers."

Resilience Building
"The American Psychological Association suggests "10 Ways to Build Resilience", which are: (1) maintaining good relationships with close family members, friends and others; (2) to avoid seeing crises or stressful events as unbearable problems; (3) to accept circumstances that cannot be changed; (4) to develop realistic goals and move towards them; (5) to take decisive actions in adverse situations; (6) to look for opportunities of self-discovery after a struggle with loss; (7) developing self-confidence; (8) to keep a long-term perspective and consider the stressful event in a broader context; (9) to maintain a hopeful outlook, expecting good things and visualizing what is wished; (10) to take care of one's mind and body, exercising regularly, paying attention to one's own needs and feelings and engaging in relaxing activities that one enjoys. Learning from the past and maintaining flexibility and balance in life are also cited."

"Children in times of the Great Depression
Elder studied the life of men who were children during the Great Depression of 1929-1939 and came to maturity at the outset of World War II. When these children came of age Elder found them to be healthy, law abiding, well adapted and bright.
One stunning finding was that poverty had slight positive effects on children from the middle classes. Once they reached adulthood those men earned a college degree as often as men from nondeprived middle class homes. In later life they did a little better in terms of economic success than their nondeprived middle class peers.[86]
Men of working class background did not do as well as men from middle class homes. However many of them were upwardly mobile and on most measures they did do just as well as men from never-deprived working class backgrounds."

"Children of American farmers
Elder and Conger examined data from several Iowa counties to see how the farm crisis of the 1980s and 1990s affected children growing up in rural parts of the state. They found that a that a large number of those young people were on paths to successful development and life achievement. Most children of those children grew up to be academically successful and law-abiding.
Elder was able to identify five resource mechanisms:
strong intergenerational bonds, joint activity between parents and children
being socialized into productive roles in work and social leadership; stressing non-material goals
a network of positive engagement in church, school, and community life
close ties with grandparents, support from grandparents
strong family connections with the community"

Vietnamese Refugees
"Vietnamese stress the value of education. Parents wanted their children to enjoy a better education than they did themselves. The Vietnamese children spend an average of 3 hours and 10 minutes per day doing their homework and reading for school, while American middle class students just spend an average of 1 hour and 30 minutes per day with these activities. Nathan Caplan also found out the older siblings were supposed to help their younger siblings. That way the younger ones did not only learn facts but also attitudes towards school and learning from their older siblings. The more siblings a child of Vietnamese parentage has, the more likely is he or she to achieve in school."

Fostering resilience in children
"Fostering resilience in children requires family environments that are caring and structured, hold high expectations for children’s behavior, and encourage participation in the life of the family."

Cross-Cultural Resilience Aspects
"1. Access to material resources - Availability of financial, educational, medical and employment assistance and/or opportunities, as well as access to food, clothing and shelter
2. Access to supportive relationships - Relationships with significant others, peers and adults within one’s family and community
3. Development of a desirable personal identity - Desirable sense of one’s self as having a personal and collective sense of purpose, ability for self-appraisal of strengths and weaknesses, aspirations, beliefs and values, including spiritual and religious identification
4. Experiences of power and control - Experiences of caring for one’s self and others, the ability to effect change in one’s social and physical environment in order to access health resources
5. Adherence to cultural traditions - Adherence to, or knowledge of, one’s local and/or global cultural practices, values and beliefs
6. Experiences of social justice - Experiences related to finding a meaningful role in one’s community that brings with it acceptance and social equality
7. Experiences of a sense of cohesion with others - Balancing one’s personal interests with a sense of responsibility to the greater good; feeling a part of something larger than one’s self socially and spiritually"

Resilience and Emotion
"Positive emotions are critical elements in resilience and as a mediator that buffer people from depression after the crises. Moreover, high resilient people were more likely to notice positive meanings within the problems they faced (e.g., felt grateful to be alive), endured fewer depressive symptoms, and experienced more positive emotions than low resilient people...People with high levels of resilience are likely to show low levels of depression, and less likely to smoke cigarettes or use marijuana (Bonanno et al., 2007). Moreover, low resilient people exhibit the difficulties of regulating negative emotions and demonstrate sensitive reaction to daily stressful life events (e.g., the loss of loved one) (Ong et al., 2006). They are likely to believe that there is no end for the unpleasant experience of daily stressors and may have higher levels of stress. In general, resilient people are believed to possess positive emotions, and such emotions in turn influence their responses to adversity"

I know it is from wikipedia but I love the broad simplicity of wikipedia. The page seems very legit. http://en.wikipedia.org/wiki/Psychological_resilience

Answer here or discuss in group in Bipolar Chat room in 3 1/2 hours.

Cheers!

Jade

np tortoise - glad you made it in :)

Nice Charmy :)

I was reading the Anne Dreveson book at p148 and decided to flick on the tv. There was this man lecturing about positive psychology - or strength based therapy. (http://www.abc.net.au/tv/bigideas/stories/2012/04/30/3489669.htm if you'd like to watch it). I found it fascinating - and I took down his name. When I went back to the book realised it was the same person I was reading about! - Martin Seligman. How freaky is that? to be on that page while I happened to flick on the tv. I was covered with goosebumps!!! It was if I was being lead to something that would help me. I'd heard of and seen his website before http://www.authentichappiness.sas.upenn.edu/Default.aspx but hadn't explored it out before now. I found there's heaps of testing you can do to find out where your strengths and weaknesses lie. I found my results alarmingly accurate - now what to do with those results? My greatest character strength area is honesty/authenticity/genuineness. So now I have to work out how I going to use that to help me mow the lawn. lol I'm signing out for the night after a pretty full on 24 hours. Will check out the boards tomorrow. Nite all xxx

bump :) For the American Sunday as peeps potter and ponder around home :)

Hi Red,

Yeah the ones you picked out are probably the best ones imho - and also the hardest! Just keeping coming back to them - don't expect to stay in a nirvana of perfect resilience, it's not humanly possible - just be prepared to keep coming back to them.

I'm glad you feel more positive - and well done on buy a fruit that makes you feel good. If you just want a nutshell answer re DBT - it is simply a therapy that promotes balance in all things. Below I have posted detailed stuff about what DBT is about if you want more detailed info. It is long - so please don't let it overwhelm you!

My point is that DBT is good in that it helps people with no support still survive. There is a line between that and resilience that teaches us to rely on others and foster our relationships. Relationships are often difficult for the mentally ill, and we don't always come from safe families that will support us. We can "miss the boat" in developing friendships as a child due to trauma and mental illness. I like DBT because it helps us hang on when all is lost. But if we are lucky enough to have that outside support, resiliency teaches us to accept it and that in doing so, our healing will be faster and smoother than going it alone.

Cheers,

Jade

DBT
DBT is dialectical behaviour therapy with involves 4 modules:
1. Mindfulness
Mindfulness is one of the core concepts behind all elements of DBT. It is considered a foundation for the other skills taught in DBT, because it helps individuals accept and tolerate the powerful emotions they may feel when challenging their habits or exposing themselves to upsetting situations. The concept of mindfulness and the meditative exercises used to teach it are derived from traditional Buddhist practice, though the version taught in DBT does not involve any religious or metaphysical concepts. Within DBT it is the capacity to pay attention, non-judgmentally, to the present moment; about living in the moment, experiencing one's emotions and senses fully, yet with perspective.
*"What" skills
Observe -This is used to non-judgmentally observe one’s environment within or outside oneself. It is helpful in understanding what is going on in any given situation.
Describe - This is used to express what one has observed with the observe skill. It is to be used without judgmental statements. This helps with letting others know what you have observed.
Participate - This is used to become fully involved in the activity that one is doing. To be able to fully focus on what one is doing.
*"How" skills
Non-judgmentally - This is the action of describing the facts, and not thinking about what’s “good” or “bad”, “fair”, or “unfair.” These are judgments because this is how you feel about the situation but isn’t a factual description. Being non-judgmental helps to get your point across in an effective manner without adding a judgment that someone else might disagree with.
One-mindfully - This is used to focus on one thing. One-mindfully is helpful in keeping your mind from straying into emotion mind by a lack of focus.
Effectively
This is simply doing what works. It is a very broad-ranged skill and can be applied to any other skill to aid in being successful with said skill.[9]

2. Distress tolerance
Many current approaches to mental health treatment focus on changing distressing events and circumstances. They have paid little attention to accepting, finding meaning for, and tolerating distress. This task has generally been tackled by psychodynamic, psychoanalytic, gestalt, or narrative therapies, along with religious and spiritual communities and leaders. Dialectical behavior therapy emphasizes learning to bear pain skillfully. Distress tolerance skills constitute a natural development from DBT mindfulness skills. They have to do with the ability to accept, in a non-evaluative and nonjudgmental fashion, both oneself and the current situation. Since this is a nonjudgmental stance, this means that it is not one of approval or resignation. The goal is to become capable of calmly recognizing negative situations and their impact, rather than becoming overwhelmed or hiding from them. This allows individuals to make wise decisions about whether and how to take action, rather than falling into the intense, desperate, and often destructive emotional reactions.
*Distract with ACCEPTS
This is a skill used to distract oneself temporarily from unpleasant emotions.
Activities - Use positive activities that you enjoy.
Contribute - Help out others or your community.
Comparisons - Compare yourself either to people that are less fortunate or to how you used to be when you were in a worse state.
Emotions (other) - cause yourself to feel something different by provoking your sense of humor or happiness with corresponding activities.
Push away - Put your situation on the back-burner for a while. Put something else temporarily first in your mind.
Thoughts (other) - Force your mind to think about something else.
Sensations (other) – Do something that has an intense feeling other than what you are feeling, like a cold shower or a spicy candy.[9]
Self-soothe
This is a skill in which one behaves in a comforting, nurturing, kind, and gentle way to oneself. You use it by doing something that is soothing to you. It is used in moments of distress or agitation.
*IMPROVE the moment
This skill is used in moments of distress to help one relax.
Imagery - Imagine relaxing scenes, things going well, or other things that please you.
Meaning - Find some purpose or meaning in what you are feeling.
Prayer - Either pray to whomever you worship, or, if not religious, chant a personal mantra.
Relaxation - Relax your muscles, breathe deeply; use with self-soothing.
One thing in the moment - Focus your entire attention on what you are doing right now. Keep yourself in the present.
Vacation (brief) - Take a break from it all for a short period of time.
Encouragement - Cheerlead yourself. Tell yourself you can make it through this.[9]
Pros and cons
Think about the positive and negative things about not tolerating distress.[9]
Radical acceptance
Let go of fighting reality. Accept your situation for what it is.[9]
Turning the mind
Turn your mind toward an acceptance stance. It should be used with radical acceptance.[9]
Willingness vs. willfulness
Be willing and open to do what is effective. Let go of a willful stance which goes against acceptance. Keep your eye on the goal in front of you.[9]

3. Emotion regulation
People managing mental illness can find that they are frequently emotionally intense and labile. They can be angry, intensely frustrated, depressed, or anxious. This suggests that these clients might benefit from help in learning to regulate their emotions. Dialectical behavior therapy skills for emotion regulation include:
Identify and label emotions
Identify obstacles to changing emotions
Reduce vulnerability to emotion mind
Increase positive emotional events
Increase mindfulness to current emotions
Take opposite action
Apply distress tolerance techniques
Story of emotion
This skill is used to understand what kind of emotion one is feeling.
Prompting event
Interpretation of the event
Body sensations
Body language
Action urge
Action
Emotion name, based on previous items on list
*PLEASE MASTER
This skill concerns ineffective health habits can make one more vulnerable to emotion mind. This skill is used to maintain a healthy body, so one is more likely to have healthy emotions.
PhysicaL illness (treat) - If you are sick or injured, get proper treatment for it.
Eating (balanced) - Make sure you eat a proper healthy diet, and eat in moderation.
Avoid mood-altering drugs - Do not take non-prescribed medication or illegal drugs. They are very harmful to your body, and can make your mood unpredictable.
Sleep (balanced) - Do not sleep too much or too little. Eight hours of sleep is recommended per night for the average adult.
Exercise - Make sure you get an effective amount of exercise, as this will both improve body image and release endorphins, making you happier.
MASTERy (build)
Try to do one thing a day to help build competence and control.
Opposite action
This skill is used when you have an unjustified emotion, one that doesn’t belong in the situation at hand. You use it by doing the opposite of your urges in the moment. It is a tool to bring you out of an unwanted or unjustified emotion by replacing it with the emotion that is opposite.
Problem solving
This is used to solve a problem when your emotion is justified. It is used in combination with other skills.
Letting go of emotional suffering
Observe and experience your emotion, accept it, then let it go.

4. Interpersonal effectiveness
Interpersonal response patterns taught in DBT skills training are very similar to those taught in many assertiveness and interpersonal problem-solving classes. They include effective strategies for asking for what one needs, saying no, and coping with interpersonal conflict.
Individuals with borderline personality disorder frequently possess good interpersonal skills in a general sense. The problems arise in the application of these skills to specific situations. An individual may be able to describe effective behavioral sequences when discussing another person encountering a problematic situation, but may be completely incapable of generating or carrying out a similar behavioral sequence when analyzing his or her own situation.
The interpersonal effectiveness module focuses on situations where the objective is to change something (e.g., requesting that someone do something) or to resist changes someone else is trying to make (e.g., saying no). The skills taught are intended to maximize the chances that a person’s goals in a specific situation will be met, while at the same time not damaging either the relationship or the person’s self-respect.
DEARMAN - getting something
This acronym is used to aid one in getting what he or she wants when asking.
Describe your situation.
Express why this is an issue and how you feel about it.
Assert yourself by asking clearly for what you want.
Reinforce your position by offering a positive consequence if you were to get what you want.
Mindful of the situation by focusing on what you want and ignore distractions.
Appear Confident even if you don’t feel confident.
Negotiate with a hesitant person and come to a comfortable compromise on your request.
GIVE - giving something
This skill set aids one with maintaining his or her relationships, whether they are with friends, coworkers, family, romantic partners, etc. It is to be used in conversations.
Gentle: Use appropriate language, no verbal or physical attacks, no put downs, avoid sarcasm unless you are sure the person is alright with it, and be courteous and non-judgmental.
Interested: When the person you are speaking to is talking about something, act interested in what they are saying. Maintain eye contact, ask questions, etc. Do not use your cell phone while having a conversation with another person!
Validate: Show that you understand a person’s situation and sympathize with them. Validation can be shown through words, body language and/or facial expressions.
Easy Manner: Be calm and comfortable during conversation, use humor, smile.
FAST - keeping self-respect
This is a skill to aid one in maintaining his or her self-respect. It is to be used in combination with the other interpersonal effectiveness skills.
Fair: Be fair to both yourself and the other person.
Apologies (few): Don’t apologize more than once for what you have done ineffectively, or apologize for something which was not ineffective.
Stick to Your Values: Stay true to what you believe in and stand by it. Don’t allow others to get you to do things against your values.
Truthful: Don’t lie. Lying can only pile up and damage relationships and your self-respect.