Psychodynamic Therapy and DBT: A Pretty Sweet Match

Psychodynamic Therapy and DBT: A Pretty Sweet Match

Since I work with attachment trauma, lots of folks who come to see me have intense emotions that can feel like they're coming out of nowhere and wreak terrible havoc.

(Like Daenerys' dragons… pic from HBO of course)

These intense feelings can be so overwhelming to your body and your mind that you can't think anymore. All you can do is feel. And when all you can do is feel, you want to do something, anything, to make the feeling go away.

So maybe you cut. Or you drink. Or you call your ex over and over again until she blocks you or refuses to pick up. Maybe you check out, numb out, binge out, freak out– whatever you do,  you're just trying to get rid of the intensity of the emotion that feels like it's going to overtake you.

Dialectical Behavior Therapy (DBT) is one treatment approach for addressing these intense emotions.

DBT skills development can help you regulate your emotions and tolerate your distress, and has been helpful for many people I work with and for myself personally. There are several DBT centers in the East Bay and San Francisco, all of which have their own personality and style but go through the same training through Behavioral Tech.

While I highly recommend DBT for many, it is one part of a multifaceted treatment plan. If you are experiencing overwhelming emotions and subsequent impulsivity, I highly recommend you try a concurrent DBT treatment with your psychodynamic or analytic talk therapy. With DBT or another mindfulness practice such as body movement (like dance, lifting, stretching), meditation, being in nature, or spiritual prayer, you can learn to regulate the overwhelming feelings so that you are able to take in in more of the deep work you're doing with your therapist, which can help you feel more connected to others and to your joy and desires.

Maybe we can think of it this way: If we can imagine your psyche and soul as an fruit tree, I see DBT as shaping and pruning the limbs of your tree. In order to get the sweetest fruit, i.e. your joy and hope coming to fruition, it's important to prune the limbs of your tree so that those fruits can grow and ripen. Any master gardener will tell you that pruning is one of the most important elements of harvesting amazing fruit.

That said, as with anything growing in the ground, the roots also need constant and consistent tending. This is where dynamic and analytic therapy comes in.

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The Language of "Good-Enough Therapy"

The Language of "Good-Enough Therapy"

I was talking with a therapist friend today about our personal relationships with authority. We were sharing that, as therapists, we have a particular authority that we as non-therapists might also rail against. As therapists, we have authority in the room. Whether we like it or not, there is often a power differential in the clinical hour. But that authority does not have to be a toxic one, and in fact, can become the very container in which to support profound transformation and growth. Here’s how I think that can happen.

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On Healthy and Fulfilling Relationships

“Lovers embrace that which is between them, rather than each other.” – Kahlil Gibran

even just a small impromptu note from one friend to another can remind you why you are connected to each other.

even just a small impromptu note from one friend to another can remind you why you are connected to each other.

Being in relationship with another person is a complex and deeply personal experience. Sometimes you may feel completely in sync with them, while other times you might feel disconnected, out of touch, and even hurt. Relationships can be fraught and they can be smooth; since we don’t really have much (okay, ANY) control over other people, when we become willing to risk being hurt in order to get the benefits of being connected, a lot of unexpected emotional stuff can come up.

When it comes to relationships, there are layers about the other person(s), as well as things that exist between you, that can feel very difficult to untangle from your own relationship with yourself. We spend much of our childhood taking in the expectations of others around us. Often, we feel the power of others “naming” us, both literally (our parents usually give us our names) and figuratively (“You are so picky at dinner!”), which can seem like the truth when we’re so young. As we grow older, the people around us may change, but the messages from childhood remain, and influence how we relate to the world and the people we’re close to.

So let's try on the possibility that what can help us have more fulfilling relationships is to embrace that which is between us as well as each other and ourselves. The best way to start feeling fulfilled and healthy in your relationships is to learn what it's like to feel fulfilled and healthy with yourself. Learning how not to be afraid of yourself, how to listen to yourself, how not to hide things away from yourself-- all of this can help you feel connected to you, and this will radiate through into your relationships with others. If you’re critical or intolerant of yourself, you’ll probably be critical and intolerant of others. If you cut off or ignore parts of yourself, you’ll probably cut off or ignore parts of others. If you allow yourself enough grace, enough forgiveness, enough space to allow yourself to be fully who you are, you will be able to do the same for the people you love. You’ll become one of those people you love. And that’s the key to all of it.

Here are some questions that might help you think about how you respond to people you love in situations where you’re triggered. Since these questions might evoke somatic or unconscious responses, it might be easier to think about them as you walk, or talk them through out loud with your therapist or confidant. Journaling in a free-flowing and non-judgmental way can also help you sit with some of the more uncomfortable feelings that might come up. I also suggest you pay attention to your dreams in the next few days, noticing places where you have interactions with people, where you feel safe, and where you feel scared.

What happens to you when you’ve had a rough day? When you’re preoccupied with something, like the interaction you had with someone in the grocery checkout line or a pending situation at work that you feel unsettled about- how do those feelings leak through into your interactions with people close to you? How do you respond when your partner is irritable, shows their vulnerability, or closes off? These are all micro-interactions that occur constantly between people, and it’s really easy to get caught in the emotional web of our expectations, fears, wishes, needs, and triggers and forget how to think together, and share together with another person. Noting when these happen for you can help you create a little more room for yourself when you’re feeling caught up in these emotions.

And: Who are you connected to in your life? How do you feel when you’re with them? Do you sometimes wish you could be alone, and not need other people, because maybe it’s safer that way? How do you, or could you, balance alone time with connected time? How can you find ways to be yourself in all the relationships you consider meaningful? What relationships might need to change if you were to feel more comfortable in them, and how might they change? How might you need to change to be more flexible in your relationships- or more boundaried?

Understanding Your Inner Critic

When Your Protection Becomes Your Prison: Understanding Your Inner Critic You know those harsh, penetrating thoughts you have-- the ones that haunt you, even when you do something you love? The thoughts that tell you you’re not good enough, that you should “shut up” and “stop thinking you’re all that”, that try to beat you into submission? Yeah, those thoughts. The ones that hurt.

What if I told you those thoughts were actually there to help you?

Let’s consider for a moment that you are a child, and you’re doing something that feels fun. You’re feeling safe, so you play. You’re in “the flow.” Suddenly, someone shouts at you: “Stop doing that!” and takes away the rusty nail you’re about to put down your gullet.

Now, that voice is in you, reminding you: "Don’t eat the rusty nail!" That’s good, right? But it feels scary to be shocked out of that "flow". Let’s say you didn’t have someone there to tell you that you’re going to be ok. We could even go so far as to say, what if the person chided you, or shamed you for wanting to explore the world around you?

Now, that voice has a chance to grow bigger. It grows louder. It makes you wonder: Well, when I was feeling safe and playing, I learned I was bad. Maybe I shouldn’t let my guard down like that.

That harsh inner critic used to be a voice outside of you, but now it's lodged itself inside of you. It's your armor and your guard, after all.

And then, sometime, when you’re feeling safe, and feeling in “the flow”, and you start to let your guard down, the voice that's now deep inside you says, “DON’T!” And you are brought right back in to an anxious, guarded, vigilant place. You might even start feeling really badly about yourself.

You might start to feel like everything you’re curious about is actually bad for you.

But even though your inner critic might be really loud sometimes, you do have inner resources that can help you. Those resources are intertwined with understanding, and offering kindness and relaxation to, that the harsh, overprotective, and now harmful voice. We can find ways to lessen the harshness and add kindness by getting to know what feels scary, overwhelming, and challenging to you.

We all need validation of the parts of us that soar, and because the harsh critical voice often feels like the “true” voice, it can be easier to find yourself in situations where the criticisms are echoed in the people around you. It can also feel very difficult to accept the warm, kind voices, since they can actually have the opposite effect and make the inner critic louder.

What ways have you found to still the inner critic, for even just a moment?

Sometimes, that critic can feel so powerful that the only thing we can do is distract from it. Watching TV, cleaning the bathroom, going for a run, taking a nap—these are all ways we can distract ourselves from perseverating on the harsh inner landscape. Try to notice this process of distracting yourself from the fearful feelings so that you can make it to the other side. If you can spend just a few seconds identifying that that’s what you’re doing, then you’ve begun to offer some space to breathe and begin to allow yourself the option to feel just a little bit differently.

These moments you offer yourself are an important reminder that what you do best is survive. Sometimes, your survival skills can become restrictive and unhelpful, which can perpetrate more criticism and despondency. It is crucial at these times that you remind yourself, however you need to-- post it notes, a loved one, a video of yourself, or a snap of a rubberband on the wrist-- that there is more to your life than just this feeling, and that this feeling thinks it’s doing its job by protecting you. This feeling doesn’t quite get, yet, that it’s hurting you more than it is doing good for you.

But maybe it can learn, with kindness and time, to trust itself again. And, instead of protecting you, maybe together you both will learn that you deserve to explore, to discover what’s thrilling to you, to try on new things, and to take risks in places that could be healing and delicious for you.

Maybe, paying attention to this harsh, critical part of you will be just the thing to help you unlock what is healing, soothing, and reparative for you. Paying attention to the painful stuff may just be the way to open up new possibilities for you of how you relate to yourself and your world.

For more on letting go and noticing your patterns, I recommend listening to any of Pema Chödrön’s talks, which can be found on the Shambhala Press website. If you are interested in contacting your difficult feelings and attending to your inner critic, I encourage you to call me at 510-594-4035 to talk about how therapy with me could help you understand and work with some of the harshness of your protective self. I provide depth psychotherapy in Berkeley, CA. This piece is not intended to treat, diagnose, prevent, or cure any disease, and is not intended to provide psychotherapeutic treatment to anyone who reads or interacts with it.

To cite this page: Merson, M. (2014) When Your Protection Becomes Your Prison: Understanding Your Inner Critic. Retrieved month/day/year from http://mollymerson.com/2014/04/23/understanding-your-inner-critic/