Building A Life Worth Living

“Life moves pretty fast. If you don't stop and look around once in a while, you could miss it.” -Ferris Bueller

Reduce Anxiety Fast

In DBT, there is a crisis survival skill that works faster and better than any other skill you’ve tried before.

It is part of TIPP, which is changing your emotions with Temperature, Intense exercise, Paced breathing and Progressive muscle relaxation.

But more specifically, it is The Ice Skill, the Mammalian Dive Reflex, or Dive Response.

When you put your face in cold water, you heart beat slows down. It can slow by 10%-30%, which is a huge relief if you're having a panic attack.

Your body also redirects your blood - away from your arms and legs to your heart and brain. This happens automatically to protect your heart and brain. It also helps you think more clearly, because you have more blood going to your brain.

The final piece of the puzzle comes in when you hold you breath under the water. It works like a reset button on your respiration. When we're anxious or scared, we start to hyperventilate (have too much oxygen) and then feel the effects of a panic attack.

These panic attack symptoms (light-headedness, numb or tingling hands, and a tight chest) can be cut off very quickly by activating the Dive Reflex and the vagal nerve.

How To Practice

  1. Grab a bowl and fill it with very cold water

If you don’t have a bowl or water, you can also use an ice pack, an ice cube, or a cold wet compress. You can even do this skill by splashing water on your face, but it works better when you put your whole face in the water.

2. Bend over the bowl and hold your breath

The act of standing and bending at the waist helps with activating the vagal nerve and the dive reflex. It tricks your mind into thinking you are going headfirst into the water. Even if you’re using an ice pack, bend over for better results.

3. Put your face, up to the temples, into the cold water for 30 seconds

With your face in the water, hold your breath for at least 30-60 seconds. The area between your brow bone and cheek bones is the most important part of your face to be in the cold water.

4. Stand up, breathe normally and check in on your emotions

Do you feel any different? If no, repeat until your emotions are less intense and able to cope with or until you’re so cold and wet that you’ve forgotten what got you upset in the first place. (j/k, but also you will be less likely to be thinking about problem behaviors)

Cautions: Don’t use water colder than 50°F, because the cold will hurt. If you have heart problems, check with your cardiologist before trying this skill. This skill lowers your heart rate very quickly.

Trans-Affirming Care

Gender Dysphoria Diagnosis Confirmation

Part of the process to have health insurance cover gender affirming surgeries, such as top surgery, is getting a letter from a therapist or doctor confirming that you have gender dysphoria and that you understand the risks inherent to surgery.

I understand the need from the insurance companies to confirm that they are paying for a medically necessary procedure, to alleviate gender dysphoria. However, I am ethically opposed to the gatekeeping of life saving surgeries by providers who need you to “prove your transness” to them. If you say you are trans, that means you are trans.

I am able to complete a one-session assessment to confirm your diagnosis of Gender Dysphoria for gender affirming surgery letters.

This one-time meeting will consist of us talking about your experiences with dysphoria and the ways in which you feel surgery will benefit you and your journey to becoming your most authentic self.

We’ll talk about your research on surgeons and aftercare, and brainstorm solutions to barriers to completing your goals. We can talk about the pros/cons of surgery and identify supportive people in your life who are willing to help care for you afterwards.

You know yourself best. You are the expert on you.

At the end of our 50 minute session, I will email you a personalized .pdf letter signed and confirming your gender dysphoria diagnosis. This can be given to your surgeon and health insurance company to open the door to scheduling surgery.

If you decide that you feel comfortable with me as a therapist, we can schedule ongoing therapy sessions. If you only need a letter for surgery, I will celebrate with you on becoming your best self and say goodbye.

Email me at EmbraceWillingness@gmail.com for more information on gender affirming care or to schedule an assessment for $70.

Four Options for Problem Solving

In DBT, there are 4 options to choose from when you are deciding how to respond to a difficult situation:

1) Solve the problem

2) Change your perception of the problem

3) Radically Accept the problem

4) Stay Miserable

Throughout life, we get to decide how we respond to situations. Some things are outside of our control, but our reactions can be chosen.

Option One: Solve The Problem

Wouldn’t it be nice if every problem we came upon could be solved?

1) Identify the problem.

2) Brainstorm solutions.

3) Try one solution.

4) Evaluate the effectiveness of the solution.

5) Celebrate your solution, or try a different solution.

Sometimes, even being aware that there is a problem, or being able to articulate what is going wrong is difficult.

When that happens, go back to the emotions you are feeling to figure out what prompted the emotion and if it is justified or unjustified.

Option Two: Change Your Perception

Perception is the understanding and meaning you find in a situation. By gathering more information, and shifting how you think about what is happening, you can change how you feel about a problem.

Anaïs Nin said, “We don’t see things as they are; we see them as we are.”

Your perception of your reality can change your perspective.

1) Make the choice to examine the problem from every side.

2) Use Loving Kindness to build empathy and self-compassion.

3) Find Meaning in the situation, or how growth can come from this problem’s fertilizer.

4) Use Opposite Action to distract yourself and feel a different emotion.

Option Three: Radically Accept The Problem

Radical Acceptance is not approval.

When you fully acknowledge that something is happening, you are not saying that it is ok, or good, or positive. It is simply noting that something is occurring. You have to notice the dumpster is on fire to be able to plan how to stop the fire.

Non-acceptance of painful situations leads to suffering.

Radical Acceptance of painful situations leads to ordinary pain.

Pain is part of the human condition. We can cope with pain.

We do not need to suffer.

1) Notice that you are fighting the reality of the problem.

2) Remind yourself that the problem cannot be solved right now.

3) Remember what happened to create the problem.

4) Pretend and practice accepting the problem. Act like you do accept it.

5) Allow disappointment to rise within you. Know that life can be worth living even when you are in pain.

6) Identify the pros and cons of accepting reality.

Option Four: Stay Miserable

This fourth option is always present in everyone’s life, and with every problem. You can choose to do nothing, and stay miserable.

When nothing changes, nothing changes.

6 Benefits of Exercise for Mental Health

  1. Sleep better at night

  2. Feel less depressed

  3. Happy and proud feeling of accomplishment

  4. Lower stress and anxiety levels

  5. Improved self-esteem

  6. Feel more connected to community

Ideas For Low-Impact Exercise

Sometimes, you just don’t feel up to a full workout. Don’t let that stop you from being active. Even small steps can make a big difference in your mood.

  1. Walk Around Your Block

  2. Go To The Park

  3. Chair Yoga or Chair Exercises

  4. Swimming

  5. Elliptical

Mindfulness isn’t meant to be relaxing

I’ve been going about mindfulness in an unskillful way. I’ve been trying to build a sense of peace, serenity, and calm.

I can’t seem to recreate that chill feeling I get while doing mindfulness in DBT skills group.

Turns out, the purpose of mindfulness is to make you more aware of what you’re feeling in that second. Being mindful means paying attention to experiences in the moment. Not to be calm.

When I lead a mindfulness activity in group, or do one by myself, I am trying to build a practice to live a mindful life.

Mindfulness Is Not:

  • Relaxing

  • Calm

  • Soothing

  • Just Breathing

  • Spiritual Practice

Mindfulness Helps:

  • Lower Stress

  • Improve Mood

  • Increase Focus

  • Strengthen Immune System

  • Respond To Distraction More Skillfully

The Goal Of Mindfulness Practice

Is

Mindfulness Practice