Bill of Rights Part 3

A Recovery Bill of Rights for Trauma Survivors, Part 3

 

Here is our lastest installment in the series.  I found this worthwhile for therapists as well as clients and hope you do too. 

For the integrity of your personal communication you have the right to…

Ask for explanation of communications you do not understand.

Express a contrary view when you do understand and you disagree.

Acknowledge your feelings, without having to justify them.

Ask for changes when your needs are not being met.

Speak of your experience, without apology for your uncertainties.

Resolve doubt without deferring to the views or wishes of anyone.

 

Bill

Recovery Bill of Rights

A Recovery Bill of Rights for Trauma Survivors, Part 2

In my last entry I posted the first part of Thomas V. Maguire’s recovery bill of rights.  This is the second installment.   I hope you find it interesting.

To guard your personal boundaries you have the right to…

Speak or remain silent, about any topic and at any time, as you wish.

Ask for help in healing, without having to accept help with everything.

Take action to stop a trespass that does not cease when challenged.

Choose to accept or decline feedback, suggestions, or interpretations.

Be touched only with, and within the limits of your consent.

Challenge any crossing of your boundaries.

 

Bill

Recovery Bill of Rights

A Recovery Bill of Rights for Trauma Survivors

Thomas V. Maguire published a recovery bill of rights with the National Council for Community Behavioral Healthcare.  I thought I would pass it along in some installments.  Here is the first, I hope you find it useful. 

By virtue of your personal authority you have the right to…

                Manage your life according to your own values and judgment.

                Direct your recovery, answerable to no one for you goals or progress.

                Gather information to make intelligent decisions about your recovery.   

                Seek help from many sources, unhindered by demands for exclusivity.

                Decline help from anyone without having to justify the decision.

                Believe in your ability to heal and seek allies who share your faith.

                Trust allies in healing so far as one human can trust another.

                Be afraid and avoid what frightens you.

                Decide for yourself whether, when and where to confront fear.

                Learn by experimenting, that is, make mistakes.

Bill

Rumination, Mindfulness, and Being in the Moment

One of the most common issues my clients struggle with in therapy is rumination. Rumination can be related to a wide variety of issues and types of emotional responses. For instance, we may feel we’ve been wronged or slighted by someone we “thought” we could trust and ruminate about how and why that person did the perceived dirty deed. During the ruminating the event is played over and over and the initial emotional response is experienced again and again.

Another example would be focusing on a “possible” future event that would be hurtful even though the actual likelihood of the event is inflated due to worrying. I’m sure almost everyone has had the experience of interacting with a family member or friend who was irritable or short with you, and then wondering what you might have done to offend or upset them (even though it may not have anything to do with you at all). What often happens next is rumination about why the other person is upset plus worrying about the next interaction. In this example there are an infinite number of possible scenarios for future interactions to ruminate about, and I will bet none of the ones you imagine are positive, causing negative emotions like anxiety, sadness, anger, and maybe even fear. Consequences for this rumination can include being distracted from current activities which in turn can have any number of negative effects.

Rumination is analogous to suffering and is something we can learn to reduce. There are usually distinct thought patterns that can be identified that can be changed and counteracted. Judgmental thoughts such as “if only,” “why,” “it shouldn’t have,” or “it should be” are often part of rumination. Replacing judgmental statements with acceptance and non-judgmental observation of facts can slow down and counteract rumination. Try visualizing an event you ruminated about in the past and then saying to yourself two types of statements. First say: “That was a very sad and hurtful thing that happened to me.” Then say: “Why does that always happen to me?” Do they feel different to say? Which one sounds like a statement that lets you move on? Which one leaves you feeling unsatisfied and needing to pursue an answer again and again? Learning how to reduce or stop ruminating thoughts will reduce your stress and improve your life.

 

Mark E. Hankla

Taking Hold of Your Mind

People experiencing trauma related problems often say that they have difficulty controlling their thinking.  They may describe being bothered by thoughts that keep intruding on their thinking, or impulses to do things that might be harmful.  Obsessional thinking or going over the same thought repeatedly is another disturbance that can be a big problem.  These, as well as other disturbances in the process of their thinking are often described by our clients. 

While there are a variety of ways to address problems with the thinking process, using mindfulness skills is one that most people can learn and practice.   In her skills training manual, Psychologist Marsha Linehan devotes a major section to mindfulness skills which she titles “taking hold of your mind.”  I find this a fitting title because many people describe the experience of thinking problems as feeling like their mind is out of control. 

One of the first skills that Dr. Linehan covers is called “observe, just notice” which falls into the category of easy to say, difficult to do.  The skill involves observing your thoughts without getting caught up in what they are.  Dr. Linehan says to “…watch your thoughts coming and going, notice each feeling, rising and falling like waves in the ocean.”  I have found another useful metaphor to be that of standing beside a river watching your thoughts and feelings come floating down from upstream, drifting across in front of you and continuing to float downstream out of your awareness.  These and other observe techniques can be very helpful in learning to be in greater control of your thinking.  They are not very easy to use at first and coaching and a lot of practice is usually needed.  I think the time and effort taken to learn and use them is worth it.   I’ll describe more mindfulness skills in future posts.

Bill Bonacker

Acceptance

In the last post I wrote about Dialectical Behavior Therapy’s use of validation.  Another characteristic that Dialectical Behavior Therapy (DBT) emphasizes is the use of acceptance.  Marsha Linehan, the psychologist who developed DBT says that it adds the technology of acceptance to cognitive behavior therapy.  Years after DBT gained popularity, other therapies have included acceptance as a component but I think that DBT is the most organized and systematic in its use.

Dr. Linehan writes about radical acceptance in the DBT Skills Training Manual stating that “freedom from suffering requires acceptance from deep within of what is.  Let yourself go completely with what is.  Let go of fighting reality.” 

In later writing on DBT we find the equation, suffering = pain + nonacceptance.

Swiss American Psychiatrist Elisabeth Kübler-Ross included acceptance in her description of the stages of grief.  She wrote that people confronted with a loss pass through stages of anger, denial, bargaining, depression and acceptance.  Usually people visit the stages a number of times, working through them until they spend most of their time in the acceptance stage.  My clients often find this structure helpful in dealing with problems.  They usually can identify which stage they are stuck in and, with support, figure out what feelings and thoughts the acceptance stage would contain.  Then, of course, there’s the task of getting there.

Bill Bonacker

Validation

Validation

One of the elements that make Dialectical Behavior Therapy (DBT) unique is its emphasis on validation.     Validation can be described as the acceptance of what is.  The common popular comment, “it is what it is” sort of expresses this.  We don’t have to like it, we don’t have to approve of it, we can work to change it but there it is.  DBT’s creator, Marsha Linehan, contrasts DBT’s focus on validation with Cognitive Behavior Therapy’s constant focus on change.  She says that spending most of the time on changing is invalidating to many people.  They can feel that they shouldn’t have their feelings, thoughts or beliefs about what has happened to them.  They can feel that they should be doing better and that their current behavior is bad.  While Dr. Linehan recognizes that change is necessary and important, she stresses that change must be balanced with validation.  DBT’s individual therapy contains structured ways in which validation is used and therapists who have studied DBT are familiar with them.  Skilled DBT therapists are always working to find the balance between validation and change. 

Bill Bonacker