CBT is often used when a client wants to create a tangible change in her life. This change could be directed at broad topics like anxiety, depression, or OCD symptoms, or the targeted change could be something more specific. The concept that drives CBT is the theory that cognition (our thoughts), behaviors (what we do), and emotions (how we feel), all impact each other. For example, if someone feels happy (emotion), then she might think positive thoughts about others (cognition) and go out of her way to do something kind (behavior). Conversely, if someone wants to change a feeling, thought, or ..read more

Generally, whenever a person starts something new, she is oriented to the structure, guidelines, regulations, and setup of that new entity so that she can appropriately adjust her expectations to her new reality. Orientation at the start of preschool might be two hours, and at the start of university, it might be two weeks. In all cases, once orientation is over, it’s done. That should not be the case with orientation to therapy. A therapeutic relationship is a relationship between two experts. The therapist is the expert on the treatment or treatments. The client is the expert on herself. The ..read more

DBT is not the ideal treatment for all clients. It is, however, a fantastic treatment for clients who have trouble managing large and intense emotions. DBT is also purposefully structured as an outpatient treatment. These two ideas go together. Emotions are great. That’s a pretty big premise in DBT. They motivate us to affect change, communicate information to others, and are a way in which we communicate with ourselves. Humans need them and they also make life much richer. For some, emotions are experienced as gigantic and hard to manage, influence, and control. We call this “emotion dysregul ..read more

Happiness. It is the topic of much debate. Everyone is looking for that elusive goal, to be happy. People spend their entire lives searching for it. But what is happiness? Is it really such a worthy goal? Dr. Russ Harris, author of the bestselling book The Happiness Myth and ACT trainer, has some answers. He discusses the three most prevalent happiness myths that can actually cause the opposite effect.  The first happiness myth is that people are naturally happy. Of course, the person must have his basic needs met, such as food, shelter, and even healthy loving relationships. But why is t ..read more

A major tenet of DBT is the concept of observing limits. For example, the “Observe skill” is taught as part of the Core Mindfulness Skills, and an extension of that is to observe one’s limits. It is a skill that is expected to be practiced by the primary therapist, the client, the group co-leaders, the team, and ultimately generalized into real-world action. Limits are important. In the natural world, limits keep the oceans from overflowing onto dry land and animals safe from natural predators. In relationships, limits enable healthy spaces in which each person can cultivate a sense of self wh ..read more

with Sarah Green, PsyM Navigating the Yomim Noraim and the Teshuva Process A massively important aspect of Jewish holidays in contrast with other holidays is that, while other holidays are generally commemorative, Jewish holidays are happening in the present. During Pesach, there is actual freedom to tap into. During Chanuka, there’s a light in the darkness of geula to hold on to. The Ramchal in Derech Hashem discusses this concept, that time in Judaism works like a screw: as you move down the screw, a year later, and a year later, you reach the same point along the screw, but further down. Wh ..read more

Why Don’t We Achieve Our Goals? It’s that time of year again. As frum Jews, we don’t believe in New Year’s resolutions but we do have the concept of kabbalos or goals for the upcoming year. But it can sometimes feel like we keep making goals for ourselves without ever accomplishing anything. We have this picture of what we want our lives to look like but we have no way of realistically getting there.  The Role of ACT  Our biggest problem when it comes to achieving our goals is that we don’t know how to set the right kind of goals. One type of therapy, called ACT, addresses this issue ..read more

My Child is Manipulating Me  Parents can sometimes get frustrated with their children when they feel like they are manipulating them. Somehow, they know the exact buttons to push and get what they want. The parent is left feeling annoyed, even angry at the child and at themselves for “letting it happen.” Is the child manipulating the parent? The Science of Learned Behavior The answer is typically no, children don’t usually manipulate their parents! Children learn about the world around them by seeing the behavior adults model and by seeing what works to meet the functions they are seeking ..read more

The Truth about BPD Part 2: Facts and Myths In part one, we discussed the biosocial model, which explains how symptoms arise and how problems continue. The bio part involves the idea that emotional sensitivity is inborn and the social part is the invalidating environment. I like to share a story to explain what an invalidating environment can look like. I call it my sandwich boy story. Imagine, 4-year-old kid, playing outside, and his mother calls him in for lunch, gives him a sandwich, he eats his sandwich, and goes back outside to play. Fifteen minutes later he comes back in and says, “Mom ..read more

Cope Ahead The handwriting is on the wall. It is 7:42 and Princess (not her real name) is slumping against the wall with a pout on her pretty little face, her shoulders lifting and dropping, lifting and dropping. Mom, dressed for success and ready for work takes a deep breath and her stomach drops… not again, not this… not nooooooow… In a decidedly unprofessional whine of her own, Mom pushes out the words forcefully through gritted teeth, “We are not spending another morning like this! Get your bag and get down to the car before we are all late!!” Mom’s mind is frantic; I can’t exactly drag he ..read more