The Lighter Side of Transformation

Observed and reported by Lisa Wessan, LICSW

Westford, MA: New DBT Skills Groups (Dialectical Behavior Therapy) start 10/26/17 and 12/14/17

dbt-skills

Good news! For those of you who have been waiting to get into one of our DBT Groups, there are several openings in our daytime DBT Skills Group starting October 26, 2017,  Thursdays from 3:15 – 4:45 PM at my office in the beautiful Westford Center for Counseling and Holistic Therapies, 234 Littleton Road, Suite 1D, Westford, MA.

This group is co-ed/non-binary, mature teens, trans and adults welcome, and is limited to 10 participants per group. One initial consultation  with me is required prior to joining the group, plus the completion of some DBT Skills registration forms. To get started, click HERE or call me at 978.710.8039.

For this next trimester, we will be studying Mindfulness and Distress Tolerance from the DBT Skills curriculum.

Why do I teach DBT Skills?

Over the years, I have seen outstanding evidence of how DBT helps to rewire our brains with gentle cognitive restructuring exercises, reduce inflammatory thoughts and untangle our irrational beliefs and interpretations — which cause so much pain and suffering — all in a relatively short time span.  DBT is Solution Focused Therapy at its best!

DBT includes powerful and easy relaxation techniques for anxiety; a large array of tools for depression and mood issues; and effective communication and boundary setting skills which make this a brilliant vehicle for interpersonal effectiveness, peak performance and personal growth.

Four leaf DBT

ANNUAL OVERVIEW

[This is a one year program divided into three 14-week trimesters. Students decide to renew their commitment towards the end of each trimester.]

Each trimester delves into Mindfulness plus one of the remaining three main modules of DBT, which are Distress Tolerance, Emotional Regulation and Interpersonal Effectiveness (see diagram above). We repeat the Mindfulness module at the beginning of each semester to reinforce the powerful foundational skills it offers for general anxiety (Kabat-Zinn et al, 1992).

 

2017 – 2018 GENERAL CALENDAR

 [Dates are subject to change, due to snow days and other factors.]

UP NEXT: Daytime Group: October 26, 2017 – January 25, 2018. Mindfulness and Distress Tolerance.  Practical tools and skills are explored to process “crisis” emotions, impulse issues and more difficult feelings. We also cover Radical Acceptance, Turning Willfulness to Willingness, and moving from destructive self-harm to positive self-care (especially useful for the “Holiday Red Zone,” Halloween, Thanksgiving, Christmas and New Year’s Eve!)

Evening Group: December 14, 2017 – March 29, 2018.  Mindfulness and Interpersonal Effectiveness. Through discussions, readings and interactive exercises you will be learning to set healthy boundaries, learning to say “YES” when you mean yes and “NO” when you mean no without worrying about getting others’ approval.  You will  learn how to become bulletproof to others invalidation of you, and learn to be a self-validating person.  The art of asking for what you want and negotiating well  is also explored. In addition, we study various forms of interpersonal protection, e.g. emotional safety skills, learning to identify  Energy Vampires (Orloff, 2004) and recover well from their hurtful and draining interactions.

Daytime and Evening Groups: April – July 2018.  Mindfulness and Emotion Regulation. Learning to identify your vast array of feelings, articulate them and express emotions appropriately is part of this powerful work. Also, learning to check the facts, edit misinterpretations and assumptions, and turn down the volume on your intense emotions yet still experience them. You will learn to regulate your emotions successfully, so that you have a more positive experience of feeling better and stronger.

TUITION

Each trimester is $700 for 14 weeks (watch for the Early Bird rate which usually expires two weeks before each trimester).

** It is a requirement of this group that participants are working with an individual therapist while they attend the group. The therapist does not need to be me, nor does the therapist need to be trained in DBT, but will be available for all processing outside the group. (Release forms will be sent to you and/or your therapist after the Initial Consultation with me).

I hope I can be of service to you, your clients or loved ones who would benefit from this group in the greater north Boston/Nashoba Valley area.

Learn more about the details of this DBT Skills Group by visiting my web site, www.lisawessan.com.  Also, please feel free to contact me for further information.

Onward and Upward,

Lisa Wessan

 

DBT Mindfulness

__________________________________________________________________________
References

Kabat-Zinn, J., Massion, A. O., Kristeller, J., Peterson, L. G., Fletcher, K. E., Pbert, L., et al. (1992). Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. American Journal of Psychiatry, 149, 936–943.

Orloff, Judith, MD. (2004). Positive Energy.   New York: Random House.  Chapter 9, The Ninth Prescription:  Protect Yourself from Energy Vampires.  288 – 318.

Copyright © 2017 by Lisa Wessan. All rights reserved.

Advertisements
Leave a comment »

Decompressin’ with Wessan: Walk and Talk Therapy comes to Chelmsford, MA

LW WATT

Since I changed careers in 1999,  morphing from science journalist to therapist, I feel as if I have given birth to three clinical children in this journey…

First, I delivered Therapeutic Laughter for Caregivers (and others) in New York City, which emerged as keynotes, workshops and seminars.  I still enjoy presenting these programs which also include Team Building with Laughter, the Let Go and Lighten Up program and LaughAnanda (laughter meditation).  Each program serves a different sector, for corporate, medical/healthcare, educational, non-profit, and spiritual organizations.

Second, after a long gestational study period,  I delivered Dialectical Behavior Therapy Skills Groups (DBT) two years ago and currently facilitate two DBT groups in my office in Westford, MA, one daytime and evening group.

Third, and brand new as of June 2017, Walk and Talk Therapy (WATT) was born.  I am very excited about the progress and results my clients are experiencing during WATT.

Over the past several years, every time I read about exercising with clients, I was more intrigued…yes, there is solid science and empirically verified research on the benefits of WATT.

In brief, the motion of walking stimulates the bicameral brain and increases activity between the left and right hemispheres.  This allows people to access more complex feelings and memories, and have the ability to process the sadness, grief or trauma even more effectively while walking. While walking, everything is flowing, and the negative or heavily charged energy from the  traumatic memories can discharge quicker.  (I’m in the process of writing an article on a few of my clients who have had dramatic shifts and turnarounds on these walks.)

RISK MANAGEMENT

I have my clients sign an Indemnity Agreement prior to the WATT, and we discuss the possible challenges that may occur, such as tripping on a rock, or falling for some reason.  For some, this often leads to a lively discussion of their previous adventures and how confident they are in their walking ability.  “Walking around a lake? This is nothing, a piece of cake!”  they say.  For others, the prospect of walking for two miles is daunting, but they understand they can do as much or little of the walk as they want.  We have a choice of several benches for resting along the way with stunning views of the lake.

If you are considering WATT, I strongly recommend it.  As the Scottish-American naturalist John Muir once said, “In every walk with nature one receives far more than he seeks.”

Copyright © by Lisa Wessan 2017.   All rights reserved.

 

 

 

 

 

 

 

 

 

Leave a comment »

New daytime DBT Skills Groups starts Thursday June 8, 2017 in Westford, MA. This group is co-ed/non-binary, mature teens and adults welcome…

We will be studying Mindfulness and Emotion Regulation from the DBT Skills curriculum. This class will be held on Thursdays, 3:15-4:45 PM,  in the beautiful Westford Center for Counseling and Holistic Therapies, in Westford, Massachusetts. (One initial consultation is required prior to joining the group, plus the completion of some DBT Skills registration forms.)

dbt-skills

Over the years, I have seen the strong evidence of how DBT helps to rewire our brains, and reduce the inflammatory cognitions and irrational beliefs and interpretations which cause so much pain and suffering. So I am passionate about teaching DBT Skills, and truly believe it should be offered to all adolescents.

DBT has powerful and easy relaxation techniques for anxiety; a large array of management tools for depression and mood issues; and brilliant communication and boundary setting skills which make this an amazing vehicle for interpersonal effectiveness, peak performance and personal growth.

Each 14 week course delves into Mindfulness and Dialectics plus one of the remaining three main modules of DBT, which are Distress Tolerance, Emotional Regulation and Interpersonal Effectiveness. We repeat the Mindfulness module at the beginning of each semester to reinforce the powerful foundational skills it offers for general anxiety (Kabat-Zinn et al, 1992).

UP NEXT FOR 2017-2018
FALL – WINTER – SPRING – SUMMER OVERVIEW

Fall 2017- Winter 2018 trimester: Mindfulness, Dialectics and Distress Tolerance (especially useful for the “Holiday Red Zone,” which is fraught with unique challenges and conflicts, including severe Compare and Despair Syndrome).

Winter – Spring 2018 trimester: Mindfulness, Dialectics and Emotional Regulation. Learning to identify your vast array of feelings, articulate them and express appropriately is part of this powerful work. Also, learning to turn down the volume on your intense emotions yet still experience them is most empowering.

Summer – Fall 2018  trimester: Mindfulness, Dialectics and Interpersonal Effectiveness. Through discussions, readings and interactive exercises you will be learning to set healthy boundaries, learning to say “YES” when you mean yes and “NO” when you mean no without worrying about getting people’s approval.  You will  learn how to become bulletproof to others invalidation of you and as you become a self-validating person.  The art of asking for what you want and negotiating well to get it is also explored. In addition, we study various forms of interpersonal protection, safety and skills to identify your Energy Vampires (Orloff, 2004) and recover well from their hurtful interactions.

TUITION

Each trimester is $630 for 14 weeks. (There is no insurance for this psycho-education program. Useful statements can be provided, however, for your Flexible Spending Account or as a business expense for taxes, as this is also considered a skills training program).

** It is a requirement of this group that participants are working with an individual therapist while they attend the group. The therapist does not need to be me, nor does the therapist need to be trained in DBT, but will be available for all processing outside the group. (Release forms will be sent to you and/or your therapist after the Initial Consultation with me).

I hope I can be of service to you, your clients or loved ones who would benefit from this group in the greater north Boston area.

Learn more about the details of this DBT Skills Group by visiting my web site, www.lisawessan.com.  Also, please feel free to call or email me for further information.

Onward and Upward,

Lisa Wessan

________________________________________________________________________________________
References

Kabat-Zinn, J., Massion, A. O., Kristeller, J., Peterson, L. G., Fletcher, K. E., Pbert, L., et al. (1992). Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. American Journal of Psychiatry, 149, 936–943.

Orloff, Judith, MD. (2004). Positive Energy.   New York: Random House.  Chapter 9, The Ninth Prescription:  Protect Yourself from Energy Vampires.  288 – 318.

Copyright © 2017 by Lisa Wessan. All rights reserved.

Leave a comment »

Moving towards wholeness with Dialectical Behavior Therapy (DBT) Skills Group, Thursday evenings in Westford, MA

Grateful Plug:

I am pleased to announce the next 14-week Dialectical Behavior Therapy Skills (DBT) Group in Westford, MA will be starting a new module on Thursday, April 6, 2017.  We will be covering both the Mindfulness  and Emotion Regulation modules.  (This is an ongoing group that has open enrollment periods three times per year.)  At this writing, there are two spots left for the next trimester.

The Mindfulness material includes:

  • Learning to be a good observer
  • Being non-judgmental
  • Staying in the present
  • Practicing non-multitasking
  • Accessing Wise Mind (aka higher self, higher consciousness or other spiritual beliefs, e.g. Christ Consciousness, HaShem, Atman)
  • Understanding Reality Acceptance and detaching from thoughts.DBT Mindfulness

The Emotion Regulation module has four sections:

  • Understanding and Naming Emotions
  • Changing Emotional Responses
  • Reducing Vulnerability to Emotion Mind
  • Managing Extremely Difficult Emotions

 

#MirthMaven |

As DBT founder Dr. Linehan says, “It is difficult to manage your emotions when you do not understand how emotions work. Knowledge is power.”

For dates, fees, location and more details, please visit www.lisawessan.com

Onward and Upward,

Lisa Wessan

 

Copyright © by Lisa Wessan 2017. All rights reserved.

 

Leave a comment »

Beyond the Waiting Room: The Time Lapse and Gaps of Behavioral Health Care

This goal of this article is to provide insight into the “back office” of  behavioral health care practitioners, especially for our patients, and the administrators who work with us.

unavoidable-delay1

Even though I tell new patients that they need to allow for some “wiggle room” at the top of their session and at the end of their 45-50 minute therapeutic hour, there are always some who are hurt and upset when I am not punctual, and that would be for anywhere from five to fifteen minutes. I am writing this article for them… and my fellow behavioral health care practitioners, who may appreciate this illustration of what goes on while our patients are waiting for us.

One factor to keep in mind is that there are many different opinions on the “therapeutic hour.” Most insurance companies reimburse for a 45 minute session, a unit of time that they deem is appropriate for treatment. There is an ongoing debate on this matter.1

My patients know that they will get their full time here, whether we start at 2 PM or 2:10 PM. Most of the people I work with have no problem if I am a few minutes past the hour. They understand the ebb and flow of a behavioral health care facility, or they are conditioned to wait from previous appointments with other practitioners. There are just a handful of people that are in acute pain in the Waiting Room, and this article will hopefully soothe their concerns (until we can work through their attachment issues).

What do therapists typically do in that 10-15 gap between patients?   We are usually returning phone calls, making appointments, reviewing or writing notes, visiting the restroom,  and perhaps eating lunch, dinner or some kind of metabolic adjustment. There isn’t much time for a phone call, unless we have at least 30 minutes between appointments.  (Typically I don’t attempt to initiate  any phone calls unless I have that block of time available.)

Then we have the Unavoidable Delays which occur during these gaps:

Delay #1: Collateral calls between sessions. What is a collateral call?  That’s when we return urgent calls to your  doctors,  nurse practitioners, teachers, guidance counselors, lawyers, judges, concerned family members or call your insurance company.

For example, when I have a patient in the hospital, and her doctor wants to talk to me, he leaves a message in the morning “Please call me today as soon as you can before 1 PM.”  So what happens at  10:50 AM or 11:50 AM when I am returning his call during a 10 minute gap?  I call the doctor, and then his secretary tells me to “Please hold while I page him.”  I can be on hold for more than 10 minutes at times — waiting to find out how our mutual patient is doing. Naturally  I am concerned for my hospitalized patient’s well being and may also need to respond to the doctor’s questions. Plus, Medical Release forms may need to be signed and faxed so that we can speak without violating the HIPAA Privacy Rule2.

Am I concerned about you being in the Waiting Room?  Yes, I regret when this happens. But to remedy this challenge, when I have a collateral call to place — which may guarantee a delay  —  I immediately send you a “Courtesy Notice” via text.  I let you know that I am being detained, and that we will most likely meet closer to 11:15 AM, or 12:15 PM, or whatever is 15 minutes past your original appointment. I am always doing the best I can, given the urgent and timely nature of these collateral calls.

I am honoring your time as much as I possibly can, and I deeply care that you are waiting, but I also need to make these calls between seeing patients in my office. You need to know that I am not thoughtless, careless or indifferent to your waiting time. That would be an extremely false assumption.

Delay #2:  Longer sessions.  Sometimes a client is delving into a very difficult thought or memory, and is having a breakthrough at the 43rd minute of the 45 minute hour, often referred to as “Doorknob Therapy.”3.  Do I stop the client at the stroke of 45 minutes and say, “Sorry, we will pick this up next week.”  No, I allow them to finish their thought, or complete their process, especially when they are releasing a traumatic memory or having a major breakthrough or insight. Again, it’s just a few extra minutes past their usual time.

Please understand, I am not working at a bottling plant, popping caps on bottles,  where I can just flip the switch and shut down the conveyor belt. If I was a factory worker, or a bean counter of any kind, yes, this would be possible. But in behavioral healthcare, this is typically not possible.

you-are-fascinating

Delay #3:  Engrossed  listening, not watching the clock. The good news and the less good news…I am listening to your story,  you have my full attention, and I do not watch the clock every minute. I sometimes lose track of time while I am deeply concentrating on your words, and what is happening with you. This is a natural hazard of working in this field4.  Yes, there are ways to keep track of the time despite the process of  intensive reflective listening, putting together symbolic themes and meaningful interpretations for you.

Possible solutions for Delay #3: How would you feel if I set a timer for 43 Minutes?  Would you mind if a chime went off right before your time was up?  That is one solution for this delay. Other solutions involve keeping one eye on the clock and thereby removing myself from total immersion in your story. When I go over the hour due to engrossed listening, it is rarely more than 5 or 10 minutes. Yet this does anger some patients in the Waiting Room who feel miffed that I am a few minutes past their appointment time.

Delay #4:  Clinical meetings off-site. Sometimes I perform home visits for my elderly patients, or teens without wheels. Traveling from another location, where I was in a clinical meeting that ran later than expected, could cause a small delay.  Again, when I see that coming, I send a text with a Courtesy Notice.  During home visits, sometimes there are extra complications, or equipment needs to be ordered, and urgent paperwork needs to be processed which takes a bit longer. This is all part of the unavoidable delay caused by this off-site work.

In Conclusion

It remains questionable as to whether the 45-50 minute hour can be effective when processing deep trauma and chronic grief.  I do the best I can during this standardized treatment window, but you need to know that there are methods and techniques which do require longer time for maximum benefit, including Dialectical Behavior Therapy (DBT),  Eye Movement Desensitization and Reprocessing (EMDR), Hypnotherapy and other trauma treatments. These do not always fit into the 45-50 minute hour5.

In sum, this work occurs in a non-linear, sometimes timeless space that cannot be boxed into a precise unit of time if the practitioner is working with true empathy, compassion and a commitment to excellence6.

So the next time you are sitting in the Waiting Room, I hope you consider that one of these four delays are probably happening and that’s why you are waiting, hopefully patiently.

Suggestion: It would be an excellent use of your time to make a list of topics that you want to discuss with your therapist, or sit quietly with your eyes closed and scan your body and mind for what you are feeling in the moment, to get in touch with your inner world in the Waiting Room.  This will contribute to your having a more effective and successful quality of session and therefore you will be using your time with deeper purpose and meaning  in the Waiting Room. You could also write your check for your fee or copayment while you wait, also a good use of those minutes.  [Please refer to my article on “The Art of Waiting,” for your enjoyment and better understanding of this issue7.]

 

Finally, this is an important issue to discuss with your therapist. Chances are if you are impatient in the Waiting Room, you are impatient everywhere. You are not behaving this way only at this time. It’s how you roll, your Modus Operandi.  You may also discover that you are avoiding dealing with your painful issues and interpersonal conflicts by hyper-focusing on the 10 minutes you are waiting. 

You may be triggered by this short wait, and it is bringing up important tender golden threads from your childhood when you were neglected or kept waiting by a harsh relative.  But being condemning, critical and complaining of your therapist’s time delay will not help you in dealing with your inner troubles and your personal transformation process unless you discuss it openly with your therapist.  Ultimately, railing about your therapist’s time delay to your friends  will just keep you feeling like a victim, and you will stay stuck right where you are until you process this out with your therapist.

 

We are your Practice Human. In the best of all possible therapeutic relationships, you will feel safe enough to say anything to us, tell us exactly how you feel, what you think, and how frustrated you are with your waiting experience (or any other issue you are having with therapy).  This is all very useful and helpful in your journey towards wholeness.
When you practice improving your communication with us, you increase your interpersonal effectiveness in the world.  I always tell my people “This is the Huddle!  You come in here to defrost painful feelings, get some relief, regroup, strategize, learn some new skills, tools and methods, and then go out and practice.  The real work is done out in your life.”

 

If waiting for your therapist continues to be a huge issue for you, speak to your therapist about getting treatment for practicing Radical Acceptance8. Or if none of this fits for you, then just get a referral to see a different therapist.

At the end of the day,  you are always 100% accountable for your life.  As the captain of your ship, you can always sail on to the next safe harbor.

May you have the best life ever, and learn to process your “time issues” with love and grace.

Onward and Upward!

 

NOTES
____________________________________________________________________________

1. Goleman, D. (1984). The New York Times. Therapy: Critics Assail ‘Assembly Line’ sessions. By Daniel Goleman.

2. Health Insurance Portability and Accountability Act of 1996, aka the HIPAA Privacy Rule.

3.  Gould, C. (2014). PSYCHED. Getting to “The Good Part” of therapy.

4.  Lazarus, A. (1997).  Brief But Comprehensive Psychotherapy: The Multimodal Way. New York: Springer Publishing Company.

5. Ibid.

6. For this reason, some of my patients have double sessions, where we can do accelerated work and have the advantage of a 90 or 100 minute session to cover a broad reach of material successfully.

7. Wessan, Lisa (2016). PULSE. The Art of Living is the the Art of Waiting.

8. Brach, T. (2004). Radical Acceptance: Embracing Your Life With the Heart of a Buddha.  Bantam Dell: New York, New York.  [There are many sources for learning about Radical Acceptance, and it’s also included in the Distress Tolerance module of Dialectical Behavior Therapy.  Tara Brach’s book is a wonderful source for delving deep into the process of learning to accept reality and find peace with the imperfections of your life.]

© Copyright 2017 by Lisa Wessan. All rights reserved.

 

Leave a comment »