Resources: Learn More

• “Dialectical Behavior Therapy for Adolescents,” (dakotafamilyservices.org)
• Dialecticalbehaviortherapy.com

Things to Think About

• Dakota Family Services offers the only comprehensive DBT program in North Dakota, incorporating individual therapy, group therapy, phone coaching, and psychologist consultation meetings for therapists involved in the program.
• DBT is designed not just to prevent mental health issues like suicidality, but to build a life worth living.

About the Guest

Hannah Baczynski, Psychologist, works with people of all ages—providing diagnostic and psychological evaluations for children as young as 2, adolescents, and adults, as well as individual therapy for adolescents. As the clinical director of Dakota Family Services’ DBT Program for Adolescents, she also provides Dialectical Behavioral Therapy and is a firm believer in using treatments that are well-supported by research and that match the client’s goals. When she understands the “why” or the function of the behavior of difficulty a client is experiencing, she collaborates with them to set goals and find new, more productive skills and behaviors.

April Morris, LCSW, provides therapy for adolescents and adults. She enjoys working with clients from all walks of life, and is honored to join them on their mental health journey and help them build skills to adapt to life challenges. She loves building relationships with people and is dedicated to helping them become their best selves.

Transcript
Shining Light in the Darkness with DBT (Community Chat Series)

Featuring Dr. Hannah Baczynski, Psychologist, and April Morris, LCSW, Dakota Family Services

Tammy Noteboom:

Community chat recordings are presented by Dakota Family Services, an outpatient clinic with mental health providers in Minot and Fargo, North Dakota. Thank you for listening. We have two presenters today. Dr. Hannah Baczinsky is a psychologist at Dakota Family Services and Dakota Boys and Girls Ranch and she is a clinical director of our comprehensive and intensive DBT program for adolescents. April Morris is a licensed clinical social worker at Dakota Family Services and she is one of the therapists on our DBT program team. With that, I will turn it over to Hannah and April to get started.

April Morris:

Great, thank you Tammy. Like many of our meetings with our DBT consultation meetings and our DBT group, we like to start with the mindfulness, and I know some people feel like they know a little bit about mindfulness and maybe others don't know as much, but it is paying attention on purpose in the moment non-judgmentally. So thinking just about the activity that you are doing at that time. So a quick little fun one that Dr. Baczinsky shared that I will do is we are going to take our thumbnail and we are just going to pull it across our lip gently. Now what you probably can notice is feeling the sensation still after having completed this and whether you would sit and pay attention to this for a moment, see how long it lasts, what it continues to feel like, can you feel it all the way across your lip? It is really good for us to just take the time to be in the moment.

April Morris:

And there's many different types of mindfulness activities people can do and it's just really good grounding and resetting for us to make sure that we are here in the space that we're meant to be in in the moment. Now usually we would try to grab some observations on how that felt with everybody, but just think about how that made you feel. If you can still feel where you did yours. I can still feel mine actually. I'm part of my lips. So it's just kind of interesting that there's little things we can do throughout our day that is actually mindful that doesn't have to be focusing on our breath and more meditative. So just wanted to start with that.

Hannah Baczynski:

Whenever I do this one, I always start to wonder after about a minute or two if I'm making up the sensation or if I still feel it, like if I'm holding onto it or if it's still a real sensation. Yeah, but I still definitely feel it. So thank you April. That's one of my favorites because it's so simple. Let's talk about DBT. So dialectical behavior therapy or DBT as a much shortened version of it was originally developed in the late 1970s throughout the eighties. The first book was written in 1992. The red DBT Bible was written in 1992 and it was developed by Dr. Marsha Linehan because she noticed that there were a large group of people who were chronically suicidal, who are hurting themselves and who were not being helped by the current system back then.

Hannah Baczynski:

And even through today, people who are chronically suicidal, people who hurt themselves, who self-harm tend to be pushed off by the mental health community because it's too dangerous, too much liability. They feel like they need a higher level of care and it's just really hard for some people to get the help that they need. And so she thought that she would try and figure out what would be the best way forward with people who are chronically suicidal or self-harming. And so she tried some more of the traditional approaches. She tried a traditional cognitive behavior approach where a lot of it is about can we look at what happened and change your thoughts about it? If you can change your thoughts about it, then you can feel better about it and it doesn't bother you anymore. Well she found when she used this with people who were chronically suicidal, a lot of them stopped coming because they felt like she wasn't listening.

Hannah Baczynski:

Like she didn't understand their pain, she didn't fully grasp what was going on for them. So she tried to switch to a much more humanistic like regerian sort of thing where she just offered a lot of validation and acceptance and you're right, like this sucks. That's it. And so when she tried that, people kept coming but they never changed. And so she tried to find a way to balance this acceptance that they needed to stay in therapy to get the help that they needed and that change piece because you couldn't have them being chronically suicidal forever. You need some change going up. So DBT brings this more cognitive behavioral like let's change your thoughts, let's change your behavior stance and melds it with the more Buddhist, Eastern philosophy, zen, in the moment acceptance side of things. So in DBT we're always looking at what is valid and what is something that we can like look at and say yes, that makes sense and what can we change?

Hannah Baczynski:

When I was little growing up in Chicago, there was, I don't know why I remember this, but a radio commercial for a musical or something that was going on in Chicago at the time and the musical was called "I Love You, you're Perfect, Now Change." I know nothing about this musical except that that was the title. And so that is how DBT kind of comes across when you're doing it, when you're in the moment it's "I love you, you're perfect, now change." And so we are looking at that balance, like I said, of acceptance and change and DBT is based off of, as most therapies are, on theory, a reason why people get to be chronically suicidal. And that theory is called the Biosocial model. And it sounds a lot like what you would think it sounds like, right?

Hannah Baczynski:

So half of what happens when people are emotionally dysregulated is biologic. Some of it comes from just a general difference in your brain. Like people who are more sensitive to emotions can be that way because they were exposed to something in utero. It can be that way because of early life trauma. A lot of people that end up in DBT have chronic early life trauma, but not all. It can be just a general difference. I tell this story and I'll tell it here in a second, but me and my sister we're five years apart. But besides being five years apart, we are much the same. We have the same parents, we were growing up in the same environment. We lived in the same house, the same town our whole lives. So there isn't a whole lot different between me and my sister except genetic variability gave me more emotional sensitivity and my sister less emotional sensitivity.

Hannah Baczynski:

And so people who are average in terms of their emotional sensitivity, they walk around the world with very little emotion. You are walking through the grocery store, you're probably not feeling particularly anxious, particularly happy, particularly angry, nothing. You're just neutral walking around your day doing whatever. And then something happens in the case of the story that I'm about to tell you, we'll call it a breakup. So my sister dated a guy throughout high school for two years and when they went to college they broke up. I tried to be a good big sister and say Hey, you wanna go get ice cream? You wanna talk about it? Whatever, you know, that sucks that you broke up. You and your boyfriend of two years broke up. So I would imagine that she was having this spike in emotion where her emotions going up, she may be feeling more sad, you know, a little bit more anxious, maybe a little angry about it.

Hannah Baczynski:

And for most people, most of the time something happens like a breakup, your emotions go up and then they come back down. It's a wave that you have to ride, right. My sister told me at that moment that no, she was fine. And I said, what do you mean you're fine? I thought she was maybe pushing it down or something. And she said, well you know, high school relationships don't often last. So I decided when we started dating that I wasn't gonna fall in love with him. As someone who was more on the emotionally sensitive side of things, this blew my mind. I had no idea that emotions were choices like that. So people who typically end up in DBT fall more on the me side of things, right? People who are more emotionally sensitive, they walk around with a higher background level of emotion.

Hannah Baczynski:

You might be kind of anxious all the time. There's a lot of people that are kind of frenetic and anxious all the time, right? You might be kind of irritable all the time. I was talking to my husband the other day about irritability and how you might treat irritability or whatever and he said, can you even imagine what an irritability of like 10 or 15 would be? And the answer is no. Like I have no irritability or I'm at like 40 or 50, there's no in between. I don't know what a little irritability feels like. When I'm having an emotion, it is noticeable and I'm almost always having some sort of emotion. So then an event happens, you call it a breakup and the emotion spikes really, really high and it stays that way for a really long time, which means that you're not coming down from your emotions as quickly as other people.

Hannah Baczynski:

And so when the second event happens, you spike up really high again, you have no time to recover. This leads people who are emotionally sensitive to have meltdowns over pens, right? You lose a pen, you have a meltdown and everyone around you is looking at you like Hannah, it's a pen. Like we can get you a different pen. And so it's not about the pen, it's about these 2, 3, 4 events that happened beforehand that I haven't yet recovered from. And so people who end up in DBT often are emotionally sensitive. They often don't have time to recover from events because their emotions are so intense and they last so long and they start off at a higher baseline of emotions. And so everyone who has emotional sensitivity does not end up in DBT. Everyone who is emotionally sensitive does not end up chronically suicidal or self-harming.

Hannah Baczynski:

It is what it is, right? Sometimes people who are emotionally sensitive use it as a power, as a superpower, you feel negative emotions more strongly, but you also feel positive emotions more strongly. People who are really creative and really passionate are emotionally sensitive people and that's okay. And when you put someone who is emotionally sensitive in what we're gonna call an invalidating environment, then they never get time to recover from the last invalidation and each time a new invalidation comes, they become more and more reactive over time. So what is invalidation very quickly, invalidation is just you hearing from your environment, whether that be friends, teachers, family, parents, whoever that the way you're feeling is incorrect for some reason. If I went to my parents when I was little and said, Hey, I'm hungry, and they said, how can you be hungry? You just ate.

Hannah Baczynski:

That's invalid, right? And maybe they're right, maybe they're not. Everyone invalidates people all the time. I tell the story about my son who is constantly scared of lint because he thinks that they're spiders. And when I say Rupert buddy, that's a piece of lint, not a spider that is invalidating. So he might get more upset when I say that and it's important that I tell him those things. So in invalidating environments, you're a kid, you go to your parent and you say, I'm sad something happened at school today. My friend laughed at me and made fun of me and now I'm sad. If you were in a perfectly validating environment, your parent might say, oh honey, that sucks when your friends are mean to you. And like what can we do about it? Right? Let's figure it out. Do we need to take some breaths?

Hannah Baczynski:

Do we need to talk to your friend? Like what do we need to do in regular environments that are not perfectly invalidating, like all environments are, you might say, oh honey, that's not that big a deal. Like get over it friends make fun of each other. Or in even more traumatic environments, right? The parent might ignore them altogether or the parent might say, I'm really busy and then there'll be some abuser like whatever. And so all of these levels of invalidation can lead to more emotional sensitivity, more emotional reactivity. And the longer your emotional reactivity transacts with this invalidating environment, the more likely you are to your emotions just being out of control. Leading to a place where you can't do anything other than something dangerous like self-harm, like suicide because you feel like you've tried everything else. You go to your parent, you say, I'm sad, and they say, get out of the room dude, I'm working.

Hannah Baczynski:

Or then you maybe you act up, you throw some stuff on the floor, your parent comes out and hits you for making a mess and then you run away and you just get in trouble again, right? And so eventually the only thing you can think to do is kill yourself to get out of this cycle. And over time, the more you go through this cycle, the cycle speeds up. You don't go to your parents and say I'm sad anymore. You feel sad and you go straight to self-harm or suicide. And so it's a cycle that these kids are really caught in through really no one's fault. It's an interaction of environmental factors like trauma and what's kind of already been going on their head since they were born. And we have to use DBT to reverse that cycle to make the transaction work in a much more effective way to help them slow down and add skills in there that they're not current, that they don't currently have.

April Morris:

Super helpful, right? To have a base of understanding of how maybe people end up in these massive challenges in regulating emotions in day-to-day life and how people maybe end up in DBT programs and how they can be helpful. And I know we'll talk more about some of the effectiveness, but even just to talk about some of the assumptions when we do work with clients in DBT, which still will just support a lot of what Dr. Baczynski has already said is that people are doing the best that they can, right? That they are bringing everything that they have to the table. It's not a lack of effort with not having progress and having that assumption is important when working with them. That also helps us as therapists to come at this as they can't fail in DBT, but we can.

April Morris:

And this is why we have the case consultation group for providers in DBT to be able to look at, you know, what else can I be doing and trying and coming at this so we can feel like our patients are getting a good successful opportunity. Chime in anytime, Hannah, if there's things you wanna add, I just wanted to go through some of these quickly so we don't also run out of time, but they may not have caused all of their problems, but they do have to solve them. And this was one we were talking about earlier and lots of good analogies. But even just coming at these clients with the idea, or I shouldn't say coming at them, but helping them come out of a situation where maybe they're the pilot and the plane is malfunctioning and not working. They didn't cause the problem but they still have to solve the problem.

April Morris:

They still have to figure out if they're gonna land the plane, if they're gonna calm the the patients on the plane, but we can't avoid the situation. And so helping them understand even just that mentality that we can't sit and blame people that it's happening, it's still happening and we can't avoid it. So what can we do about it? What skills can help them get to those points and to balance the, they're doing the best they can still is balancing the people need to do better, try harder and be motivated for change is another assumption that fits in with how Hannah explained DBT.

Hannah Baczynski:

I think the assumptions are really important to mention when we talk about DBT because a lot of times, not so much with adolescents, but even as adolescents get older into being adults and things like that, they have gone through a lot of therapists or therapists have have dumped them or whatever. I have had plenty of adult patients who are like, I went to a bunch of therapists as an adolescent and they all just told me they couldn't help me or I wasn't trying hard enough or I wasn't doing my part. And in some ways yes, like we need people to do their part right? To do their homework. And it's also our job as therapists using these assumptions to know that if something is going wrong in the therapy, like it's not the patient's fault, it's not the client's fault. We need to work together to build this relationship, to build up these skills.

Hannah Baczynski:

And so they can't fail. It's not them that's gone wrong. Maybe it's the wrong time, maybe it's the wrong treatment, maybe it's the wrong therapist, maybe the therapist didn't do enough and it's not their fault, right? And so these assumptions are really helpful in therapy for me and freeing in that I don't need to put a lot of pressure on them, I don't need to put a lot of pressure on me. The right amount of pressure has to be applied along with the right amount of validation. So we're mixing again that validation and change. So how does DBT do this? There are in the DBT skills group, which is one part of what we have, and we've had a DBT skills group here now going on two months. We're moving into the second, the second module. DBT skills group focuses on four main types of skills.

Hannah Baczynski:

First and most foremost and most central is mindfulness. So April led us off with a mindfulness, but we need mindfulness. It's not just like some hippie woo-woo stuff, right? Mindfulness truly is being in the present moment on purpose and we need to do that because the present moment is the only time that we can act. If I am constantly just worrying about the future or thinking about the past, if I'm stuck in the past, like in the case of PTSD or trauma, then I can't use skills right now. It is impossible for me to go into the past and use skills in a situation that's already over. It is also impossible for me to jump ahead into the future and use skills then. So I have to use skills now and the only way that I can be now is by being mindful.

Hannah Baczynski:

And so none of the other skills work unless we are now. And so mindfulness is really about that control of where you are. You're not worrying about the future, you're not in the past, you're right now. And how do we get now so we can use skills. So mindfulness is a core skill. I call it a core skill because we go through it in each module. Each module of the skills group. It's about two months long and we spend the first two weeks talking about mindfulness. We come back to mindfulness every time because it is so important. The second module that we talk about is distress tolerance skills and distress tolerance skills are really important because when you are self-harming and when you are suicidal, a lot of the issue is that you cannot tolerate this moment. There is too much emotion, too much distress, you lose the pen and you have a meltdown.

Hannah Baczynski:

Your emotions are at a hundred out of a hundred. You cannot think to do a complicated skill, you need to do something simpler, right? And we have skills that are really simple like paced breathing, right? Breathing out for longer than your breathing in takes advantage of your body chemistry and slows your heart rate down. Or we have something called ice diving, which we have a video of me teachingon the Facebook I think. So you can look up ice diving if you want. But that's putting your face in cold water. And again, taking advantage of your body's natural reflexes to calm down. These are also kind of your typical coping skills that you might learn in any therapy, right? Distract yourself, do a Sudoku, go for a run. All of those different things. And the goal of distress tolerance is really just to not make things worse when you're in that emotional state.

Hannah Baczynski:

When you want to do something like run away or use substances or self-harm or punch somebody, all that ultimately makes things worse. And so distress tolerance is all about not making things worse, at least surviving this current moment. Distress tolerance also includes the acceptance skills, radical acceptance and moving forward. And the acceptance skills are really important because some situations are what they are, right? The reality is what it is. If you think about past traumas or something bad that happened to you last week, like that is what it is. And continuing to suffer about it, continuing to be stuck in that moment, continuing to reject that it is what it is is going to cause you more suffering, right? If my dog dies today and I continually come back to, oh, when I get home I'm gonna see my dog and tomorrow I go, well I'm gonna get home, I'm gonna see my dog, every day I come home that I've rejected the reality of my dog's death, I am suffering. Whereas if I can see reality as it is and accept this moment as it is, even if this moment is hard, then I reduce my suffering because I'm seeing the world as it is and I can take that and change what I need to change from there. After distress tolerance, we go into emotion regulation. Now these are like the bread and butter of DBT. These are like really where you're gonna get the most bang for your buck because DBT is based on the idea that you are the way you are or your adolescent is the way that they are because of emotion dysregulation. And so if you can use skills to regulate those emotions, then there will be less opportunity to get that high where you are trying to self-harm where you're at the hundred rank where you can't think straight.

Hannah Baczynski:

And so emotion regulation uses skills like problem solving. How do we go through and make sure that if I'm angry at my friend for borrowing my shirt, like do I sit around and be angry about it or do I just solve the problem and go ask them for my shirt back? Right? It also has the skills of opposite action, which is, if you think about it when you're scared of something, like if you're scared of a spider, then the way to be less scared of spiders is to expose yourself to spiders. So the opposite action for fear is to approach the things you're scared of. And we have opposite actions for most of the major emotions. It also talks about checking the facts or making sure that you, you know, understand reality as it is or if you're reacting to something that's not actually happening.

Hannah Baczynski:

And reducing vulnerability to emotions. So living a life that's more closely aligned with your values actually reduces vulnerability to emotions. Having pleasant events in every day reduces vulnerability to emotions. Anyone who's ever been grumpy because they're hungry or tired, like getting enough sleep and eating healthy food and exercising and drinking enough water, all of that, that reduces your vulnerability to emotions. So then you're not needing to use the distressed tolerance skills as much. And so emotion regulation is this really important piece of the therapy that people just typically aren't getting. Maybe another therapy skill. It's a whole new way of thinking about it and putting it together to help you regulate your emotions. The final piece, because in DBT, a lot of people with their dysregulated emotions have caused problems in relationships. Whether it's because their emotions are too big and people get kind of scared off or they get kind of too depressed to hang out with their friends or they're starting fights with their parents or whatever.

Hannah Baczynski:

You wanna be more effective in your relationships. And so interpersonal effectiveness ends us up in how do you get what you want while keeping the relationship and your self-respect? Because you can get what you want by being aggressive, but only in the short term because you lose your own self-respect and you lose the relationships. How can we use skills to improve the likelihood that we're gonna get what we want to set boundaries to say no to do all these things and keep relationships and keep your self respect, which is going to be really helpful when you're having trouble making and keeping friends. So we go through all four of these things and you learn a ton of new skills and as part of the group, you get homework, you go practice it, you can see kind of, even with the people that we've had in our group just two months, you can see kind of in real time the improvements that they make when they're starting to implement things like breathing and wise minded, all of these things. And so it's something that you can see the benefits of pretty quickly, which is really awesome.

April Morris:

Yeah, and that's a good segue into just talking to people about the program specifics, right? So as far as I understand, we're the only ones in North Dakota offering a full comprehensive program and working on the full certification for that. So it includes four primary things, weekly skills group like Hannah had mentioned. Right, now the adolescents come Wednesday night six to eight, and they come with a parent or guardian support person. So that also helps them, not just them bringing the skills back into the home, but the parents supporting what they're learning and sometimes learning things themselves. And it's just, it's been really cool to see. And like she said, we literally see that when they bring back homework and talk about examples that they had used that skill in that past week. And then the weekly individual therapy, usually with one of us, but it also can be if they have an individual therapist in the community, but working on more of the intimate skill application and and focus on them individually every week.

April Morris:

And phone coaching is also kind of another cool way of being able to help them do these skills in all environments and their life. Sometimes we practice skills in a room with one other person and maybe it goes well, but can we do it when we're at a level 10 distress and can we do it within these different environments? And they can reach out to their therapist and say what skills they've tried and maybe get some encouragement to try some of the other skills and then set them on their way to do that. And so I'm kind of excited about that piece too. And then weekly consultation for us therapists has been really, really great. So those of us that are doing the group we meet every Tuesday and we talk about how the group is going. Of course we have some administrative stuff and we stay current on how our program is going, but even just the ability to talk about the challenges of working with chronically suicidal and some of these challenging situations that patients are experiencing and getting the support we need as therapists to be able to continue to do this work.

April Morris:

And those are kind of the the four ways I look at what's all included in this program. Do you have more you wanna add? I know you've been doing this longer.

Hannah Baczynski:

I was gonna say, I think the phone coaching piece is really cool. Cause not only does the adolescent get phone coaching where they can call their therapist or text their therapists kind of depending on the individual therapists limits, but parents can do that too. You know, like if you're a parent of an adolescent and you're really frustrated and you're like, Hey April, I've been trying to use these DBT skills and I've been trying to use a dear man and have this discussion with my adolescent, but it's not working, April can help you too. Or like, if you're having this argument like you both can call and we can figure out how to use ice diving together or do these things together, it brings everyone together. We cannot have the adolescent group with just the adolescents because then we're only dealing with one side of that transaction.

Hannah Baczynski:

The environment is such a huge piece of recovery that without parents there, then we're not tapping into the adolescent full potential. And there are such crazy words in DBT, like opposite action or Dear man, or things that you've probably never heard of. If you're in the group, if you're doing the skills, you know what's going on. If they say, oh, I wanna use opposite action, then you know what they're talking about. Or if you think, oh, well if you wanna ask your teacher about that grade, maybe you could use a dear man. That's not something you could do if you weren't in group. And so having the parents there is so crucial because then you have this shared experience, this shared language to move forward. The other thing is the consultation team is so important because when you're working with a lot of people who are chronically suicidal, that is hard.

Hannah Baczynski:

It's hard on therapists, it's hard on the team. Like it has a lot of potential for burnout. And as therapists get burned out, it has potential for things to, you know, go wrong. But that consultation team keeps us not burned out. It keeps us on the level, it keeps us making sure that we're using DBT the way that it's supposed to be used, which is ultimately best for you guys who are in the group because then you are getting the best of us, you are getting the best of DBT, you are getting as close to the full DBT model as is humanly possible and that means your outcomes are better. And so we do a lot of work kind of behind the scenes to make sure that you are getting the best possible treatment that's going on, which is actually really cool.

Hannah Baczynski:

And it gives us a community of therapists to help each other. So to kind of wrap all this up, DBT was created to help those that were labeled maybe untreatable in the past. DBT is the gold standard at this point for patients with this chronic suicidality, chronic emotional dysregulation, chronic self-harming behaviors. But with adolescents it's also been shown to help with depression that hasn't been successfully treated in other modalities. It's shown to be able to reduce oppositionality and defiance. It is a great lead in to trauma treatment. If you're so dysregulated that you can't do trauma treatment, it helps you regulate to do that trauma treatment afterwards. DBT is not a trauma treatment, but is a wonderful like lead in to trauma treatment if you wanna do that. It helps people build safe connections. It helps people heal and make mistakes without fear of abandonment.

Hannah Baczynski:

Those assumptions that we share with all of the people in our program allow you to build these relationships with your therapist and not be afraid that the therapist is just gonna be like, yeah, I don't know. You're too hard. You're gonna have to find someone else. Right? I've had a lot of kids come to me and say like, the most important thing that I gave them as a therapist was when they messed up and they made a mistake that I said, it's okay, we'll try again tomorrow. And so I'm not out because it's hard. I'm here for the hard, that's why we're doing this DBT program. DBT also gets kind of painted as this suicide prevention program. And it does do that. I mean, it does reduce suicide, it does reduce things like hospital stays. It does reduce self-harm, it reduces kind of whatever you're hoping to reduce, whether it's substance use, self-harm, disordered eating behaviors.

Hannah Baczynski:

It's not eating disorder treatment, but it can help with some of those things. It's about constructing a life worth living. Like it's not a suicide prevention program, it's a life construction program. We build a life where suicide doesn't even make sense anymore. When you're living by your values, when you're doing things that you enjoy, when there are people you wanna be around, then suicide takes itself off the table. And so we work on keeping you safe and building that life that you wouldn't wanna leave anyway, which takes suicide off the table. We are in the present moment because it's the only time we can do things. And we learn that present moments aren't always fun or pleasant and that's okay. Like life can be worth living even when there is pain. And so being able to tolerate that pain moves us closer to having that life worth living. And so DBT works by balancing acceptance and change, like we've talked about this whole time, being in the present moment and understanding that life is okay, life can be okay even when it's painful because as the dread pirate Roberts said in the Princess Bride, <laugh> "Life is pain highness, anyone who says differently is selling something." Life is pain. And it's so much more than that.

April Morris:

That's what I, I definitely grab onto with this program is yes, like this is what I think we are all here to do is help people build a life worth living. And not all modalities have been built sometimes to really get to that. And I think this covers so many bases of opening up the opportunities to figure out what those things are when they're not sitting at a level 10 all the time about everything that they can get to that. And you know, just, I'm literally going to read what Dr. Baczynski wrote in her last article about it is why DBT? "Because Everyone deserves to live a life worth living. Learning these skills gives us freedom. And because staying alive is a goal worth fighting for," really is at the heart of what I feel about DBT too and why we do what we do. Now I know we wanted to show you one other quick DBT thing, willing hands.

Hannah Baczynski:

I say things are my favorite all the time, but you guys wouldn't know that. But this is my favorite skill for now because it's the one we're talking about. So willing hands is a very, very simple skill. Essentially. If you think about a picture of like the Buddha or Jesus or the Saints, any of those pictures that you have, they always have their hands kinda like in this open posture, right? They're just open, they're willing, they're like looking at the universe, right?

April Morris:

Like ready to accept.

Hannah Baczynski:

Ready to accept. There you go. That's what I'm looking for. So willing hands is a skill that you can do anytime. And if you notice yourself sitting in a meeting, this meeting perhaps, and you got your hands all twisted up or you're like, you know, whatever, anxious, playing with your fingers, willing hands, you put your hands like this, you can do it on your lap, but you can't see my lap, so I'm gonna do it up here. You put your hands like this on your lap and you just breathe. And even the act of just having your hands in this open posture actually reduces anger and anxiety. And so willing hands is a skill that I use daily whenever something is happening. And so that's what I wanna leave you with. I wanna leave you with willing hands because you can do it literally anytime. And it does reduce those emotions. It's a skill that helps improve acceptance. And so because you are open to the universe. So if you wanna sit for the next couple minutes, sit in willing hands and see how you feel.

Tammy Noteboom:

Thank you for listening to this Community Chat presented by Dakota Family Services. To make an appointment with one of our mental health providers or to learn other ways to mind your mind, go to dakotafamilyservices.org.

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