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by Matthew McKay, PhD
from New Harbinger's newsletter for mental health professionals, July 2011
Dialectical behavior therapy (DBT), with its four key skills (mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness), was originally developed to treat Axis II borderline personality disorder (Linehan, 1993). All the early research focused on DBT's ability to reduce hospitalization rates, suicide attempts, parasuicidal behaviors, therapy interfering behaviors, and emotion dysregulation. The outcomes of multiple studies have shown that DBT successfully targets some of the most disabling and life-threatening symptoms of borderline personality disorder.
Early on, seeing the treatment's marked success, many clinicians began to wonder whether DBT's emotion regulation skills could be helpful for other disorders. Thomas Marra, in his book Dialectical Behavior Therapy in Private Practice (2005), argued that DBT could be used with any disorder driven by emotion regulation problems. These would include Axis I diagnoses... Read more>
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by William A. Eddy, LCSW, JD, and Randi Kreger, coauthors of Splitting: Protecting Yourself While Divorcing Someone with Borderline or Narcissistic Personality Disorder, to be published by New Harbinger in July, 2011.
from New Harbinger's newsletter for mental health professionals, June 2011
One or both of the partners in a high-conflict relationship often have cluster B personality disorder traits, if not the full-blown disorder. These couples present special problems and often catch therapists by surprise. Whether the couple ultimately stays together or splits up, the therapist must be careful to avoid several predictable therapeutic mistakes and legal risks. The following are five suggestions for managing this minefield... Read more>
by Bob Stahl, PhD, and Elisha Goldstein, PhD, authors of A Mindfulness-Based Stress Reduction Workbook
from New Harbinger's newsletter for mental health professionals, May 2011
Since Jon Kabat-Zinn founded it over thirty years ago, mindfulness-based stress reduction (MBSR) has become an international movement. It has expanded into medicine, neuroscience, psychology, and education. The heart of MBSR is mindfulness meditation, which is intentional nonjudgmental awareness of moment-to-moment experience. It can be practiced informally by bringing awareness into daily activities, as well as formally with mindful breathing, the body scan, or sitting meditation. All of these practices bring in mind and body awareness that can become an important ally in therapy. And they can help therapists as much as clients.
Many times we come into the office delivering an inner monologue about the traffic we just experienced, an email we just read, all the things we need to get done that day, or clients we are worried about. Establishing a mindful check-in practice has been enormously helpful for us. It stops the automatic pilot and deepens our presence in the moment so that we can be present for the next client. In fact, we now hold mindful check-ins with most of our clients when beginning a session. Clients arrive with the same preoccupations, and many of them are thankful for the opportunity for "being" rather than "doing" all the time. Starting sessions this way often sets a very different tone of presence within the therapist-client relationship... Read more>
The news that the DSM-V will likely omit narcissistic personality disorder as a diagnosis has created some controversy among clinicians. On one hand, it seems absurd to throw away a classification that describes traits and defenses that we see all around us. Everyone knows someone—hopefully not one of our patients—who has a narcissistic personality structure. Narcissistic defenses are commonplace, and show up everywhere from the boardroom to the locker room. If the disorder is so easy to recognize, and the term describing it is so apt, why would we remove the term from our nomenclature?
On the other side sits the argument that narcissistic personality disorder isn't real psychopathology. Narcissists are really just unpleasant people who are full of themselves and get rather perturbed when you tell them so. Just because they aren't nice doesn't mean they are crazy. In fact, some would suggest that self-esteem is a trait with a bell-shaped distribution—and people at the very high end look pretty much like classic narcissists. Is thinking too much of yourself while seeking fame, praise, and power a sign of deep illness? By that standard, many of our politicians and captains of industry are candidates for an Axis II diagnosis... Read more>
If you’re experiencing difficulty with a client, chances are, one of our Quick Tips for Therapists offers a solution. Sign up to receive Quick Tips for Therapists in your e-mail inbox or visit our archive. We make it easy to access advice for specific client problems.
New Harbinger will be attending the following professional conferences in 2011- we'd love to see you!
August 4-7, American Psychological Association (APA)- Washington, DC
November 10-13, Association for Behavioral and Cognitive Therapy (ABCT)- Toronto, Ontario, Canada
Mind and Emotions
The Dialectical Behavior Therapy Skills Workbook
Get Out of Your Mind and Into Your Life