GIVE to Yourself

Dialectical Behavior Therapy’s (DBT) GIVE is a powerful therapeutic tool I find myself returning to over and over again in my work with clients, particularly in strengthening interpersonal communication skills. Recently, when preparing for a session, I was thinking of new ways to treat negative self-talk; realizing there is great potential in applying GIVE not only to communication with others, but also toward one’s self!  Today I would like to introduce you to Marsha Linehan’s GIVE and how it can be used for positive self-talk.

What GIVEs?

GIVE stand for Gentle, Interested, Validate, Easy Manner. Gentle can mean many things, I often tend towards tender or non-judging in my approach. Interested means to be listening, if you are listening you can summarize what the speaker said and they would agree with it. Validate means to acknowledge what is being said, this does not mean agreeance. Easy Manner means light-hearted, at ease or humorous.

How can I GIVE to myself?

When I talk with strangers or friends I use GIVE as a guideline to monitor if it is a healthy conversation. The same holds true with my self-talk. If I cannot be gentle with myself, I must be hurt. It’s important that I talk to myself gently if I wish to feel heard, much like I require of myself and those I associate with. If my internal dialogue is abrasive and rapid (cutting myself off) - it is time to implement a coping skill to center myself so that I can fully listen to myself. If conflicting parts of me cannot acknowledge that I have differing roles   that can conflict (being a therapist is different than that of a brother, son or partner) then it is no wonder that I am hurting. Even in ambivalence I have to create space to acknowledge  inner conflicting ideas, thoughts, and emotions. I admit that Easy Manner is an odd and deeply personal approach when it comes to self-talk. I am not particularly humorous, but I can be at ease. My role as a therapist should be at ease with my role as a son, even though they conflict from time to time. GIVE is a great way to support healthy internal communication, which can lead to improvements in other aspects of life including emotional well-being, interpersonal communication, and self-esteem.

What do I do when GIVE doesn’t work?

This is where coping skills come in. What can you do that will ground  yourself so that you can practice GIVE? Use your creativity! You know yourself best. For some inspiration here are a few ways I have seen clients successfully ground themselves in this situation: (1) Just breathe. Find an easy rhythm that keeps your attention on your breathing. (2) Music. Let the tone or lyrics speak to you in a positive way to balance the negativity. (3) Reach out to a close friend, or family member, and talk about mutual interests that you enjoy. Once you feel relaxed, centered, and grounded try to focus on one of the principles of GIVE and see how you feel on the second try. 

Self-talk is one of the hardest parts about communication. If you are trying to communicate with others and it is difficult, you can take a break. When it comes to yourself, you can never quite leave yourself. This is where using GIVE can help, because it is about respecting you, and all your parts, when you use it for self-talk.

--

Linehan, M. (1993). Skills Training Manual for Treating Borderline Personality Disorder. The Guilford Press.

The 3-minute exercise to manage anxiety while under quarantine

Anxiety has the capacity to be both incredibly helpful and harmful. In the event of finding yourself face to face with a cougar, down to the wire on a final project, or gearing up for a big race, anxiety gives us the "juice" to dig deep, focus, and function at a high level. There are consequences of course to these bouts with anxiety, including adrenaline and its counterpart cortisol - which, studies have shown, can be very harmful in high doses. Similarly prolonged states of anxiety can lead to fatigue, GI issues, heart problems, and memory problems. For brief periods of time, this anxiety can be functional and help us overcome challenges.

 Unfortunately, anxiety isn't always helpful. Often the evolutionary anxiety that would help us in the event of a battle against a wild animal is constantly "ON" as we fight internal fears surrounding things that haven't actually happened yet. In fact, I often find that when anxiety is over functioning it leads us to look to the future and build dozens of different possible outcomes, then mount problem solving against them all. This is overwhelming, often unhelpful, and multiplies distress by focusing on situations that do not yet exist!

 The beauty of practicing mindfulness as an anxiety management technique is that it helps us to stay focused on the present moment. Much of our psychological distress exists when we ruminate about the past or catastrophize the future - both are out of our control and are not happening in the present moment. You do not have to hold the distress of the past, present, and future simultaneously - it is too much!

 My favorite quick trick to bring anxiety down to a more manageable level is a grounding technique that engages your senses. This helps take you out of your mind and into the physical space around you. Here you can remind yourself of what is actually happening - relieving your mind of the burden of holding so many possible realities at once. This has been increasingly helpful to folks as they are stuck in self-isolation due to the growing impact of COVID-19 on our world (a veritable powder keg for anxiety and catastrophic thought).

 Before starting, I encourage you to take a few deep, full breaths - holding at the top of the inhale briefly and slowly exhaling. Then I invite you to turn to your senses and work through the following list. Repeat at least once (more if needed):

 *Name 5 things that you see

 *Name 4 things that you physically feel

 *Name 3 things that you hear

 *Name 2 things that you smell

 *Name 1 thing that you taste

 *REPEAT*

 Extra notes: it is normal to still feel your mind racing and to experience internal dialogue (even critiquing the exercise). Allow those thoughts to come and go and continue to focus in on the exercise - the anxious voice will start to subside as you draw more and more attention to the world around you. Also, I encourage you to try to slow down with each item you name, trying to avoid rattling things off as quickly as possible "PILLOW - COUCH - LAMP - CHAIR"; instead try to also include one detail or adjective along with the item "the faded chair" or the "patterned rug". 

If you are interested in more mindfulness activities, I highly recommend checking out meditation apps such as Calm, Simple Habit, and more. If you prefer a hands-on resource I encourage you to check out A Mindfulness-Based Stress Reduction Workbook by Stahl & Goldstein.

Using Dialectical Behavior Therapy as part of Holistic Wellness

Owner Danielle Zawadzki, LMFT talks about using DBT in therapy and its role in holistic wellness with Dr. Serena Wadhwa. Episode recorded on July 23, 2017.