Parenting Therapy: Strategies for Raising Resilient and Emotionally Healthy Children

Raising children can be incredibly rewarding, but it can also come with challenges that leave you feeling uncertain and overwhelmed.

As a parent, you want to make sure your child grows up resilient and emotionally healthy, but figuring out how to support them through difficult times isn’t always easy.

This is where parenting therapy can help.

By exploring effective strategies tailored to your family’s unique needs, parenting therapy provides the guidance and tools to nurture your child’s emotional well-being and foster a strong, supportive relationship.

Let’s look at the benefits and strategies offered by parenting therapy, helping you raise resilient and emotionally healthy children.

Why is it Important to Raise Resilient Children?

Resilience is the ability to bounce back from challenges and adapt to life’s hurdles. This means developing a strong mindset that enables children to face setbacks confidently.

Why is resilience so crucial?

Life will inevitably present difficulties—academic pressures, social conflicts, or personal losses. Resilient kids are better equipped to navigate these obstacles without feeling overwhelmed.

Additionally, resilience fosters emotional strength. It helps children understand their emotions and encourages them to view challenges as opportunities for growth rather than insurmountable barriers.

By cultivating resilience early on, parents can lay the groundwork for their children’s future success in various life aspects— school, relationships, or career endeavors.

Strategies for Raising Resilient and Emotionally Healthy Children

As a parent, you can foster resilience and promote emotional health in your children in many ways.

Here are some strategies to get you started:

Validate Your Child’s Emotions: This means acknowledging and accepting their feelings, even if we don’t agree with them.

When we validate our children’s emotions, we teach them that their feelings are important and worthy of recognition.

This helps them develop a healthy relationship with their emotions and promotes emotional intelligence.

Encourage Problem-Solving: Instead of always fixing our children’s problems for them, we can encourage them to come up with their solutions.

This teaches them to think critically and develop problem-solving skills essential for resilience.

Model Healthy Coping Strategies: Our children learn from watching us, so it is important to model healthy coping strategies. This can include taking breaks when feeling overwhelmed, discussing our feelings, and practicing self-care.
Teach Positive Self-Talk: We can teach our children to use positive self-talk by modeling it and encouraging them to replace negative thoughts with positive ones.

What Role Does DBT and CBT Play in Parenting Therapy?

DBT (Dialectical Behavior Therapy) and CBT (Cognitive Behavioral Therapy) can be valuable tools in parenting therapy.

Here are some ways DBT and CBT can be applied in parenting therapy:

Emotion Regulation: In parenting therapy, these skills can be applied to help parents manage their own emotions and model healthy emotional regulation for their children.
Communication Skills: DBT and CBT can teach parents to communicate effectively with their children, including using active listening skills, healthy expressing emotions, and setting boundaries.
Problem-Solving: DBT and CBT focus on problem-solving skills, which can be applied in parenting therapy to help parents and children work through conflicts and challenges.

Effective Parenting Therapy at Behavioral Psych Studio

At Behavioral Psych Studio, we know parenting isn’t always easy, and we’re here to help.

We use proven methods like CBT and DBT to give you the tools you need to help your kids grow up resilient and emotionally healthy.

Schedule an appointment today.

DBT vs. CBT in Treating Anxiety and Depression

Anxiety and depression can leave you feeling uncertain about the best path to recovery. DBT and CBT are two effective therapies, each with its approach to treatment.

But how do you decide which one is right for you?

Let’s explore the differences between DBT vs. CBT so you can better understand their unique strengths and make a more informed choice for your mental health.

Understanding these options can bring you closer to finding the support that meets your needs.

What is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy (CBT) is a type of psychotherapy that focuses on identifying and changing negative thought patterns and behaviors.

It is based on the idea that our thoughts, feelings, and behaviors are interconnected and can influence each other.

CBT aims to help individuals become aware of their thoughts, challenge and reframe negative thinking patterns, and learn healthier coping skills.

What is Dialectical Behavioral Therapy?

Dialectical Behavioral Therapy (DBT) is a type of cognitive behavioral therapy that was originally developed to treat individuals with borderline personality disorder.

It combines elements of CBT with mindfulness practices and dialectics, which are philosophical principles that emphasize finding the balance between opposing ideas.

DBT focuses on helping individuals regulate their emotions, improve their relationships, and develop skills to cope with distress.

DBT vs. CBT: What are the Similarities?

Here are some key similarities between DBT and CBT that highlight how both therapies work to support mental health:

DBT and CBT focus on connecting thoughts, emotions, and behaviors.
They are evidence-based therapies with research supporting their effectiveness.
Each therapy is structured and goal-oriented, offering practical strategies to manage mental health challenges.
Both emphasize developing coping skills to handle negative thought patterns and behaviors.
Homework assignments are often used in both therapies to help clients practice new skills in real-life situations.
They aim to empower individuals to take control of their mental health through self-awareness and behavior modification.

DBT vs. CBT: What are the Key Differences?

DBT and CBT are evidence-based but differ in their approaches and focus areas.

CBT primarily helps individuals identify and change negative thought patterns that influence behavior and emotions, making it effective for anxiety and depression.

On the other hand, DBT, a form of CBT, adds strategies for emotional regulation, distress tolerance, and interpersonal effectiveness, making it especially useful for individuals with intense emotional experiences or borderline personality disorder.

DBT vs. CBT: Which is Better for Treating Anxiety and Depression?

Both DBT and CBT have been extensively researched and found to be effective in treating anxiety and depression.

The choice between DBT and CBT may depend on the individual's needs and preferences.

For example, DBT may be more suitable for individuals with intense emotions or a history of invalidation.
At the same time, CBT may be a better fit for those who prefer a more structured and goal-oriented approach to therapy.

Individuals can also benefit from combining both therapies, complementing each other in focusing on acceptance and change.

DBT and CBT for Anxiety and Depression at Behavioral Psych Studio

At Behavioral Psych Studio, we understand that choosing the right therapy is crucial in your journey to mental wellness.

Our compassionate and experienced team is well-equipped to use DBT and CBT, tailoring our approach to meet your needs.

Whether you're dealing with anxiety, depression, or complex emotional challenges, we’re here to support you.

Family Therapy: How It Helps Heal Complex Family Dynamics and Trauma

Family dynamics can be complicated, and when trauma is involved, the emotional strain can feel overwhelming.

You might struggle to communicate with loved ones, feel misunderstood, or even isolated within your family. The right support can make all the difference in these moments.

Family therapy helps by providing a space where everyone can be heard and understood and heal together.

This blog post will explore how family therapy can guide your family toward stronger, healthier relationships.

What is Family Therapy?

Family therapy, or family counseling, is a form of psychotherapy that focuses on the dynamics and relationships within a family unit.

It involves multiple family members attending sessions with a trained therapist, who acts as a mediator and guide.

Family counseling aims to improve communication, resolve conflicts, and strengthen relationships within the family.

It acknowledges that the larger family system often influences individual issues and behaviors; therefore, the whole family must be involved in the healing process.

What are the Common Issues Addressed in Family Counseling?

Family therapy can be helpful for a wide range of issues and challenges that families may face.

Some of the most common issues addressed in family therapy include:

Trauma: Traumatic experiences, such as physical or emotional abuse, can have a profound impact on individuals and their families.

Family therapy can help families heal from the effects of trauma and rebuild trust and safety within the family unit.

Conflict Resolution: All families experience conflicts, but when they become persistent and destructive, they can significantly damage relationships.

Family counseling can help families learn healthy ways to resolve conflicts and prevent them from escalating.

Parent-Child Relationship Issues: Parenting can be a challenging and overwhelming experience, and it's not uncommon for parents to struggle with their children's behavior or development.

Guided family therapy sessions can help parents and children strengthen their relationships and learn effective parenting strategies.

Blended Family Challenges: When families merge, there can be many adjustments and conflicts as everyone navigates their new roles and relationships.

Family therapy can help blended families work through these challenges and create a harmonious dynamic.

What Approaches are Featured in Family Therapy?

There are various approaches to working with families, each offering unique techniques and philosophies tailored to different needs.

These include:

Cognitive Behavioral Therapy (CBT)

CBT helps families identify and challenge unhelpful thoughts and behaviors, replacing them with positive, effective alternatives.

Cognitive Behavioral Therapy is particularly useful for improving communication, resolving conflicts, addressing parenting challenges, and managing mental health issues like anxiety or depression.

Dialectical Behavior Therapy (DBT)

Combining CBT with mindfulness, DBT helps regulate emotions and enhance relationships.

Dialectical Behavior Therapy is ideal for families dealing with intense emotions or communication difficulties. Skills like distress tolerance and emotion regulation are key components.

Narrative Therapy

This approach empowers families to reshape their stories, focusing on their strengths and resilience.

It’s especially helpful for those dealing with trauma, as it allows families to reclaim their narratives and find new meaning in their experiences.

Family Counseling at Behavioral Psych Studio

At Behavioral Psych Studio, we support families through tough situations in a caring and safe environment.

Using proven therapies like Cognitive Behavioral Therapy and Dialectical Behavior Therapy, we help improve communication, resolve conflicts, and strengthen relationships.

If you're dealing with trauma or other challenges, we're here to help you build a healthier, happier family life.

The Benefits of Couples Counseling: Strengthening Relationships Through Therapy

Feeling stuck in your relationship can be overwhelming, with communication breaking down and tensions rising. Couples counseling offers a lifeline to those who want to repair and strengthen their connection.

By exploring the benefits of couples counseling, you can find ways to rebuild trust, improve communication, and deepen your bond.

Let’s discuss how therapy provides a compassionate space to address the challenges that may pull you apart, helping you and your partner grow closer and more resilient.

What is Couples Counseling?

Couples counseling, also known as relationship therapy or marriage counseling, is a form of psychotherapy designed to help you and your partner resolve conflicts and improve your relationship.

It involves working with a licensed therapist who has specialized training in working with couples.

Couples counseling aims to help you and your spouse identify and address the underlying issues that are causing problems in your relationship.

This can include communication difficulties, conflicts, trust issues, and other challenges hindering your ability to connect and maintain a healthy relationship.

What are Some Common Issues Addressed in Couples Counseling?

Couples counseling can address various issues that couples may face.

Some of the most common relationship issues addressed in therapy include:

Communication Problems: Communication is the foundation of any healthy relationship. When communication breaks down, it can lead to misunderstandings, conflicts, and feelings of resentment.
Trust Issues: Trust is crucial to a strong relationship. When trust is broken due to infidelity or other forms of betrayal, it can be challenging to repair.
Conflict Resolution: All couples experience conflicts from time to time. However, when conflicts become frequent and unresolved, they can damage the relationship.
Intimacy and Sexual Issues: Intimacy and sexual problems can also arise in a relationship, causing tension and distance between partners.
Life Transitions: Changes such as starting a family, moving to a new city, or changing careers can strain relationships.
Emotional Dysregulation: Emotional dysregulation refers to difficulties managing and expressing emotions healthily and appropriately.

What are the Benefits of Therapy for Couples?

Booking sessions with a couples therapist can be a game-changer for your relationship.

Here are some of the benefits you can expect from couples counseling:

Improved Communication: Couples counseling can help you and your spouse learn how to communicate more effectively, listen to each other's needs, and express your needs without causing harm.

This can lead to a deeper understanding and connection between the both of you.

A Safe Space to Address Issues: Couples counseling provides a safe and neutral environment to address issues without judgment.

This can be especially helpful if you or your partner have difficulty discussing sensitive topics or have a history of unresolved conflicts.

Increased Understanding and Empathy: Couples counseling can also help you better understand each other's perspectives, needs, and feelings.
Tools and Strategies for a Healthy Relationship: A couples therapist can provide you and your partner with practical tools and strategies to improve your relationship.

These may include communication techniques, conflict resolution skills, and ways to strengthen intimacy and connection.

Prevention of Future Issues: Couples counseling not only addresses current issues but also helps prevent future problems from arising.

Behavioral Psych Studio Offers Relationship Therapy to Help Couples Reconnect

At Behavioral Psych Studio, we understand the complexities of relationships and offer a non-judgmental space where couples can address their concerns openly.

Our experienced therapists are dedicated to helping you and your partner work through challenges, improve communication, and strengthen your bond.

Schedule an appointment with us today.

The Cycle of Anxiety: Breaking Free with CBT

Have you ever felt like you’re caught in an endless loop of worry, where every anxious thought feeds into the next, creating a never-ending cycle of fear and unease? If so, you are not alone. Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults every year, according to the CDC. Yet, despite its prevalence, many people feel trapped by their anxiety, unsure of how to break free from its grip.

The Cycle of Anxiety

Anxiety often begins with a single thought or concern. Maybe it’s a worry about an upcoming presentation, a health scare, or even a social event. This thought triggers a cascade of physical symptoms: a racing heart, sweaty palms, or a tightening in the chest. In response to these uncomfortable feelings, we might try to avoid the situation or engage in other safety behaviors—things people do to lower their anxiety when there is a perceived threat. Examples of safety behaviors include checking and rechecking your presentation multiple times to make sure there are no mistakes, excessively seeking reassurance from others that you are in perfect health, or bringing a good luck charm with you wherever you go. While these actions might provide short-term relief from anxiety, initially easing our discomfort and making the situation seem more manageable, they reinforce the anxiety in the long run, keeping us stuck in a cycle that’s hard to escape.

Thankfully, there’s hope. Cognitive Behavioral Therapy (CBT) offers effective strategies for breaking the cycle of anxiety. By focusing on the interplay between thoughts, feelings, and behaviors, CBT helps individuals develop healthier ways to cope. Here are three key CBT techniques to manage anxiety:

Behavioral Experiments

Behavioral experiments involve testing out new behaviors to see if your anxious predictions come true. Here’s how they work:

Identify Predictions: Start by identifying what you predict will happen in an anxiety-provoking situation. For instance, if you're anxious about speaking in public, you might predict that you'll forget your words and be embarrassed.
Test Your Predictions: Gradually expose yourself to the situation while collecting evidence about what actually happens. Start with smaller exposures, such as speaking up in a meeting, and gradually work up to larger ones like giving a presentation.
Evaluate Outcomes: After the exposure, evaluate what happened versus what you predicted. Did your worst fears materialize? What actually happened? Use these reflections to adjust your future behaviors and expectations. This helps in reducing the power of anxiety-driven thoughts by confronting them with reality.

Exposures

Exposure therapy is a cornerstone of CBT for anxiety. It involves gradually facing feared situations or objects in a controlled and systematic way. By doing so, you can reduce your fear response over time. For instance, if you have a fear of public speaking, you might start by speaking in front of a small, supportive group and gradually work your way up to larger audiences. The key is consistency and patience, as repeated exposure helps to desensitize the anxiety trigger and allows you to see that you were able to face your fears without running away from them. Exposures include the following elements:

Hierarchy Creation: List situations that trigger your anxiety, ranking them from least to most anxiety-provoking.
Gradual Exposure: Begin with a lower stakes anxiety-provoking situation and gradually work your way up. For example, if social interactions are a trigger, start by having a short conversation with a friend and gradually increase the complexity and length of social interactions. Make sure to celebrate small successes along the way!
Consistent Practice: Regular exposure helps increase willingness to confront feared situations rather than struggling against them or trying everything in your power to get rid of them—two behaviors that ultimately increase suffering and a sense of being overwhelmed by anxiety. The more willingness you are to lean into exposures, the more opportunities you’ll have to learn that you can cope!

Cognitive Strategies

Cognitive strategies, such as cognitive reappraisal, help you identify, challenge, and change unhelpful thought patterns. When practicing this strategy, try the following:

Identify Thinking Traps: When you notice anxiety, write down the thoughts that are running through your mind. For example, "I can't handle this," or "Something bad will happen." Oftentimes anxiety is accompanied by thoughts that overemphasize the negative aspects of a situation or predict catastrophic outcomes.
Challenge These Thoughts: Examine the evidence for and against these thoughts. Ask yourself, “Is this thought based on fact or fear? What evidence do I have to support this thought? What’s the worst that could happen, and how likely is it?"
Replace with Balanced Thoughts: Develop more balanced thoughts based on the evidence. For example, replace "I can't handle this" with "I’ve handled similar situations before and can use my coping skills to manage this one."

Applying These Skills: A Practical Example

Let's take the example of someone who feels anxious about driving.

Behavioral Experiment: They predict that if they drive on the highway, they'll have a panic attack and cause an accident. To test this, they start by driving on a quiet street and gradually progress to busier roads. After each drive, they note what happened versus what they predicted. They might find that, although they felt anxious, they were able to drive safely without a panic attack.
Exposure Therapy: They create a hierarchy of driving situations, starting with short trips on familiar roads, progressing to longer trips, and eventually driving on the highway during off-peak hours.
Cognitive Reappraisal: They identify thoughts like "I will definitely have a panic attack," and challenge them with evidence such as "I have driven many times without having a panic attack." They replace these thoughts with balanced ones like "I might feel anxious, but I can use my coping strategies to manage it."

Combining these CBT techniques provides a comprehensive approach to managing anxiety. By regularly practicing these skills, individuals can disrupt the cycle of anxiety, reduce avoidance behaviors, and build confidence in their ability to handle anxiety-provoking situations.

Conclusion

Breaking free from the cycle of anxiety isn’t easy, but it’s possible with the right tools and strategies. Cognitive Behavioral Therapy offers a structured and effective approach to understanding and managing anxiety. By experimenting with new behaviors, facing your fears, and challenging unhelpful thoughts, you can take control of your anxiety rather than letting it control you. Remember, you don’t have to do it alone—seek support from a therapist or support group to guide you on your journey.

10 Tips to Support Your TGNB (Transgender/Nonbinary) Loved One

Considering the recent increase in anti-trans legislation across the U.S., I wanted to write this post to show our direct support of transgender, nonbinary and gender-diverse people, who make up a large portion of our clients at BPS. The impact of these bills can be understood as an example of traumatic invalidation, which ie extreme or repetitive invalidation of an individual’s significant private experiences or characteristics, resulting in damage to their self-construct and pervasive insecurity (Harned, 2022). Sources of traumatic invalidation can be macro (institutional, systemic) or micro (among important relationships, especially parents and family of origin).

When Possible, Choose Joy over Grief

Many parents experience a period of grief, sadness, or shock when adjusting to their child’s gender disclosure. This may be related to hopes or expectations that parents formed about who their child would be; which may extend beyond their gender. Similarly, we often expect our children to participate in specific activities, achieve certain grades, or pursue a particular career. While these emotional reactions are common, they can be effectively processed alone, with one’s co-parent or partner, with one’s therapist, friends or other sources of social support, and not their transgender nonbinary (TGNB) child. These reactions can be emotionally burdensome to children who may internalize negative reactions from their parents as evidence of their own failures or rejections of their identities. Research indicates familial support, more than any other source of support, as the number one protective factor against suicidal ideation and attempts (Travers et al, 2012; Matsuno & Israel, 2018).

Once the grief is less pressing, you may have more emotional capacity to join in on the joy. How many new moments of connection might you enjoy with your child once you can celebrate their gender? How many might you miss during a period of non-acceptance?

In the spirit of dialectics, I believe we are all doing the best we can to support our TGNB friends and relatives, and we all need to try harder, do better and show up more for our TGNB loved ones. These include the people in your life that might not even be out to you as TGNB. (There are at least 1.4 million of us in the U.S. alone) (Flores, Herman, Gates & Brown, 2016; Wilson & Meyer, 2021). The tips below are here to help you show up in a validating way.

10 Tips for How to Show Up for Your Transgender / Nonbinary (TGNB) Family Member

1. Use their pronouns and chosen name. There are many ways to “transition:” medically, legally, and socially. Not everyone has the option or interest in transitioning medically, so correctly acknowledging social aspects of people’s gender may be even more important as a means of communicating your support.

2. Get them a gift with their chosen name or initials on it (a cup, a key chain) and tell them you love the name they chose. These are great ways to celebrate this step with them.

3. If you’re not sure what pronouns to use for someone, ask! “What pronouns should I use for you?” is not an offensive question. However, refusing to use someone’s pronouns communicates that their gender is not valid or you don’t perceive them as they experience themselves. Misinterpreting and ignoring are forms of traumatic invalidation (Harned, 2022).

■ Challenge question: Can you remember the last time someone misunderstood or ignored something about you that is fundamental to your self-concept? How did this affect your subsequent interactions? 4. Practice, practice, practice! Practice pronouns with this free (and addicting!) online game. Practice using they/them pronouns with your pets, your friends, yourself, or practice when you are talking about the TGNB person when they are not in the room.

5. Don’t give up. What happens when I mess up? It’s ok! And, keep trying to do better. Forgive yourself internally, acknowledge the mistake briefly, and move on with the conversation. Mistakes happen, especially when we’re learning something new. Dwelling on this moment by apologizing multiple times or trying to explain how it happened is generally more overwhelming to the person who has been misgendered.

○ “She, I mean he, loves skateboarding. My bad. Where should we go for lunch?”

6. Get outside support. Tap your community, including online support threads (linked below) for advice and resources. It’s okay to be struggling, and it’s best to process your challenging emotions away from your trans or nonbinary child.

7. Familiarize yourself with trans culture, media, and narratives. Who does your child look up to and why? Celebrate their role model’s successes and keep an eye out for potential mentors to hire for additional support.

8. Diversify your sources of information. Direct your questions and research to trans-led organizations and doctors who are trans and/or have extensive experience working with TGNB individuals.

9. Practice radical acceptance. In order to avoid intentional or inadvertent rejection of their gender-diverse children, parents can practice the DBT skill of radical acceptance of both their emotional reactions and their child’s gender.

10. Be intentional about your observations, comments, and questions. The following is a table of common TGNB microaggressions. A microaggression is a seemingly inconsequential comment or action that is invalidating or hurtful. These are usually accidental and have a significant negative impact, especially cumulatively and over time. The negative impact on the person receiving the comment is often unknown to the person who committed the microaggression (Sue & Spanierman, 2020).

Common Microaggression	Example & Affirming Replacement	Rationale
Misgendering	“Charlie was born as a girl and now is a boy.” → “Charlie is a boy.” If you must reference someone’s assigned sex at birth and you have their consent to share this information: → “Charlie was assigned female at birth.”	Comments about who a person “used to” be can be invalidating because people are often aware of their gender before coming out to others about it - the fear of rejection might have kept them from disclosing widely. It’s best practice to retroactively refer to people with the pronouns and gender they currently identify with.
Unwanted body commentary	“You used to have such nice (body-related comment)” “But you’re such an attractive/beautiful/handsome girl/boy!” → “I love who you are becoming.” → “Let’s go shopping for some new clothes!” → “What words would you like me to use to refer to you? (handsome, beautiful, intelligent…)”	Comments about someone’s physical appearance, body, or attractiveness in regards to their assigned gender can be really hurtful to TGNB people. When uncertain, always frame compliments or observations in the context of their present sense of gender.
Dismissing / controlling transition-related goals	“I’m scared that you’re going to want surgery/hormones.” “I’ll support you as long as you don’t medically transition.” → “If you feel open to sharing, what are your goals for transition? → “How can I support you?” → “What do you like to receive affirmation about?” → “What gives you gender euphoria?”	Not everybody wants to medically transition, and people’s gender related goals are personal and change over time. It’s important to ask questions about medical transition with sensitivity and an openness to not receive an answer. They might not be ready to share details about their body, goals for transition or current gender affirmation processes. Depending on your relationship (sibling, parent, etc.) certain questions may be more or less appropriate.
Projecting fears	“I feel sad/worried for you” “You must feel trapped in your body.” “I’m scared of how people will treat you.” → “I’m so proud of you.” → “I’m going to be right by your side through this process.” → “I have some questions, and I’m going to do research on my own.”	While there are higher risks of distress and negative psychosocial outcomes associated with being TGNB, these risks come from social stigma, invalidation, and barriers to resources, not from one’s gender identity! Instead of sharing your concern for their anticipated difficulties, decide to be an ally and ask how you can support them.
Ageism	“You’re too young - you won’t know what’s real or best for you until you’re older.” “You’re too old - if this were real, you would have known about it since you were a child.” → “I’m honored you decided to share this with me. It’s never too late/too early to come out as trans.” → “I believe you, let’s get more information together about potential options for affirming your gender.” → “Thank you for telling me, that was really brave. I’m excited to get to know more about you and who you’re becoming.	TGNB people are told they are either “too young” or “too old” to be trans quite often. This shows that ageism exists across the spectrum of transness. There is no “right” age when we “truly know” what our gender is. At the same time, our readiness to make decisions about which gender affirming steps to take may shift depending on a number of factors, including our age. Regardless of these decisions and readiness factors, validation and support are necessary every step of the way.

Additional Resources

APA: Singular “They” Is Grammatically Correct

Practice pronouns with this free online game

How parents can support a child who comes out as trans - by conquering their own fears, following their child’s lead and tolerating ambiguity

Free and low-cost letters of support from therapists for clients seeking gender-affirming medical care

Gender-affirming tele-health care Counseling groups for TGNB youth/parents

Sylvia Rivera Project & Lambda Legal - Trans legal collective and legislative support

References

Flores, A.R., Herman, J.L., Gates, G.J., & Brown, T.N.T. (2016). How many adults identify as transgender in the United States? Los Angeles, CA: The Williams Institute

Harned, M. S. (2022). Treating trauma in dialectical behavioral therapy: The DBT prolonged exposure protocol. The Guilford Press.

Matsuno, E. & Israel, T. (2018). Psychological interventions promoting resilience among transgender individuals: Transgender resilience intervention model (TRIM). The Counseling Psychologist, 46(5), 632-655.

Olson, K.R., Durwood, L., DeMeules, M. & McLaughlin, K.A. (2016). Mental health of transgender children who are supported in their identities. Pediatrics, 137(3), 1-8.

Sue, D. W., & Spanierman, L. B. (2020). (2nd ed.). John Wiley & Sons, Inc.

Travers, R., Bauer, G., Pyne, J., Bradley, K., Gale, L., & Papadimitriou, M. (2012). Impacts of strong parental support for trans youth: A report prepared for Children’s Aid Society of Toronto and Delisle Youth Services. Retrieved from http://transpulseproject.ca/wp-content/uploads/2012/10/Impacts-of-Strong- Parental-Support-for-Trans-Youth-vFINAL.pdf

Wilson, B. D. M. & Meyer, I. H. (2021). Nonbinary LGBTQ adults in the United States. Los Angeles: The Williams Institute.

There REALLY is No Place Like Home for the Holidays

Perry Como wasn’t wrong when he sang those iconic Stillman lyrics. “There’s no place like home for the holidays.” Really. And whether it’s your biological family, your chosen family or your new partner, home (for the holidays) carries a weighty pressure that perfectly encompasses Dialectical Behavioral Therapy’s (DBT) core dialectic of acceptance and change.

(‘What the heck is a dialectic?’ you may ask. Head here for a deeper dive into this term.)

As much as I love my family, and I really, truly do, there’s an unshakeable reversion to childhood patterns that the holiday season, and subsequent return home, can provoke in us all. (Adding another escalating ingredient to the mix is COVID-19.) I’ll spare my family the indignity of revealing too much about our interpersonal dynamics on the internet. However, I will say that we all come home for the holidays carrying our own baggage — both literally and figuratively. This can be baggage that’s been simmering for a few days, months, or years. Sometimes it’s baggage that’s entirely irrelevant to the individuals sitting around that open fire roasting chestnuts — I’ve literally never roasted chestnut, and I simply couldn’t begin to tell you how to do that. Other times, it’s baggage that has absolutely everything to do with a very particular scenario, involving a very specific individual, who’s watching that ball drop beside you on New Year’s Eve.

And, it’s at this moment that DBT’s core dialectic comes into play. Accept? Change? Sometimes, we accept. For those who are considering this course of action, because yes, acceptance is a choice, I recommend reviewing some of DBT’s Distress Tolerance Skills. In other circumstances, perhaps when we’re looking to obtain a specific goal or objective, we pursue change.

This holiday season, if you have a specific goal or objective, once you’ve clarified your priorities, consider DEAR MAN. This is one of my personal favorite skills in the entire DBT repertoire, as I have found it to be particularly effective for me. Surely, contacting your individual therapist, or diving more deeply into DBT Skills Training at BPS will support this process in greater depth, and, for now, with just a few days before heading ‘home,’ I’ve included a very quick primer on DEAR MAN.

My sample situation? My sister repeatedly takes my clothing from my closet. My objective? Get my sister to stop taking my clothing.

D - Describe the Situation

Ex: I’ve noticed that you have taken a few articles of clothing from my closet without asking me in advance.

E - Express Clearly

Ex: I feel anxious when I can’t find a missing clothing item. I wonder where it has gone, and whether I’d brought it back home in the first place.

A - Assert Wishes

Ex: I would like you to stop taking my clothing.

R - Reinforce

Ex: My hope is that we can figure this out so that we can minimize our bickering during this trip.

(Stay) M - Mindful

This is the part of the conversation where I would emulate a broken record, continuing to express my opinion in spite of any diversions or deviations from my sister.

A - Appear Confident

While I might be nervous to make this ask, using a confident tone of voice and physicality will better support my efforts to obtain my objective.

N - Negotiate

If my ask or refusal appears to be hitting a wall, I must be willing to give to get. For example, if I’m comfortable with this alternative, I might ask my sister to, at the very least, ask me before taking my clothing.

As with every skill, practice, practice, practice!

What the Heck is the Biosocial Theory?

We’re talking about the biosocial theory today, and as with the concept of dialectics, the biosocial theory is a fundamental underpinning of Dialectical Behavior Therapy (DBT). Therefore, whether you’re considering DBT for yourself, or you’re interested in learning more about this treatment in general, an elementary grasp on the biosocial theory of Borderline Personality Disorder (BPD), and other problematic behaviors associated with emotional dysregulation, is a good starting point for all that follows in treatment. In fact, it may provide a healing and illuminating explanation for why one functions the way one does!

Let’s start with a definition, shall we?

Dr. Marsha Linehan posits that problematic behaviors, adapted and adopted to regulate emotions, are rooted in the evolving interaction and transaction of biological and environmental factors.

An individual's particular biology may predispose them to struggles with emotional vulnerability and emotional modulation. For example, research has shown “...hyperactivity in the limbic system and decreased activation of the prefrontal cortex...may contribute to affective instability in BPD” (Niedtfeld & Bohus, 2018, p. 1). Say it with me (and I know this can be very, very hard!): It is what it is. This is how your biology, how your brain, functions. There is not something wrong with you. This is just how you are!

Likewise, an invalidating social environment occurs when figures in one’s life “...consistently and persistently fail to respond as needed to primary emotion and its expression” (Koerner, 2012, p. 6). Raise your virtual hand if any of the below applies to any interaction you’ve ever had with anyone (ever):

You’ve been told you’re overreacting to a situation.
You’ve been told your emotions are, in some way, stupid, wrong, or manipulative.
You’ve been ignored during a state of emotional distress, and then lashed out at by that same individual when your distress became too overwhelming for that individual.

These are just some examples of invalidation, and over time, invalidation may impact an individual’s capacity to regulate emotion.

Breaking it down even further, we have the bio and we have the social, and when one pairs biological vulnerabilities with invalidating social environments, it would be reasonable (and quite natural!) to assume the development of maladaptive patterns of behavior.

As a final and important note, if we envision a scale, one’s biological vulnerabilities may weigh more than one’s invalidating social environment, and vice versa. Regardless of the source, the fallout from managing these interactions can be unbearable, and this is something that DBT seeks to address through both individual therapy and skills groups. After all, it is a DBT Assumption that, while you may not have created your problems, you do have to solve them anyway.

About BPS

Welcome to “Let’s Talk Psych at Behavioral Psych Studio”, a science and evidenced-based mental health blog created by Behavioral Psych Studio. Behavioral Psych Studio is a private, group psychology practice, dedicated to providing effective, science-driven treatment to people struggling with psychological or social issues in New York City. At Behavioral Psych Studio, we are passionate about providing effective, comprehensive and compassionate treatment and we believe that treatment should be driven by science. To ensure that our clients receive the best treatment at BPS, our practice is committed to using interventions and treatments that have been empirically supported by scientific research. Very often, mental health issues are fraught with stigma and people feel shame or judgment about seeking out treatment. Behavioral Psych Studio is launching “Let’s Talk Psych at Behavioral Psych Studio” to both help combat the social stigma people face, and also provide up-to-date, accurate information on the types of treatments that exist for various mental illnesses and issues, across the lifespan. Stay tuned for our first post!

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The Cycle of Anxiety: Breaking Free with CBT

The Cycle of Anxiety

Behavioral Experiments

Behavioral experiments involve testing out new behaviors to see if your anxious predictions come true. Here’s how they work:

Identify Predictions: Start by identifying what you predict will happen in an anxiety-provoking situation. For instance, if you’re anxious about speaking in public, you might predict that you’ll forget your words and be embarrassed.
Test Your Predictions: Gradually expose yourself to the situation while collecting evidence about what actually happens. Start with smaller exposures, such as speaking up in a meeting, and gradually work up to larger ones like giving a presentation.
Evaluate Outcomes: After the exposure, evaluate what happened versus what you predicted. Did your worst fears materialize? What actually happened? Use these reflections to adjust your future behaviors and expectations. This helps in reducing the power of anxiety-driven thoughts by confronting them with reality.

Exposures

Hierarchy Creation: List situations that trigger your anxiety, ranking them from least to most anxiety-provoking.
Gradual Exposure: Begin with a lower stakes anxiety-provoking situation and gradually work your way up. For example, if social interactions are a trigger, start by having a short conversation with a friend and gradually increase the complexity and length of social interactions. Make sure to celebrate small successes along the way!
Consistent Practice: Regular exposure helps increase willingness to confront feared situations rather than struggling against them or trying everything in your power to get rid of them—two behaviors that ultimately increase suffering and a sense of being overwhelmed by anxiety. The more willingness you are to lean into exposures, the more opportunities you’ll have to learn that you can cope!

Cognitive Strategies

Cognitive strategies, such as cognitive reappraisal, help you identify, challenge, and change unhelpful thought patterns. When practicing this strategy, try the following:

Identify Thinking Traps: When you notice anxiety, write down the thoughts that are running through your mind. For example, “I can’t handle this,” or “Something bad will happen.” Oftentimes anxiety is accompanied by thoughts that overemphasize the negative aspects of a situation or predict catastrophic outcomes.
Challenge These Thoughts: Examine the evidence for and against these thoughts. Ask yourself, “Is this thought based on fact or fear? What evidence do I have to support this thought? What’s the worst that could happen, and how likely is it?”
Replace with Balanced Thoughts: Develop more balanced thoughts based on the evidence. For example, replace “I can’t handle this” with “I’ve handled similar situations before and can use my coping skills to manage this one.”

Applying These Skills: A Practical Example

Let’s take the example of someone who feels anxious about driving.

Behavioral Experiment: They predict that if they drive on the highway, they’ll have a panic attack and cause an accident. To test this, they start by driving on a quiet street and gradually progress to busier roads. After each drive, they note what happened versus what they predicted. They might find that, although they felt anxious, they were able to drive safely without a panic attack.
Exposure Therapy: They create a hierarchy of driving situations, starting with short trips on familiar roads, progressing to longer trips, and eventually driving on the highway during off-peak hours.
Cognitive Reappraisal: They identify thoughts like “I will definitely have a panic attack,” and challenge them with evidence such as “I have driven many times without having a panic attack.” They replace these thoughts with balanced ones like “I might feel anxious, but I can use my coping strategies to manage it.”