counseling

5 Ways To Be A Better Listener: Communication Through DBT Skills

DBT for Communication

by Megan Delp, MFT

Psychotherapy and Couples' Counseling through DBT and communication skills on the Main Line of Philadelphia in Bryn Mawr and West Chester.

The Dialectical Behavioral Therapy (or DBT) tenant called Interpersonal Effectiveness teaches us how to be a more effective communicator through learned to be a better listener.  We have always known that progress depends on the ability to communicate effectively.  The most effective communication does not begin with what a person says, but how well they hear the person they are communicating with. Only by listening effectively can you respond appropriately inany situation.

Throughout all forms of communication (reading, seeing, speaking, listening), we spend 40% of that time listening.  And yet, we get less training in listening than in any other kind of communication. All throughout childhood, we are taught how to speak, how to read, but very little time is spent on learning how to listen.  Learning to listen is difficult, but worth it.

For instance:

  • You can not NOT communicate.  We're communicating verbally or nonverbally all the time.

  • Whenever contact is made, some form of communication does occur.

  • The true meaning of something is not in the words we use, it's in how people interpret the words.

  • Yet the meanings cannot be transferred. We can't just put a computer file directly in someone's head. We can only send the words. So listening becomes a critical skill if we are going to fully understand the meaning someone is trying to send us.

We have the ability to listen in many different ways - it is important to be able to distinguish how we are approaching our communication so that we are prepared to handle it effectively.

The Five Listening Approaches are:

1. Appreciative:

People are more likely to listen if you feel inspired by what you are hearing or if you are enjoying yourself. You’re not necessarily interested in the details when you are using Appreciative Listening, rather you are more focused on the impression of the experience.

2. Empathic:

This style is often a sounding-board to others. A person would offer support to the person they are listening to.  They focus specifically on the feelings revealed by the person they are listening to. If you are often approached by people who need to confide or vent about something, you will know that's your typical approach to listening!  This style is much more focused on offering compassion.

3. Comprehensive:

A comprehensive listener can recognize key details between one message and another even when the speaker is less than organized. They can also recognize when someone doesn't understand what is being said and can re-explain clearly in their own words.

4. Discerning:

This approach of listening wants to get all the information and may take detailed notes.  Distractions can be very disturbing when using this listening approach. An example would be when other people are talking in class and you are trying to get all the notes.

5. Evaluative:

When listening with an evaluative approach, the listener will not automatically accept what is being said as true just because an expert says it. If they disagree, they will simply stop listening. They will also be more doubtful if the speaker is too passionate about their topic. This approach can be helpful when evaluating something and making a decision about it.

It can be highly useful to adapt your listening approach to the needs of the situation.  For example, if a close friend is sharing their difficulties with you, you would want to be empathic and not evaluative.  You have probably had the experience of someone giving you unsolicited advice when you really just wanted them to empathize with you!  The opposite can also be true. When you recognize the correct listening approach in any situation, and use the appropriate listening approach, you can build better relationships, make the correct decisions and use your interpersonal effectiveness skills.  It all starts with learning how to listen!

Megan Delp, MFTI

Megan Delp, MFTI

Megan is a pre-licensed Marriage and Family Therapist specializing in couples counseling and individual therapy for those struggling with depression, anxiety and relationship issues.  Megan practices with Spilove Psychotherapy in West Chester, Pennsylvania and on the Main Line of Philadelphia in Bryn Mawr.  For more information or to schedule a free 15 minute phone consultation, contact us here.

 

5 Things You need to know before you start counseling

So, you’ve decided to start counseling and you’re ready to go.  Perhaps you’ve never done therapy before or maybe you’re looking to take a new approach.  Here are some things you need to know before you start counseling.

1.  Finding a therapist that you feel safe with is most important. 

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You can line up a bunch of great therapists, but if they’re not the best fit for you, you’re not going to do the intense, deep work you’re looking to do.  The role of a therapist is to be a guide through your journey, reflect back to you what we see and help you to overcome obstacles towards meeting your goals.  If you don’t click with your therapist or don’t feel safe enough to trust them, reaching your goals with them is unlikely.  Your therapist should be someone you can relax around and speak freely without fear of being judged.  Trust and safety are of paramount importance when you’re looking to do deep work on things like eating disorders, trauma, PTSD, couples’ work or issues specific to the LGBTQIA community.

2.  Specialties mean that there’s been special training in a particular issue. 

Our training in graduate school and doctoral programs very rarely provides training for specific diagnoses like PTSD, eating disorders or addictions.  So when a therapist decides to have a particular specialty, we need to seek out training geared specifically towards these issues.  If you notice that a therapist you’re interested in has indicated that we specialize in a particular area, you might want to ask us what sorts of training we’ve done to qualify us as an expert.  This will give you a better idea of how equipped we are to help you with your specific struggle.

3.  When you hire a therapist, you are paying for a space that is yours, for you.

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I’ve heard people say that therapy is like paying someone to be your friend.  This is actually not true.  When you hire a therapist and you pay money, what you are paying for is a safe, neutral, objective space and time where you can do your work.  It is an energy exchange.  You are not paying your therapist to care about you, you are paying for an hour in a room that is completely and totally about you and no one else.  In friendships, there’s a give and take, there’s a social obligation to ask how they are and be a support to them.  In a relationship with your therapist, you are taking time for yourself only and receiving support that is not reciprocated emotionally, only financially.  This dynamic can be extremely healing and empowering and for many, it is the only time and space where healing can truly take place.

4.  The more consistently you go, the more effective therapy is.

Sometimes, in an attempt to save money or save time, people want to schedule therapy sessions every other week or once per month.  While there’s nothing particularly wrong with scheduling like this, you may want to rethink the frequency and consistency of your therapy schedule.  You don’t have to be in therapy forever.  You can establish and work towards specific measurable goals with your therapist and see regular progress.  However, progress is more difficult to measure when you attend therapy inconsistently.  You may be having symptoms of PTSD, for example, and when several weeks go by without working on those particular symptoms, it is more difficult to get traction.  If you’re struggling with binging and purging and you go every week, you can check in with your therapist about the particular triggers and behaviors that may have lead to your binge and purge.  Don’t take my word for it, check it out for yourself.  Set a goal with your counselor and try going weekly, write down your progress and notice the differences between your weekly sessions over a period of at least 3 months versus bi-weekly or monthly progress over a 3-month period.  You may be surprised with the results.

5.  Therapy happens in stages.

Sometimes we think that as soon as we set foot in the door of a therapy office, we will be “cured” immediately or within a few sessions.  The reality is that there’s a therapeutic process which happens in stages.  The first stage is joining with your therapist or learning to trust them.  When we meet a new friend, we don’t usually tell them our deepest darkest right off the bat, it takes time and trust building to get to a place where we know they are a good friend.  A similar concept is applied in therapy.  Depending on the client, the level and amount of trauma and defenses, this stage can take anywhere from about a month to sometimes a year or even more.  Safety, trust and a therapeutic bond, known as a therapeutic alliance, is formed in order for the therapist to really know and understand the client and for the client to feel safe enough to open up and do their work. 

The second stage is where the work is done.  Since there’s now an underlying foundation established between therapist and client, the second stage is about vulnerability.  There is an unpacking, uncovering, examining and exploring the process that happens with the client and their trauma or their history.  This stage is where people see their patterns and make shifts and changes in their thoughts, beliefs, and behaviors.  The second stage of the therapeutic process is where clients reach their goals.

The third stage may or may not be part of the therapeutic process, dependent upon the client’s preference.  This stage is for maintenance.  The client continues therapy but perhaps doesn’t come every week any longer.  They use their therapist to check in with, get help with issues as they arise and review the goals and behaviors they established during the second stage.  Some people choose to forego this step and skip to the fourth stage.

The fourth stage of counseling is a closure process.  After attaining goals in the second stage, and maintaining new behaviors and thought processes in the fourth stage, this last and final stage is a review of accomplishments, work together and closure of the therapeutic relationship.  If the client chooses to end counseling, this practice of review and closure can be especially healing for those who have experienced traumatic grief or loss.  Saying goodbye in a healthy way, honoring the relationship without suddenly cutting it off is a beneficial process to learn about emotional maturity and sophistication. 

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I hope these tips have been helpful.  Please feel free to comment below with any other tips or feedback you have on this topic.  If you’d like to speak further about starting counseling or have any other questions about some of the things I’ve mentioned, please contact me at TiffanySpilove@yahoo.com or call 610-314-8402.  I wish you luck in your endeavors and look forward to hearing from you soon!!

"We cannot love others until we love ourselves" by Mikala Morrow

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 "We cannot love others until we love ourselves"

by Mikala Morrow, Villanova Graduate Counseling Intern

This saying has been a cliché statement that has been thrown around as a way to encourage self-care or even used as a convincing statement to those who find it hard to love themselves. What does this statement truly mean?

It means that someway, somehow we must find, within us, love. This must mean that love is an innate ability and we all possess the ability to love ourselves without the assistance of others.

Personally, I do not believe this to be true. Can we truly have an innate ability to love ourselves without any help from others? If we truly cannot love others until we love ourselves, we have to be able to love ourselves without help, right? Which comes first, the chicken or the egg? Which comes first, our innate ability to love? Or is love taught to us from our caretakers, partners, peers or a higher power?

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What if, “We cannot love others until we love ourselves” becomes “We cannot love ourselves and others until we have been loved.” My argument is that in order to learn to love others, we must first be loved. We must learn how to love and what love is.

Imagine a child who is neglected by their caretaker. This child never truly learns love. Instead, to them, love means neglect. Later on in life when meeting new people, how will they love them? If all this older child has known is that love is neglectful, they too will neglect those that they love.

Compare the first child with someone who has a loving caretaker who has shown interest in who they are. This child will grow up with the idea that love is showing interest in others and will love in this way. These examples may not be true for all, but it is something to think about. The child in the first scenario may

learn somewhere how to truly love but this will not come as easily as the child in the second scenario.

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We need to learn what love looks like towards us and we also need to learn how we love.  We may love by giving others gifts or our time. We may show our love through compliments or by offering a shoulder to cry on. We all have a unique way to show love. In order to practice our ways of loving, we need people around us to accept our love. If our unique way of showing love is rejected, we learn that we are not good at loving, or our way of loving is wrong.

Let’s say you show love with your time but your partner becomes annoyed and tells you they just want space. Your way of loving has been pushed away. We need other people around us to affirm the way we love.  While the statement, “We cannot love others until we love ourselves” has a good message at the core, it can be damaging for those who have never learned how to love themselves.

We all need love whether it is from other humans on earth (maybe even from a pet) or a supernatural love. Then we can truly love others’ authentically and comfortably.

Mikala, Villanova Graduate, Counseling, Bryn Mawr, Love, Therapy

Mikala has an intensely compassionate and unique way of connecting with you to help you identify and express your feelings and your deepest sense of self.  She is persistent and encouraging in the face of hopelessness and despair.  She especially loves working with women to provide tools to alleviate anxiety and depression.  Mikala has a wealth of experience and is skilled in the mental health field working with domestic violence, food & body issues and addiction.  If you're struggling to tolerate your emotions and you're looking for a guide to help you get to know yourself better, give her a call now at 570-412-4516. 

 

WHAT IS PTSD AND DO I HAVE IT?

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Post-traumatic stress disorder, also known as PTSD, is an indication from your body that it needs support in sorting some things out.  Traumatic memories are stored in a different part of your brain than the rest of your memories.  When therapy is completed successfully, brain scans show that the trauma memory has been moved to a different area of the brain.  This alternate area of the brain doesn’t trigger your mind to get confused, your adrenaline to rush, and your body to be on alert.

Here are some of the symptoms of Post Traumatic Stress Disorder from the Diagnostic and Statistical Manual (DSM-V):

A stressor such as actual or threatened serious injury, threatened death or witnessing of death or actual or threatened sexual violence.

Intrusion symptoms such as

  • intrusive memories
  • traumatic nightmares
  • dissociative reactions such as flashbacks
  • prolonged or intense distress after being exposed to a trigger

Avoidance symptoms such as persistent efforts to avoid anything that triggers traumatic memories.

Alterations to thoughts and mood symptoms such as

  • not being able to remember important parts of the traumatic event
  • believing bad things about yourself and/or the world
  • blaming yourself for the traumatic event
  • overwhelming emotions such as horror, shame or anger related to the trauma that continue to happen even long after the event
  • losing interest in things that you used to enjoy
  • not being able to feel positive emotions such as joy

Reactive symptoms such as

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  • exaggerated startle response
  • difficulty concentrating
  • sleep difficulties
  • hypervigilance
  • aggressive or irritable behavior
  • reckless or self-destructive behavior

If you are ready to listen your body signals and get some support to untangle the memories and put them in their proper place, I can help.  My name is Tiffany Spilove and I LOVE working with people to heal their past.  I want to make sure that you find peace inside your body and your mind.  I have specialized training and experience helping people who have gone through sexual abuse, physical trauma and emotional pain.    

Call me today for your free 15-minute phone consultation at 610-314-8402 and find out if therapy is a good option for you

12 Clinical Interventions for Eating Disorders

Here are some tips you might find helpful when working with clients with Eating Disorders, or Disordered Eating:

1.  Find a registered dietician who specializes in Eating Disorders.  It is important that your belief systems and theirs align when working together to treat a client.  For example, most people in the eating disorder recovery field believe that there are no "bad" foods and we work with clients to neutralize food.  However, some people believe in "abstinence" from certain foods or food groups.  When I am looking for a dietician, I make sure that they're not of the school of thought to tell my clients to restrict food groups as it would go against the work we are doing clinically.

2.  Buy large desk calendar and different stickers and create a behavior chart for meals and snacks well done according to their meal plan. Celebrate successes elaborately!

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3.  If age appropriate, work with parents on making "no Foods bad".  Everyone in the family can join in on recovery by coming together to share with all food groups. 

4.  If age appropriate, look into the Maudsley Method for re-feeding process.

5.  Work with your client to create an art project around beautiful people, models, actresses, friends or family and others in Pinterest or print outs who are not super skinny.  Process what they find beautiful about these people.  Encourage clients to post up these images on their wall so that they get used to seeing ideal beauty images and other than emaciated models.

6.  Make a list of all clients fear foods and safe foods and medium foods and use CBT to debunk myths of fear foods. 

7.  Eat 'normal meals' together in session - especially with fear foods - exposure therapy.

8.  Find studies that show that whatever fear foods are - are not 'bad' i.e. - sugar is not as evil as everyone says. 

9.  Use ego state work to find out which 'parts' in clients psyche are telling them not to eat and have conversations with them using Gestalt Chair Work. 

10.  Use the books Life Without Ed by Jenni Schaefer as a guilde book, everyone involved should read and the book 8 Keys to Recover from an Eating Disorder by Carolyn Costin can be used for treatment and interventions as well.

11.  The therapist can have client draw their body in the size and shape she believes it's in, then have therapist actually trace clients body and process the difference. 

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12.  If there's one body part the client is upset about like their waist, have client draw what they believe is their waist size, then use a string to measure (not using numbers) the actual size and trace THAT onto the paper and process the difference. 

Hope this helps!!

What else do you use as interventions for clients?  Please comment below!!  As always, if you have any questions or concerns, please contact me at 610.314.8402 or through www.TiffanySpilove.com

3 Keys to Finally Make Peace With Food by Geneen Roth

Dining Out ... With an Eating Disorder

Happiness is a piece of cake therapy for eating disorders and body positive in West Chester, pa and on The Philadelphia Main Line, Bryn Mawr and Rosemont, PA

I know, I know, it sounds TERRIFYING!  Yes, I'm serious - you will not die from eating food in a restaurant ... I PROMISE!  It might FEEL like you'll die, it might seem like you'll gain a hundred pounds just from eating the food that is cooked for you back in that kitchen you can't see.  

Therapy for restaurants and eating disorders in West Chester, Pa and on The Main Line, Bryn Mawr, Rosemont, Philadelphia  Counseling

As my friend and colleague, Natalie says, "there aren't calorie ninja's back in the kitchen adding calories to your food"!  I understand the fear - I get that allowing somebody else to prepare your food is giving up control in a way that might not feel safe for you just yet.  Here's the rub, though - even though it might be hard to admit, I KNOW you want to be able to participate in experiences that involve food.  You WANT to be social.  You want to hang with your friends while they get frozen yogurt or try the food at the new cafe.  You want to live your life again... it's just that ED forbids it.  Here are some helpful tips for you to get more comfortable with dining out:

Practice

When you find yourself feeling fear about eating in a restaurant, it's sort of like a phobia - a very heightened anxiety around something specific.  The way to deal with and cure this type of phobia is through exposure - WITHOUT - re-traumatizing yourself.  So you don't want to push yourself to take it all on without practicing and getting comfortable with various aspects of it first.  

Use affirmations - they are wonderfully helpful ways to rewire your brain!

You might want to enlist the help of your therapist, friend or family member.  Tell them some food options that you consider safe.  Start small.  

It's better to have success with something less challenging than to get overwhelmed with something scarier.  

Dining out with an eating disorder therapy and counseling in West Chester, pa  on The Main Line, Bryn Mawr, Rosemont, Philadelphia, Pennsylvania for eating disorders

Your support team member could either get you food from a restaurant or give you food that they made without you present.  Or if you need to start even smaller, you could watch them make your meal so you know it's safe.  Eat with them.  Notice your feelings.  Use anxiety reduction and grounding techniques.  Keep breathing and do your best.  Keep practicing this step until your anxiety stays below a 7 on a 0-10 scale with 10 being the worst anxiety you've felt and 0 being no anxiety at all. 

Increase the challenge slowly

Once you get comfortable with eating meals made by others, up the ante.  If you're still not ready for restaurant dining, try getting take-out or try eating foods you didn't see being prepared.  Use an affirmation like "This food is safe and nourishing; I am safe and I can eat this food".  Make sure you start off each experience with some breathing and relaxing techniques so that you don't associate fear with the experience.

Dining Out

If noise bothers you, choose a restaurant that's quieter or a time of day that's less intense like lunch.  See if you can get a table that's against a wall, in a corner or in a quieter area of the restaurant.  This reduces over-stimulation and feelings of vulnerability.  

Have a plan

In earlier recovery, it's helpful to have a plan.  If you know which restaurant you'll be going to, look up their menu online.  Work with your therapist or dietician to determine which menu item you'll be selecting.  Most restaurants have portions that are significantly larger than the exchanges on your meal plan.  If this is the case, you could anticipate eating half the meal.  One tip is to ask for a to-go box at the beginning of the meal so that you can put half away for later and just focus on what's on your plate.  

Therapy eating disorder support in West Chester, pa and on The Main Line, Bryn Mawr, Rosemont, Philadelphia Pennsylvania Counseling

Go with someone supportive

This experience is hard enough, don't add to it by going with someone who doesn't "get it" or tries to sabotage your recovery.  Some therapists or dietitians will conduct sessions at the restaurant with you so that you can talk through it as it's happening.  If that's not an option, or you're ready for the next step, choose a member of your support group who understands your recovery.  Let them know the plan beforehand and maybe come up with a code word in case you need to abandon the mission.

Remember to breathe

Keep taking those deep belly breaths and know that this is just one meal.  One meal won't make you fat.  If you notice yourself starting to get overwhelmed or anxious, just come back to your breath.  While you're eating, try to focus the conversation on something else like the weather, the new movie just out or anything fun.  Take a sip of water, feel your feet.  You got this!!

Do's and Don'ts:

Do:

  • Keep the conversation light
  • Have some topics in mind to talk about while you're eating
  • Get the food down
  • Chew thoroughly
  • Focus on the conversation, the beautiful setting or anything but the food and body
  • Wear comfortable clothes
  • Stay at the table for the entirety of the meal
  • Set your pace to about 30 minutes to complete your meal

Don't:

  • Count the calories
  • Compare your dish to anyone else's
  • Body check while you're at the table
  • Talk about food, weight, exercise or anything triggering while you're at the table

Keep your eye on the prize!

This experience is not just about today or next week.  You are engaging in this exercise so that you can enjoy your life - so that you can HAVE a life!  Spending all your time in isolation, feeling lonely, not participating in social events is no way to live.  Remember that you are doing this so that you can be happy and free of your eating disorder.  

One day at a time therapy for eating disorders in West Chester, pa on The Main Line in Bryn Mawr, Rosemont, Pennsylvania
One day at a time
One meal at a time
One bite at a time

You CAN recover!!  Recovery from an eating disorder is not a linear process.  It goes all over the place, it's messy at times and sometimes you need to take 5 steps backward so that you can get good 2 steps forwards.  Even one success is worth celebrating, so give yourself credit for EVERYTHING you do right.  

If you're still feeling anxious about dining out and you'd like some support, I'd be happy to schedule a time to help you reach your goals.  Contact me now at 610.314.8402 to learn more about how to dine out with an eating disorder.  Please feel free to share this post with anyone who is looking for help with eating and body issues.

Good luck and enjoy!!

If you have any questions or need support, please feel free to call me at 610.314.8402 for a free 15 minute phone consultation.

Please comment below and tell us your story!