How to Get Through Crisis

By Sara Staggs, LICSW, MPH • 2 min read

Screen Shot 2015-01-24 at 6.57.13 PMDistress is a fact of life. It’s a wide range of triggers: it’s not always our turn, or we have bad luck, or we make a bad decision and have to suffer the consequences or we experience oppression and injustice and so on. How upsetting these different degrees of distress are depends not only on the magnitude of the event, it depends on us—the same event may be annoying to one person and catastrophic to another. Most of us have different ways of dealing with different levels of distress. People who are more emotionally vulnerable don’t differentiate as well, and actually experience any amount as intolerable.

How DBT teaches distress tolerance

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Have Trouble Saying No? Here’s Help

By Sara Staggs, LICSW, MPH • 1 min read

Above, Brené Brown describes how we burn out by trying to feel good enough by pleasing and performing and perfecting.  This interferes with our ability to show up in relationships as ourselves.

How Healthy People Learn Relationship Skills

People learn to do this in childhood when

  • boundaries are respected
  • boundaries are modeled
  • boundaries are taught

Frankly, this stuff should be formally taught to everyone. Interacting with others is really challenging and everyone struggles a bit, whether they know it or not. It would help if we all knew the same stuff.

The core theme of DBT’s interpersonal effectiveness training is assertiveness, both in making requests and in setting boundaries.

The Trauma Connection

Nothing violates boundaries more than sexual assault. However, emotional neglect and abuse, physical neglect and abuse, all serve to teach children that their needs cannot be met and must be suppressed. This is why many survivors of childhood neglect and abuse wind up putting others’ needs before their own, although certainly plenty of non-survivors do that, too.

In the video above, Brené Brown argues that we say “yes” when we mean “no” because we don’t feel like we’re enough and we strive to be enough by “pleasing and performing and perfecting.” The problem is that there is no such thing as “enough,” and it’s only by recognizing our inner worthiness can we set boundaries, or as she puts it “Being enough starts with saying ‘Enough!’”

As with the other modules, there are many lessons and components in the Interpersonal Effectiveness module. One that is particularly cool is the one that highlights that despite what we make think, saying “yes” and “no” isn’t actually a binary proposition. Thinking this way has actually helped me in how I ask and receive inquiries. I find that it also helps facilitate the discussion that a “no” isn’t necessarily rejection, though many people feel like it is. Below is an example of the range of assertiveness with which you can ask or refuse request.

Screen Shot 2015-01-15 at 8.13.46 PM


This post is part of a series on how DBT is helpful for complex trauma.  Dialectical Behavior Therapy address issues of mindfulness, interpersonal effectiveness, emotion regulation and distress tolerance.  Follow the links to learn more!

Feeling Out of Control? Here’s Why

By Sara Staggs, LICSW, MPH • 2 min read


Everyone can feel out of control sometimes, but some people have more trouble than others.  What is emotion regulation and how can we improve??

How healthy people learn emotional regulation
We learn several different ways:

  • observing people around us regulate,
  • by having our feelings validated
  • learning that it is safe to express feelings
    • this is an area where boys are particularly invalidated
  • being taught appropriate ways to respond to those feelings
  • Also, temperament is important: some people are more sensitive than others

What do emotion regulation problems look like?

As Marsha Linehan describes it, there are two parts to emotion regulation difficulties: emotional vulnerability and poor emotion modulation.

Emotional vulnerability

Here is a chart from a previous post. You can read more in depth about it there, but briefly, the red line shows someone who is far more emotionally vulnerable.

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Why Mindfulness Helps with Trauma Symptoms

By Sara Staggs, LICSW, MPH • 2 min read

Screen Shot 2015-01-08 at 3.44.29 PMI have written previously about how mindfulness is helpful for trauma survivors. In particular, trauma symptoms of reliving the past, and remaining hypervigilant about potential threats disconnect us from our present and we need help getting refocused. Developing skills for noticing your body, your surroundings, your current safety is a wonderful counterpoint to many trauma symptoms.

A Natural Deficit

Actually, we don’t live in a very mindful culture.

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How are Complex Trauma and Borderline Personality Disorder Related?

By Sara Staggs, LICSW, MPH • 1 min read

Screen Shot 2015-01-05 at 9.42.18 PM

I’ll admit that when I hear that a client has borderline personality disorder (BPD), my first thought is, “Oh, this person is a trauma survivor of some sort.” And while not all people with poor emotion management, impulsive and destructive actions, intense fear of abandonment and an unstable self image have a history of complex trauma, it gets me to a non-judgmental place where I’m able to be very open to hearing someone’s story. And people can sense when you approach them with the assumption that they are very strong and are doing the best they can, as opposed some other attitude.

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Staying Sane in a Season of Excess

By Sara Staggs, LICSW, MPH • 1 min read

DSC01799This time of year most people set out extra stuff: Christmas trees, menorahs, wrapped packages, special plates, snowmen, nutcrackers, you name it. Leaving the house means an assault of sounds and smells and sights: tinsel, evergreen, Rudolph the Red-nose Reindeer. More spending is more stress for many people, as are more social obligations, or a lack thereof that’s hurtful, and of course there’s the headaches of extra traffic and shortage of parking.

This is the season of excess and it can be really overwhelming.

Parties—the double-edged sword

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How to Tell If Your Therapist is Impatient

By Sara Staggs, LICSW, MPH • 2 min read

DSC06685Monday’s post described how perfectionism can prevent clients from getting the most out of therapy. But the drive for results affects therapists as well. I remember spending many supervisions explaining why a client wasn’t improving quickly enough, only to have my supervisor remind me to be patient.

When sitting with someone in pain, who hasn’t wanted to solve the problem? To tell someone that other people have it worse, so, you know, it’s not that bad, and it’ll be better soon, so check out that silver lining and lighten up!

A Client Failed

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How Perfectionism Interferes with Therapy

By Sara Staggs, LICSW, MPH • 1 min read

IMG_0683Brené Brown reminds us that we often try to feel good enough by “pleasing, performing and perfecting.”  That’s an endless task and we’re left feeling like we haven’t tried hard enough, accomplished enough and produced enough.  So we feel inadequate.

Client:  “I feel like we aren’t doing anything. Why haven’t we processed my trauma yet?” someone will ask me in their second session.

“Well,” I say, “you’re re-experiencing your trauma all the time right now, right?”

“Yes, that’s why I need to get rid of it!”

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