Is there a place for tough love in therapy?  Or should therapy be about unconditional acceptance?

There are many schools of thought on how to conduct therapy.  A new dichotomy seems to be growing between those who favor tough love and those who focus on acceptance.

In a recent Wall Street Journal Article, clients and therapists discuss how with “tough love” therapists try to eliminate their client’s whining.  These therapists might limit what topics a client can discuss or confront a client who is “whining” about their life again.  One client says she needs this sort of therapy.  That she simply won’t change if she receives unconditional acceptance.

Each of us makes sense of the world through our past experiences, internal expectations and beliefs. We think about the events that occur in our lives and interpret their meaning based on our history, past learning and our own personal tendencies.  Sometimes our thoughts about our lives serve us well.  They help us maintain our moral compass, weather adversity, form strong relationships and find happiness.

But sometimes we get stuck in negative thoughts or a narrow set of beliefs or expectations.  At these times we may find ourselves in repetitive patterns of conflict with others or feeling angry, stressed, anxious or fearful much of the time.  At these times, shifting how you think can have a big impact on changing how you feel.

Are you stressed out? If you are, you’re not alone. According to a 2010 American Psychological Association survey, one-third of American parents are extremely stressed and the majority of Americans are moderately stressed.

Many experience on-going stress from financial need, work demands and the pressures of family life. The challenge of managing stress with healthy habits, such as exercise, less worry, or better eating can leave us worried about the impact stress is having on our health.  However, Howard S. Friedman PhD suggests that when it comes to your health and how long you live, stress is not necessarily all bad.

As many as 37% of individuals with an alcohol disorder have been found to also have a mental disorder, while 53% of individuals with drug disorders other than alcohol have been found to have a mental disorder.

Co-morbidity—the presence of more than one disorder—increases the severity of symptoms and the difficulty in treating either one of the problems.

Good mental health is something that we all strive for.  Happiness in life has long been a pursuit of people in the West.  And yet, despite our desire for optimum happiness and good mental health, many feel unable to discuss psychological problems.

In a recent interview, I talked with author Stacy Pershall (Loud in the House of Myself) about her hesitation to admit to the diagnosis of Borderline Personality Disorder.  In her book, she discusses the stigma and hopelessness that is particularly connected with a diagnosis of BPD.  It was not that long ago (the 1980’s and early 90’s) that BPD was considered by many to be an incurable disease.

Now, with DBT, the diagnosis of BPD is slowly losing some of its stigma. People with BPD are able to get help and make major improvements in their lives.

recently had the opportunity to ask Dr. Marvin Lew, psychologist, professor and author of Dialectical Behavior Therapy for Adults who have Intellectual Disability a chapter in Psychotherapy for Individuals with Intellectual Disability some questions about using Dialectical Behavior Therapy strategies with people who have intellectual disabilities.  I’m happy to share with you, today, his experience.

Christy: You worked with people with intellectual disabilities for a number of years.  What problems did you see that made you consider dialectical behavior therapy (DBT) for this group?

Marvin: This is true. I worked with people who have intellectual disabilities (ID) for fifteen years. I supervised many clinicians during that time and there was often a feeling that some individuals had so many complications in their lives that they may never get better. Sometimes it was felt that 10% of our case-load required 90% of our time.

Such individuals were challenges to their families, clinicians, and care providers. They had frequent difficulties with other people, had more than their share of community struggles such as loss of jobs, loss of housing, etc… and were often the genesis of burnout symptoms among their care providers. I’m sure I was not the only clinical supervisor who cringed at the sight of difficult to serve clients who had both ID and emotion regulation problems.

A recent article in National Geographic got me thinking about what traits are inborn and which personality characteristics are learned from our environment.

In the article, wild foxes were bred over several generations to be as human-friendly as dogs.

Are humans like foxes?  With the right combination of genes over a period of generation are we capable of drastic changes in our behavior and nature?  Is it genetics that cause some to struggle with addiction or engage in self-harming behavior? 

Do you find yourself falling short of your goals?  Always doing that same old thing?  That thing – eating too much, drinking too much alcohol, losing your temper, watching TV instead of exercising—that you have vowed you would no longer do?

New Years is a time of reflecting back and planning for the future.  As we look back, we often hope to find meaning in our experiences and direction for the new year.

In today’s look back at the blog Dialectical Behavior Therapy Understood I’m including links to the 5 most popular posts, as well as 5 of my favorite posts for looking forward in the New Year.

Do you struggle with explosive anger, self-destructive and impulsive behaviors, substance abuse, and other emotional problems, such as depression and anxiety?

Do emotional and behavioral problems consistently interfere with your life?

Dialectical Behavior Therapy (DBT) is a cognitive- behavioral therapy for people diagnosed with Borderline Personality Disorder, as well as people who have emotion regulation problems and impulse control problems.