This episode features a deep dive into Dialectical Behavior Therapy (DBT) with therapist Leo Massey, exploring how this effective modality empowers individuals to manage their mental health. Listeners gain insights into DBT's structure, skills, and the importance of seeking help from a supportive therapist.
• Overview of Leo's journey from entertainment to mental health
• Explanation of DBT and its primary components
• Discussion of skills taught in DBT
• Importance of phone coaching and real-time support
• The value of collaborative care in mental health
• Encouragement for seeking help and establishing trust with therapists
In New York City (or Maryland and New Jersey for virtual sessions) and want to book an appointment with Leo? Find him here: https://counselingcentergroup.com/therapists/leo-massey/
We are happy and honored to be part of your life changing health and wellness journey:
https://telewellnesshub.com/explore-wellness-experts/
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome, friends, to the Telewellness Hub podcast, a
space where listening is notjust a simple passive act.
It's an act of self-care.
I'm Marta Hamilton, your host,and today you are getting to
hear directly from Leo Massey.
Leo is an LGTBQ plus affirmingand identifying male therapist
who is comprehensively trainedin DBT, emdr and utilizes CBT,
(00:24):
act and exposure therapy.
He helps individuals facingchallenges around anxiety,
depression, borderlinepersonality disorder, gender
dysphoria, trauma, ptsd,self-confidence, adhd,
antisemitism and autism spectrumdisorder.
Welcome, leo, thank you so muchfor joining us today.
Speaker 2 (00:45):
Of course.
Thank you so much, Marta, forhaving me on this podcast.
I appreciate it.
Speaker 1 (00:50):
I'm very excited.
You know, I randomly approachedLeo on social media in a
message.
I was just really intrigued andI just really was drawn to the
content that Leo was sharingwith others and before hitting
record, I talked about.
(01:10):
You know, sometimes the worldcan feel very overwhelming.
I think right now there's a lotgoing on.
I'm sure there's often a lotgoing on and to be scrolling on
social media and see somethingthat really speaks to the light
of the world, like Leo, justseemed like a light was sharing,
just sharing really helpful,inspiring insight for others.
(01:36):
And I thought you know what Iwant to talk to this person and
get to record and share with theworld so that hopefully, this
can be a light and just reallyamplify all the work that Leo's
doing with clients, so thatpeople can get an inside look of
what that might look like forthemselves in terms of seeking
therapy and working with atherapist like Leo.
So thank you so much forjoining and before we get
(02:00):
started into some questions I'dlove for you to share with us
why do you do the wellness workthat you do?
Speaker 2 (02:07):
Yeah, so a little bit of background.
I actually used to work inentertainment, so I was in the
entertainment industry,filmmaking industry and
specifically, yeah, so I wasactually working at talent
agencies, talent managementcompanies, and I realized when
working in that industry inHollywood, there were a lot of
people.
I was actually working attalent agencies, talent
management companies, and Irealized when working in that
(02:28):
industry in Hollywood, therewere a lot of people I was
coming face to face with that Irecognized needed certain mental
health assistance, neededmental health help, whether it
was substance use, depression,debilitating anxiety, anger
management or even just suicidalideation, especially working in
(02:48):
that field with very intensehours and restraints, and it
just gets to people.
So I think it was one day, if Irecall correctly, that I was
actually speaking with a um, anactor, and we were talking about
they just got back from war,they were a veteran and they
(03:12):
were telling me more about theirptsd and what they were
experiencing.
And I remember actually wantingto talk more with them about
that subject matter rather thantrying to help them get this
next big role on some TV show ormovie.
Oh, wow, so I was realizing I'mmuch more interested in this
and flash forward.
(03:34):
You know I made then the careerpivot from entertainment to the
mental health field.
You know I applied to ColumbiaSchool of Social Work, got in
and then I applied to the DBTprogram, which we'll get into a
little bit, is dialecticalbehavior therapy, and I remember
actually being in entertainment.
I was going down a rabbit holelooking into just different
(03:58):
modalities, different therapythat people utilize, and I came
across DBT and then more googledit.
You know I looked up thefounder, creator, marshall
Linehan, and how it pulls fromcbt, and then I saw celebrities
that have utilized it, like PeteDavidson, zina Gomez, and I was
(04:20):
like wow, this, this modality,is just part of this really big
third wave and it's makingsplashes and people are really
enjoying the skills that comewith it, which, again, we'll get
a little bit into.
But yeah, so that's how I gotinto it.
Speaker 1 (04:35):
Wow, you know, you don't typically hear that path
in terms of entering mentalhealth from the entertainment
world, but that's so fascinating.
I can see how.
I think it's interesting.
You pointed out thatconversation where you wanted to
explore more about thatperson's you know mental health
journey and how that really justcatapulted.
(04:55):
You just never know in aconversation with someone what
kind of an impact it really has,and I think that's what's so
special about our field thathuman connection element.
I think it's just incredible.
I you know you're mentioningDBT and you know researching it
and the modality and as atherapist myself, it is a really
specialized field and training.
(05:17):
So I think if you're interestedin DBT, you're listening,
you're interested in DBT andwe'll talk a little bit about
what that is.
Definitely finding a therapistwho has background in training
and like passion, like Leo, forthis field right, they're
researching, they're training,they're diving into it because
(05:38):
it is really a specializedapproach approach.
So if you don't mind sharing,can you give a little brief
overview to listeners of whatdialectical behavior therapy or
DBT is and how it's differentfrom other approaches in therapy
?
Speaker 2 (05:52):
Arta, I thought you would never ask.
I am happy to tell more aboutDBT and talk your ear off about
it.
I always tell people whenever Italk about DBT, I feel like I'm
doing some sort of consultation, because people ask oh, I don't
know what DBT is Like, tell memore.
Yeah, you know.
15 minutes later they're likeI'm in, I've invested, I want to
learn more.
(06:12):
So, yeah, it derives from CBT,which, for those who are
listening, may be familiar withcognitive behavioral therapy.
It initially, like I said, wascreated by Marsha Linehan around
40, 45 years ago.
However, it's been perfectedover the years, been revised,
there's been adaptations.
(06:33):
It was initially created forthe purpose of helping people
with borderline personalitydisorder, helping to treat
individuals with those symptoms,whether it's interpersonal
dysregulation, cognitivedysregulation, emotional, some
sort of dysregulation that comesup and happens throughout their
day-to-day life, and over theyears of perfecting the modality
(06:55):
and research, people have foundthat it has been helpful for
individuals also withdebilitating anxiety, extreme
depression, suicidal ideationand also many other mental
health concerns, including ADHD,substance use, disordered
(07:16):
eating.
There's I always say there'slike an A to Z in terms of
adaptations.
There's adaptations of DBT thatare just used widely for
individuals for these concernsand I will say just to give you
briefly, in a nutshell, what itactually is.
It is very much a treatmentthat helps equip individuals
(07:41):
with more adaptive copingstrategies and mechanisms and
provides the psychoeducationalaspect of this is why you behave
this way, this is why you thinkthis way, this is why you're
experiencing these, these urges,these reactive behaviors.
And going back to the skills,these are skills that you can
use.
So, and people always say youknow d, dbt it's the skills.
(08:05):
However, it's more than justthe skills.
It's the process of monitoringthose target behaviors, those
behaviors that individuals cometo therapy wanting to work on
minimizing.
It's making sure that they'reworking toward their long-term
goal.
And just to go briefly downthat rabbit hole of, again, what
(08:28):
is DBT?
There are five modes andfunctions in DBT and it's very
much individual therapy, skillsclass component, phone coaching,
consultation team and then DBTcase management, and I'll go
briefly through each one.
But individual therapy is verymuch where we work one-on-one
with the individual client andwe make sure that those target
(08:48):
behaviors that they came totherapy working to want to
minimize are being worked toward.
You know, people are putting inthe effort, they're utilizing
those skills, whether it's DBTskills, or maybe pulling in
adaptive skills that they'veused throughout their lives thus
far.
And pinpointing and this is animportant one pinpointing a
(09:09):
target or a specific life worthliving goal in DBT meaning this
ultimate goal that they want towork toward, what's bringing
them into therapy, what'smotivating them to make these
changes right now and right here?
So that's very much in anutshell what happens in
individual therapy.
We're going through this diarycard, which is where we list all
(09:32):
this information, includingalso if there's been any
emotional changes day to daythroughout the week, if that
individual has experienced urgesof any sort, if they're taking
their medication.
We monitor everything on thatentire diary card.
Then there's also the skillsclass component, which is where
we're going through the DBTmanual, the four specific
(09:55):
modules of mindfulness distresstolerance, interpersonal
effectiveness and emotionregulation.
We're going through the DBTmanual, the four specific
modules of mindfulness distresstolerance, interpersonal
effectiveness and emotionregulation.
We're going through these in aclass format, talking about
specific skills to help you copethrough specific situations.
If, say, someone's at a 10 outof 10 in terms of feeling that
level of dysregulation, maybeit's utilizing a distress
(10:17):
tolerance skill, Maybe it'sutilizing an emotion regulation
skill when they're at maybe asix or seven.
So that's in a nutshell againwhat happens in the skills class
component.
And I say skills class becauseit very much is a class
component, not a group, Eventhough people still say group.
However, there's not really aprocessing aspect to it.
(10:41):
It is very much we're goingover homework, we're
incorporating mindfulness, andthen we're going to delve into
didactics, the new content thatwe'll be learning.
So that's skills class, andthen phone coaching is actually
a great resource for clients touse that are getting into that
headspace of I need resourcesand I don't know what to do.
(11:02):
I'm at that 10 out of 10, whichyou may have worked with clients
that have been there right.
Speaker 1 (11:10):
Yeah.
Speaker 2 (11:11):
Yeah.
Speaker 1 (11:11):
I mean it happens, Real life happens.
There's a lot of life thathappens between sessions, right
so?
Speaker 2 (11:16):
Exactly, yeah, exactly.
And for me in DBT world theyhave that resource of okay, let
me text my therapist, let mereach out and I'm letting them
know.
I'm highly dysregulated.
I'm in this 10 out of 10 thatwe've talked about before in
sessions.
I'm not sure what to do and I'mhaving these urges, whether
it's self-harm, lashing out atmy roommate, throwing things,
(11:39):
getting angry and just acting onthat.
So we'll talk about that infilm coaching and, in a nutshell
, it is very much ensuringskills generalization in that
environment throughout theirday-to-day life, because we want
to make sure that the skillsthat they're learning are being
applied.
Speaker 1 (11:56):
Right.
Speaker 2 (11:56):
Yeah, so that's very much the film coaching aspect.
And before we get to the othertwo, I want to ask any questions
or how does this sound?
Yeah.
Speaker 1 (12:07):
Well, I love that.
Just to point out, it's veryempowering because I think
sometimes people we wonder Ihear this a lot, maybe you've
heard this a lot, and I thinkthe mental health crisis in the
United States points to thisthat sometimes, feeling like you
can access care or there's astigma around getting help, and
(12:31):
what I love about what you'resharing is you're not pointing
out anything like this is what'swrong with you.
This is an incrediblyempowering opportunity.
You're learning skills.
You are applying there'sinsight, it's it's self-directed
um in terms of being able tomonitor, to be able to feel
empowered.
And you've got your.
You've got your support system.
(12:52):
You you've got someone to turnto.
Uh, I just have to point thatout because I think that's
important to really highlight interms of this process and
specifically with the DBT rightA lot of mindfulness, a lot of
self-awareness and skills thatyou can apply in everyday life.
(13:13):
I think that's really importantto highlight and you know you
mentioned I love the A to Z interms of being able to apply
this to a lot of differentscenarios.
So, like for real quick, beforewe go into the other ones, if,
if there, if there is someonethat maybe is listening and
maybe regardless of whetherthey're facing mental health
(13:34):
challenges or not, can you sharean example of maybe like a DBT
skill?
I love that you even mentionedyou know a skill zero to 10,
where am I at Just being able tobe aware of how they're feeling
internally?
Can you share an example of aDBT skill that listeners could
start using today, even just toreally be in terms of their
emotional well-being?
Speaker 2 (13:56):
Definitely.
I'm glad you brought that up.
So there are also just backingup.
Tbt loves acronyms, so I willshare a skill.
It is in that acronym format.
The skill that I'm going toshare is from the distress
tolerance module, which we verymuch reserve for those 10 out of
10 situations in terms of I'mat my highest peak in terms of
(14:19):
distress and we also sometimescall these these emergency
skills.
So this skill itself it's theacronym is tip.
T-i-p-p stands for tip thetemperature.
For t I intense exercise, ppace breathing, and then second
(14:39):
P is paired muscle relaxation.
So there's two P's, t-i-p-p,and it very much is one of my
favorite skills, if not my mostfavorite, and one of the most
helpful for so many people outthere.
Even if you're not a DBT clientand this is what I love about
DBT DBT skills are they'reskills that anyone can use.
(15:03):
You don't have to be in thisdysregulated state, you don't
have to fulfill the BBT criteria.
These are skills that theaverage person can use when
they're noticing that they'rereaching their threshold for
getting emotions regulated.
So going back to TIP is verymuch again.
Starting off with that T is tipthe temperature.
(15:24):
So it first starts off withactivating the parasympathetic
nervous system with tipping thetemperature and these other ones
included in the acronym.
Sympathetic nervous system withtipping the temperature and
these other ones included in theacronym, however, with tip the
temperature.
What you want to do is and it'sgoing to sound strange for
people that are listening You'regoing to want to yeah, you're
(15:45):
going to grab a bowl of icewater and you're probably
thinking what are we doing here?
What is this therapy?
Speaker 1 (15:51):
Yeah, what's happening yeah?
Speaker 2 (15:53):
I love that.
Yeah, it's.
it sounds unorthodox and it verymuch is, and it works you're
grabbing a bowl of ice water andif you're familiar with the
dive reflex it's kind of similarto that.
Right before you know if you'veseen divers or if you've dived
yourself into um a body of water, you're right.
(16:14):
Before you touch the water,your body goes completely calm,
it goes relaxed.
So that's what we're trying toactivate and the cold water
itself helps.
So it's not only the positionthat we're putting our face into
the cold water that activatesthis parasympathetic nervous
system and signals to our brainthat we are wanting to calm our
(16:34):
body down physiologically,signals to our brain that we are
wanting to calm our body downphysiologically.
However, it's also the coldwater that activates that as
well.
I always think back to somepeople right before they go to
sleep at night.
They want to make sure that thethermostat is set to a really
low temperature because peopleenjoy sleeping in colder
temperatures.
You can't sleep when it'sreally hot or stuffy in a room.
(16:55):
People enjoy that.
It activates that calmness intheir body, that parasympathetic
nervous system.
So that's what very muchtipping the temperature does.
Speaker 1 (17:03):
Interesting yeah.
I have seen people do that forpurposes of maybe vanity for
their skin too.
So maybe that's like a doublebenefit.
Speaker 2 (17:17):
No, I'm glad you brought that up, Marta, because
it does help your skin as well,which is funny, it doesn't hurt,
it could only be, good, yeah,but there is a lot just in terms
of the nervous system andtemperature just being able to
activate.
Speaker 1 (17:31):
What an easy thing that you can do in your own home
.
Just grab that bowl of ice andyou're right.
Even in the hospital when youhave a baby, I'm thinking I'm a
mom, right.
So they tell you, like, set thetemperature super, like it's 65
or something is the idealtemperature for a baby.
You know to how we're wiredright to have a cooler
(17:51):
temperature as being helpful forus, for sleep, for calm.
Speaker 2 (17:56):
So that's awesome?
No, it's, it's incredible.
And even if you don't have thatresource a bowl of water you
know, I've had phone coachingcalls where I asked someone what
you're supposed to do on phonecoaching calls is, first of all,
where are you physically, whatare the resources you have in
your environment?
Yeah, and I've heard stories ofpeople telling me that there
(18:18):
was someone they're working with.
They were driving on the highwayand they were experiencing this
dysregulated state and thetherapist hopped on the call
with them and they said you knowwhat?
What did you?
What are you doing right now?
Where are you?
What do you?
What do you have in yourresources?
They said I'm on the highway.
I don't have any resources.
I'm in my car.
And the therapist pushed backand they said well, okay, look
(18:39):
around, what do you have in yourcar?
And they said I see a waterbottle.
So and you might be thinking, Iknow where you're going with
this and they use the water toactivate T and tip tip of the
temperature.
They T and tip tip of thetemperature.
They decided to face their headdown and pour water all over
their face just to even activateit a little bit, to deregulate
them or deescalate the situation.
(19:01):
Bring them back to thatregulated state.
Speaker 1 (19:03):
Yes.
Speaker 2 (19:04):
Yeah.
Speaker 1 (19:05):
Yeah, that's wonderful.
Yeah, just being able to usethe resources.
I'm sure I was thinking like ifyou're at the airport or
wherever you are, you can accesslike that cold water bottle or
what.
What?
Yeah, that's exactly yeah,incredibly empowering.
Speaker 2 (19:19):
Okay, so that's the tea and tip, yeah yes, yes,
that's the tea and tip, and I'llgo into a little bit in terms
of ipp.
However, intense exercise alsoyou doing jumping jacks, doing
pushups that also does similarlywith tip, does you know?
It activates that part of yourbody.
(19:40):
And then pace breathing is it'sdoing similarly, tip it's, you
know, calming your internalsystem.
And pace breathing, I will say,with paired muscle relaxation
is also helpful, you know, doingboth at the same time, even
even if you can do one withoutthe other.
However, together I find thempersonally more helpful where
(20:04):
you're breathing in, maybebreathing in for five seconds
and then breathing out for sevenand just having your your
in-breath shorter than yourout-breath.
Yes, and then paired musclerelaxation in terms of clenching
your fists, like these, andthen releasing when you're doing
(20:25):
your out-breath, so it's it'shelpful yeah, that's awesome.
Speaker 1 (20:31):
Yeah, I could see how that's so beneficial Really
bringing in.
I love that there's acronyms,so you have an easy way to
remember, I am not a DBTspecialist.
I've done some training in itand really like more
mindfulness-based stressreduction.
There's a lot of overlap oftools, but those things that you
mentioned I mean incrediblyempowering and I think that's
(20:54):
the key and I have thisdisclaimer on the podcast right,
like this is not, this is notmedical advice for you.
Like, if you think this issomething that you could benefit
from, you know, talking to atherapist for your specific
recommendations and there's an,you know, like you know Leo
mentioned, there's a processright of education and meeting
(21:15):
individually, but just havingthose tools and knowing that
they're out there and thingsthat you could do everyday life,
I mean for your nervous system,because we are very wired to be
active and in flight or fight,just the way the world is.
So it's wonderful that thereare these tools available to us.
Speaker 2 (21:35):
It's so true.
And I want to get to the nextquestion and I want to tell you
about the last two components,because I think we took a little
break.
Yeah, and it's a lot.
So, like I said, every time Ibring this up in console with a
potential client, they're like,wow, there's so much, this
sounds amazing and they need itall.
(22:00):
So, yeah, so we talked aboutindividual, we talked about
skills group, we talked aboutphone coaching.
Yeah, exactly, the last two arevery much DBT, case management,
which, in a nutshell again, iswanting to get in touch with
other providers on theindividual's care team to
provide collaborative care.
We want to know what thepsychiatrist knows, what your
nutritionist knows, what yourneurologist knows, et cetera.
We want to get in touch withall the providers and, similarly
(22:24):
, they want to know what we know, what we're discussing.
If for instance if there isself-harming behavior or if
you've disclosed something toanother provider and of having a
suicidal thought or, you know,taking certain medication.
Even you know it's wanting tohave that collaborative process.
So that's very much DVT casemanagement.
(22:45):
And then there's I love thatbecause mental health and
physical health.
Speaker 1 (22:48):
I mean you, you, you there's such an overlap and the
collaborative approach is so key, just for integrated health.
I there's such an overlap andthe collaborative approach is so
key, just for integrated health.
I love that.
Speaker 2 (22:57):
Exactly, and I'm sure , even being a therapist
yourself, you know you'rewanting to get in touch with
other providers.
Speaker 1 (23:03):
Absolutely, absolutely, yeah.
What's going on with blood workmedication?
Yes, exactly.
Speaker 2 (23:10):
Exactly.
It's funny that they eveninclude this because it's like,
well, this should go withoutsaying that you know, you'd want
to know what's happening, yes,in other realms yes um, but yeah
, that's very much thatcomponent.
And then there is the last oneconsultation teams, consultation
teams, it for us at thepractice I work at, which is the
(23:31):
counseling center groupno-transcript what can we do to
(24:03):
improve this?
And it's improving motivationfor the clinicians.
They feel as though, okay, Iknow what I need to do in order
to move forward with this client.
Now you know what I need to doto make this progress yeah, yeah
, no, that's wonderful.
Speaker 1 (24:19):
And how could people get in touch with you?
So where, where do you seeclients?
You mentioned the group.
I'm curious how can people getin touch with you and, um, where
, where are you licensed so youcan see, or where do you which
clients out of what states andwhere do you work with?
Speaker 2 (24:34):
great question.
So I am licensed in new york,new jersey and maryland and,
yeah, I'm providing virtualtelehealth therapy, and then
also in person in midtown,midtown Manhattan, right next to
Grand Central, actually.
Speaker 1 (24:51):
Okay, wonderful, wonderful In terms of just
anyone out there who has beenthinking about seeking out some
help.
Maybe they're not in thosestates, but they are thinking
about seeking out help, andmaybe in DBT and I know there's.
I feel like I have so many morequestions to ask.
(25:12):
So I love that the passion isthere and I I think this is a
really important topic.
I think that's why I had somany questions and I think
there's so much value that youcan offer people and I'm just
grateful that you shared yourinsight with with us today.
It's like making you're makingan impact on many clients and
just in this recording too.
So I'm so grateful.
If someone were thinking aboutgetting help, like what, what,
(25:34):
what, what would you share tothem?
Cause I see you took a leap offaith in terms of diving into a
mental health field, changingcourse, and I don't know any
kind of just words of insight,just in terms of encouragement
for seeking that support.
Speaker 2 (25:48):
Definitely, definitely.
So, yeah, I mean, I, I verymuch.
I work with the LGBTQ community, I work with the neurodivergent
population and so, with thatbeing said, I think that if
you're wanting to seek mentalhealth help right now, my advice
is to find someone that you'reable to be open with, able to
(26:10):
experience that vulnerabilitywith, able to be open with, able
to experience thatvulnerability with, because that
I think it starts with that forme at least, that's my belief
is that it starts very much withthat you know that spark and
then turning that spark intosomething else in terms of
rapport, and then opening up andwanting to make progress,
wanting to challenge yourselfand grow, and you know work
toward the specific goals.
Speaker 1 (26:32):
Yeah, yeah, I love that you highlight that.
Thank you so much, leo, forjoining us and for being a part
of our wellness journey.
Speaker 2 (26:40):
Of course.
Thank you, Marta, for having me.
Welcome, friends, to the Telewellness Hub podcast, a
space where listening is notjust a simple passive act.
It's an act of self-care.
I'm Marta Hamilton, your host,and today you are getting to
hear directly from Leo Massey.
Leo is an LGTBQ plus affirmingand identifying male therapist
who is comprehensively trainedin DBT, emdr and utilizes CBT,
(00:24):
act and exposure therapy.
He helps individuals facingchallenges around anxiety,
depression, borderlinepersonality disorder, gender
dysphoria, trauma, ptsd,self-confidence, adhd,
antisemitism and autism spectrumdisorder.
Welcome, leo, thank you so muchfor joining us today.
Speaker 2 (00:45):
Of course.
Thank you so much, Marta, forhaving me on this podcast.
I appreciate it.
Speaker 1 (00:50):
I'm very excited.
You know, I randomly approachedLeo on social media in a
message.
I was just really intrigued andI just really was drawn to the
content that Leo was sharingwith others and before hitting
record, I talked about.
(01:10):
You know, sometimes the worldcan feel very overwhelming.
I think right now there's a lotgoing on.
I'm sure there's often a lotgoing on and to be scrolling on
social media and see somethingthat really speaks to the light
of the world, like Leo, justseemed like a light was sharing,
just sharing really helpful,inspiring insight for others.
(01:36):
And I thought you know what Iwant to talk to this person and
get to record and share with theworld so that hopefully, this
can be a light and just reallyamplify all the work that Leo's
doing with clients, so thatpeople can get an inside look of
what that might look like forthemselves in terms of seeking
therapy and working with atherapist like Leo.
So thank you so much forjoining and before we get
(02:00):
started into some questions I'dlove for you to share with us
why do you do the wellness workthat you do?
Speaker 2 (02:07):
Yeah, so a little bit of background.
I actually used to work inentertainment, so I was in the
entertainment industry,filmmaking industry and
specifically, yeah, so I wasactually working at talent
agencies, talent managementcompanies, and I realized when
working in that industry inHollywood, there were a lot of
people.
I was actually working attalent agencies, talent
management companies, and Irealized when working in that
(02:28):
industry in Hollywood, therewere a lot of people I was
coming face to face with that Irecognized needed certain mental
health assistance, neededmental health help, whether it
was substance use, depression,debilitating anxiety, anger
management or even just suicidalideation, especially working in
(02:48):
that field with very intensehours and restraints, and it
just gets to people.
So I think it was one day, if Irecall correctly, that I was
actually speaking with a um, anactor, and we were talking about
they just got back from war,they were a veteran and they
(03:12):
were telling me more about theirptsd and what they were
experiencing.
And I remember actually wantingto talk more with them about
that subject matter rather thantrying to help them get this
next big role on some TV show ormovie.
Oh, wow, so I was realizing I'mmuch more interested in this
and flash forward.
(03:34):
You know I made then the careerpivot from entertainment to the
mental health field.
You know I applied to ColumbiaSchool of Social Work, got in
and then I applied to the DBTprogram, which we'll get into a
little bit, is dialecticalbehavior therapy, and I remember
actually being in entertainment.
I was going down a rabbit holelooking into just different
(03:58):
modalities, different therapythat people utilize, and I came
across DBT and then more googledit.
You know I looked up thefounder, creator, marshall
Linehan, and how it pulls fromcbt, and then I saw celebrities
that have utilized it, like PeteDavidson, zina Gomez, and I was
(04:20):
like wow, this, this modality,is just part of this really big
third wave and it's makingsplashes and people are really
enjoying the skills that comewith it, which, again, we'll get
a little bit into.
But yeah, so that's how I gotinto it.
Speaker 1 (04:35):
Wow, you know, you don't typically hear that path
in terms of entering mentalhealth from the entertainment
world, but that's so fascinating.
I can see how.
I think it's interesting.
You pointed out thatconversation where you wanted to
explore more about thatperson's you know mental health
journey and how that really justcatapulted.
(04:55):
You just never know in aconversation with someone what
kind of an impact it really has,and I think that's what's so
special about our field thathuman connection element.
I think it's just incredible.
I you know you're mentioningDBT and you know researching it
and the modality and as atherapist myself, it is a really
specialized field and training.
(05:17):
So I think if you're interestedin DBT, you're listening,
you're interested in DBT andwe'll talk a little bit about
what that is.
Definitely finding a therapistwho has background in training
and like passion, like Leo, forthis field right, they're
researching, they're training,they're diving into it because
(05:38):
it is really a specializedapproach approach.
So if you don't mind sharing,can you give a little brief
overview to listeners of whatdialectical behavior therapy or
DBT is and how it's differentfrom other approaches in therapy
?
Speaker 2 (05:52):
Arta, I thought you would never ask.
I am happy to tell more aboutDBT and talk your ear off about
it.
I always tell people whenever Italk about DBT, I feel like I'm
doing some sort of consultation, because people ask oh, I don't
know what DBT is Like, tell memore.
Yeah, you know.
15 minutes later they're likeI'm in, I've invested, I want to
learn more.
(06:12):
So, yeah, it derives from CBT,which, for those who are
listening, may be familiar withcognitive behavioral therapy.
It initially, like I said, wascreated by Marsha Linehan around
40, 45 years ago.
However, it's been perfectedover the years, been revised,
there's been adaptations.
(06:33):
It was initially created forthe purpose of helping people
with borderline personalitydisorder, helping to treat
individuals with those symptoms,whether it's interpersonal
dysregulation, cognitivedysregulation, emotional, some
sort of dysregulation that comesup and happens throughout their
day-to-day life, and over theyears of perfecting the modality
(06:55):
and research, people have foundthat it has been helpful for
individuals also withdebilitating anxiety, extreme
depression, suicidal ideationand also many other mental
health concerns, including ADHD,substance use, disordered
(07:16):
eating.
There's I always say there'slike an A to Z in terms of
adaptations.
There's adaptations of DBT thatare just used widely for
individuals for these concernsand I will say just to give you
briefly, in a nutshell, what itactually is.
It is very much a treatmentthat helps equip individuals
(07:41):
with more adaptive copingstrategies and mechanisms and
provides the psychoeducationalaspect of this is why you behave
this way, this is why you thinkthis way, this is why you're
experiencing these, these urges,these reactive behaviors.
And going back to the skills,these are skills that you can
use.
So, and people always say youknow d, dbt it's the skills.
(08:05):
However, it's more than justthe skills.
It's the process of monitoringthose target behaviors, those
behaviors that individuals cometo therapy wanting to work on
minimizing.
It's making sure that they'reworking toward their long-term
goal.
And just to go briefly downthat rabbit hole of, again, what
(08:28):
is DBT?
There are five modes andfunctions in DBT and it's very
much individual therapy, skillsclass component, phone coaching,
consultation team and then DBTcase management, and I'll go
briefly through each one.
But individual therapy is verymuch where we work one-on-one
with the individual client andwe make sure that those target
(08:48):
behaviors that they came totherapy working to want to
minimize are being worked toward.
You know, people are putting inthe effort, they're utilizing
those skills, whether it's DBTskills, or maybe pulling in
adaptive skills that they'veused throughout their lives thus
far.
And pinpointing and this is animportant one pinpointing a
(09:09):
target or a specific life worthliving goal in DBT meaning this
ultimate goal that they want towork toward, what's bringing
them into therapy, what'smotivating them to make these
changes right now and right here?
So that's very much in anutshell what happens in
individual therapy.
We're going through this diarycard, which is where we list all
(09:32):
this information, includingalso if there's been any
emotional changes day to daythroughout the week, if that
individual has experienced urgesof any sort, if they're taking
their medication.
We monitor everything on thatentire diary card.
Then there's also the skillsclass component, which is where
we're going through the DBTmanual, the four specific
(09:55):
modules of mindfulness distresstolerance, interpersonal
effectiveness and emotionregulation.
We're going through the DBTmanual, the four specific
modules of mindfulness distresstolerance, interpersonal
effectiveness and emotionregulation.
We're going through these in aclass format, talking about
specific skills to help you copethrough specific situations.
If, say, someone's at a 10 outof 10 in terms of feeling that
level of dysregulation, maybeit's utilizing a distress
(10:17):
tolerance skill, Maybe it'sutilizing an emotion regulation
skill when they're at maybe asix or seven.
So that's in a nutshell againwhat happens in the skills class
component.
And I say skills class becauseit very much is a class
component, not a group, Eventhough people still say group.
However, there's not really aprocessing aspect to it.
(10:41):
It is very much we're goingover homework, we're
incorporating mindfulness, andthen we're going to delve into
didactics, the new content thatwe'll be learning.
So that's skills class, andthen phone coaching is actually
a great resource for clients touse that are getting into that
headspace of I need resourcesand I don't know what to do.
(11:02):
I'm at that 10 out of 10, whichyou may have worked with clients
that have been there right.
Speaker 1 (11:10):
Yeah.
Speaker 2 (11:11):
Yeah.
Speaker 1 (11:11):
I mean it happens, Real life happens.
There's a lot of life thathappens between sessions, right
so?
Speaker 2 (11:16):
Exactly, yeah, exactly.
And for me in DBT world theyhave that resource of okay, let
me text my therapist, let mereach out and I'm letting them
know.
I'm highly dysregulated.
I'm in this 10 out of 10 thatwe've talked about before in
sessions.
I'm not sure what to do and I'mhaving these urges, whether
it's self-harm, lashing out atmy roommate, throwing things,
(11:39):
getting angry and just acting onthat.
So we'll talk about that infilm coaching and, in a nutshell
, it is very much ensuringskills generalization in that
environment throughout theirday-to-day life, because we want
to make sure that the skillsthat they're learning are being
applied.
Speaker 1 (11:56):
Right.
Speaker 2 (11:56):
Yeah, so that's very much the film coaching aspect.
And before we get to the othertwo, I want to ask any questions
or how does this sound?
Yeah.
Speaker 1 (12:07):
Well, I love that.
Just to point out, it's veryempowering because I think
sometimes people we wonder Ihear this a lot, maybe you've
heard this a lot, and I thinkthe mental health crisis in the
United States points to thisthat sometimes, feeling like you
can access care or there's astigma around getting help, and
(12:31):
what I love about what you'resharing is you're not pointing
out anything like this is what'swrong with you.
This is an incrediblyempowering opportunity.
You're learning skills.
You are applying there'sinsight, it's it's self-directed
um in terms of being able tomonitor, to be able to feel
empowered.
And you've got your.
You've got your support system.
(12:52):
You you've got someone to turnto.
Uh, I just have to point thatout because I think that's
important to really highlight interms of this process and
specifically with the DBT rightA lot of mindfulness, a lot of
self-awareness and skills thatyou can apply in everyday life.
(13:13):
I think that's really importantto highlight and you know you
mentioned I love the A to Z interms of being able to apply
this to a lot of differentscenarios.
So, like for real quick, beforewe go into the other ones, if,
if there, if there is someonethat maybe is listening and
maybe regardless of whetherthey're facing mental health
(13:34):
challenges or not, can you sharean example of maybe like a DBT
skill?
I love that you even mentionedyou know a skill zero to 10,
where am I at Just being able tobe aware of how they're feeling
internally?
Can you share an example of aDBT skill that listeners could
start using today, even just toreally be in terms of their
emotional well-being?
Speaker 2 (13:56):
Definitely.
I'm glad you brought that up.
So there are also just backingup.
Tbt loves acronyms, so I willshare a skill.
It is in that acronym format.
The skill that I'm going toshare is from the distress
tolerance module, which we verymuch reserve for those 10 out of
10 situations in terms of I'mat my highest peak in terms of
(14:19):
distress and we also sometimescall these these emergency
skills.
So this skill itself it's theacronym is tip.
T-i-p-p stands for tip thetemperature.
For t I intense exercise, ppace breathing, and then second
(14:39):
P is paired muscle relaxation.
So there's two P's, t-i-p-p,and it very much is one of my
favorite skills, if not my mostfavorite, and one of the most
helpful for so many people outthere.
Even if you're not a DBT clientand this is what I love about
DBT DBT skills are they'reskills that anyone can use.
(15:03):
You don't have to be in thisdysregulated state, you don't
have to fulfill the BBT criteria.
These are skills that theaverage person can use when
they're noticing that they'rereaching their threshold for
getting emotions regulated.
So going back to TIP is verymuch again.
Starting off with that T is tipthe temperature.
(15:24):
So it first starts off withactivating the parasympathetic
nervous system with tipping thetemperature and these other ones
included in the acronym.
Sympathetic nervous system withtipping the temperature and
these other ones included in theacronym, however, with tip the
temperature.
What you want to do is and it'sgoing to sound strange for
people that are listening You'regoing to want to yeah, you're
(15:45):
going to grab a bowl of icewater and you're probably
thinking what are we doing here?
What is this therapy?
Speaker 1 (15:51):
Yeah, what's happening yeah?
Speaker 2 (15:53):
I love that.
Yeah, it's.
it sounds unorthodox and it verymuch is, and it works you're
grabbing a bowl of ice water andif you're familiar with the
dive reflex it's kind of similarto that.
Right before you know if you'veseen divers or if you've dived
yourself into um a body of water, you're right.
(16:14):
Before you touch the water,your body goes completely calm,
it goes relaxed.
So that's what we're trying toactivate and the cold water
itself helps.
So it's not only the positionthat we're putting our face into
the cold water that activatesthis parasympathetic nervous
system and signals to our brainthat we are wanting to calm our
(16:34):
body down physiologically,signals to our brain that we are
wanting to calm our body downphysiologically.
However, it's also the coldwater that activates that as
well.
I always think back to somepeople right before they go to
sleep at night.
They want to make sure that thethermostat is set to a really
low temperature because peopleenjoy sleeping in colder
temperatures.
You can't sleep when it'sreally hot or stuffy in a room.
(16:55):
People enjoy that.
It activates that calmness intheir body, that parasympathetic
nervous system.
So that's what very muchtipping the temperature does.
Speaker 1 (17:03):
Interesting yeah.
I have seen people do that forpurposes of maybe vanity for
their skin too.
So maybe that's like a doublebenefit.
Speaker 2 (17:17):
No, I'm glad you brought that up, Marta, because
it does help your skin as well,which is funny, it doesn't hurt,
it could only be, good, yeah,but there is a lot just in terms
of the nervous system andtemperature just being able to
activate.
Speaker 1 (17:31):
What an easy thing that you can do in your own home
.
Just grab that bowl of ice andyou're right.
Even in the hospital when youhave a baby, I'm thinking I'm a
mom, right.
So they tell you, like, set thetemperature super, like it's 65
or something is the idealtemperature for a baby.
You know to how we're wiredright to have a cooler
(17:51):
temperature as being helpful forus, for sleep, for calm.
Speaker 2 (17:56):
So that's awesome?
No, it's, it's incredible.
And even if you don't have thatresource a bowl of water you
know, I've had phone coachingcalls where I asked someone what
you're supposed to do on phonecoaching calls is, first of all,
where are you physically, whatare the resources you have in
your environment?
Yeah, and I've heard stories ofpeople telling me that there
(18:18):
was someone they're working with.
They were driving on the highwayand they were experiencing this
dysregulated state and thetherapist hopped on the call
with them and they said you knowwhat?
What did you?
What are you doing right now?
Where are you?
What do you?
What do you have in yourresources?
They said I'm on the highway.
I don't have any resources.
I'm in my car.
And the therapist pushed backand they said well, okay, look
(18:39):
around, what do you have in yourcar?
And they said I see a waterbottle.
So and you might be thinking, Iknow where you're going with
this and they use the water toactivate T and tip tip of the
temperature.
They T and tip tip of thetemperature.
They decided to face their headdown and pour water all over
their face just to even activateit a little bit, to deregulate
them or deescalate the situation.
(19:01):
Bring them back to thatregulated state.
Speaker 1 (19:03):
Yes.
Speaker 2 (19:04):
Yeah.
Speaker 1 (19:05):
Yeah, that's wonderful.
Yeah, just being able to usethe resources.
I'm sure I was thinking like ifyou're at the airport or
wherever you are, you can accesslike that cold water bottle or
what.
What?
Yeah, that's exactly yeah,incredibly empowering.
Speaker 2 (19:19):
Okay, so that's the tea and tip, yeah yes, yes,
that's the tea and tip, and I'llgo into a little bit in terms
of ipp.
However, intense exercise alsoyou doing jumping jacks, doing
pushups that also does similarlywith tip, does you know?
It activates that part of yourbody.
(19:40):
And then pace breathing is it'sdoing similarly, tip it's, you
know, calming your internalsystem.
And pace breathing, I will say,with paired muscle relaxation
is also helpful, you know, doingboth at the same time, even
even if you can do one withoutthe other.
However, together I find thempersonally more helpful where
(20:04):
you're breathing in, maybebreathing in for five seconds
and then breathing out for sevenand just having your your
in-breath shorter than yourout-breath.
Yes, and then paired musclerelaxation in terms of clenching
your fists, like these, andthen releasing when you're doing
(20:25):
your out-breath, so it's it'shelpful yeah, that's awesome.
Speaker 1 (20:31):
Yeah, I could see how that's so beneficial Really
bringing in.
I love that there's acronyms,so you have an easy way to
remember, I am not a DBTspecialist.
I've done some training in itand really like more
mindfulness-based stressreduction.
There's a lot of overlap oftools, but those things that you
mentioned I mean incrediblyempowering and I think that's
(20:54):
the key and I have thisdisclaimer on the podcast right,
like this is not, this is notmedical advice for you.
Like, if you think this issomething that you could benefit
from, you know, talking to atherapist for your specific
recommendations and there's an,you know, like you know Leo
mentioned, there's a processright of education and meeting
(21:15):
individually, but just havingthose tools and knowing that
they're out there and thingsthat you could do everyday life,
I mean for your nervous system,because we are very wired to be
active and in flight or fight,just the way the world is.
So it's wonderful that thereare these tools available to us.
Speaker 2 (21:35):
It's so true.
And I want to get to the nextquestion and I want to tell you
about the last two components,because I think we took a little
break.
Yeah, and it's a lot.
So, like I said, every time Ibring this up in console with a
potential client, they're like,wow, there's so much, this
sounds amazing and they need itall.
(22:00):
So, yeah, so we talked aboutindividual, we talked about
skills group, we talked aboutphone coaching.
Yeah, exactly, the last two arevery much DBT, case management,
which, in a nutshell again, iswanting to get in touch with
other providers on theindividual's care team to
provide collaborative care.
We want to know what thepsychiatrist knows, what your
nutritionist knows, what yourneurologist knows, et cetera.
We want to get in touch withall the providers and, similarly
(22:24):
, they want to know what we know, what we're discussing.
If for instance if there isself-harming behavior or if
you've disclosed something toanother provider and of having a
suicidal thought or, you know,taking certain medication.
Even you know it's wanting tohave that collaborative process.
So that's very much DVT casemanagement.
(22:45):
And then there's I love thatbecause mental health and
physical health.
Speaker 1 (22:48):
I mean you, you, you there's such an overlap and the
collaborative approach is so key, just for integrated health.
I there's such an overlap andthe collaborative approach is so
key, just for integrated health.
I love that.
Speaker 2 (22:57):
Exactly, and I'm sure , even being a therapist
yourself, you know you'rewanting to get in touch with
other providers.
Speaker 1 (23:03):
Absolutely, absolutely, yeah.
What's going on with blood workmedication?
Yes, exactly.
Speaker 2 (23:10):
Exactly.
It's funny that they eveninclude this because it's like,
well, this should go withoutsaying that you know, you'd want
to know what's happening, yes,in other realms yes um, but yeah
, that's very much thatcomponent.
And then there is the last oneconsultation teams, consultation
teams, it for us at thepractice I work at, which is the
(23:31):
counseling center groupno-transcript what can we do to
(24:03):
improve this?
And it's improving motivationfor the clinicians.
They feel as though, okay, Iknow what I need to do in order
to move forward with this client.
Now you know what I need to doto make this progress yeah, yeah
, no, that's wonderful.
Speaker 1 (24:19):
And how could people get in touch with you?
So where, where do you seeclients?
You mentioned the group.
I'm curious how can people getin touch with you and, um, where
, where are you licensed so youcan see, or where do you which
clients out of what states andwhere do you work with?
Speaker 2 (24:34):
great question.
So I am licensed in new york,new jersey and maryland and,
yeah, I'm providing virtualtelehealth therapy, and then
also in person in midtown,midtown Manhattan, right next to
Grand Central, actually.
Speaker 1 (24:51):
Okay, wonderful, wonderful In terms of just
anyone out there who has beenthinking about seeking out some
help.
Maybe they're not in thosestates, but they are thinking
about seeking out help, andmaybe in DBT and I know there's.
I feel like I have so many morequestions to ask.
(25:12):
So I love that the passion isthere and I I think this is a
really important topic.
I think that's why I had somany questions and I think
there's so much value that youcan offer people and I'm just
grateful that you shared yourinsight with with us today.
It's like making you're makingan impact on many clients and
just in this recording too.
So I'm so grateful.
If someone were thinking aboutgetting help, like what, what,
(25:34):
what, what would you share tothem?
Cause I see you took a leap offaith in terms of diving into a
mental health field, changingcourse, and I don't know any
kind of just words of insight,just in terms of encouragement
for seeking that support.
Speaker 2 (25:48):
Definitely, definitely.
So, yeah, I mean, I, I verymuch.
I work with the LGBTQ community, I work with the neurodivergent
population and so, with thatbeing said, I think that if
you're wanting to seek mentalhealth help right now, my advice
is to find someone that you'reable to be open with, able to
(26:10):
experience that vulnerabilitywith, able to be open with, able
to experience thatvulnerability with, because that
I think it starts with that forme at least, that's my belief
is that it starts very much withthat you know that spark and
then turning that spark intosomething else in terms of
rapport, and then opening up andwanting to make progress,
wanting to challenge yourselfand grow, and you know work
toward the specific goals.
Speaker 1 (26:32):
Yeah, yeah, I love that you highlight that.
Thank you so much, leo, forjoining us and for being a part
of our wellness journey.
Speaker 2 (26:40):
Of course.
Thank you, Marta, for having me.
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