MERRY LOSING YOUR MARBLES

Shanthini Naidoo looks at how to handle the holidays in your head

IS the season to have a meltdown, but don’t think you are alone in feeling the pressure of the festivities. Emotionally, the festive season is one of the most stressful times of the year, particularly if you have a mental illness.

Clinical psychologist Daniel Rabinowitz says “dialectical behaviour therapy” is one way of trying to deal with mental illnesses such as bipolar mood disorder, depression, anxiety and general life stresses, any of which may contribute to suicidal tendencies.

While it is necessary to see a mental health professional for an accurate diagnosis, anyone who finds themselves feeling emotionally debilitated may benefit from the therapy.

“Dialectical behaviour therapy is an evidenced-based, group psychotherapeutic approach, developed for those patients who experience intense emotions. The therapy helps patients to return to baseline arousal levels,” says Rabinowitz.

He says high emotional arousal can be powerful and dangerous, both for ourselves and for others.

“States of arousal can be positive and negative and include fear, anger, curiosity and love, which are felt with an overpowering intensity that drives us to act, often in an unthinking way.”

Triggers for this can be experienced through the senses — for example, the touch of a caress or a slap; the sight of something shocking; a sudden noise or something that someone says; or an odour, pleasant or unpleasant.

Rabinowitz conducts two-hour group therapy sessions.

“One hour is dedicated to the processing of feelings; the other hour incorporates a skills component, which includes mindfulness training and methods of regulating of emotions.

“The dialectical behaviour therapy sessions emphasise problem-solving behaviour for troubles that arose in the group members’ lives between sessions. The emphasis is on teaching patients how to manage extremes of emotion rather than reducing or taking them out of crises,” Rabinowitz says.

He says dialectical behaviour therapy was originally developed by Marsha Linehan, a therapist at the University of Washington, to treat people with borderline personality disorder, a longterm pattern of abnormal behaviour characterised by unstable relationships, an unstable sense of self and unstable emotions.

“It was the first psychotherapy shown through controlled trials to be effective with this disorder. But since then, multiple clinical trials have been conducted demonstrating its effectiveness not only for borderline personality disorder, but also for a wide range of other disorders and problems, including both under-control and over-control of emotions,” says Rabinowitz.

He says the skills training is a promising intervention for those who suffer mental health problems — and those who do not.

Four sets of behavioural skills that are taught:

Mindfulness, the practice of being fully aware and present in this one moment;

Distress tolerance, or how to tolerate pain in difficult situations, not change it;

Interpersonal effectiveness, or how to ask for what you want and say “no” while maintaining self-respect and relationships with others; and

Emotion regulation, or how to change emotions that you want to change.

“By understanding the process by which people become aroused, you can gain control of whether and how arousal happens,” Rabinowitz says.

“The first place to start with this is yourself. If you become emotionally aroused, then you are losing some control. This is often not a good thing, so learning self-control can be a critical skill.”

Cape Behavioural Therapists offer group dialectical behaviour therapy sessions; contact Tertia van Rensburg on 021 433 1721. The South African Anxiety and Depression Group can also recommend therapists, www.sadag.org