Meeting Karyn Hall and a Mindfulness Activity: Observe and Describe Your Thoughts

Karyn Hall is one of the most talented psychologists I have ever met.  Her practice, the DBT Center- Houston, provides clients with options for comprehensive treatment teams with psychiatrists and DBT therapists.  Her books about validation and mindfulness activities are available on Amazon; click here to see "The Power of Validation" by Karyn Hall and Melissa Cook and click here for "Mindfulness Exercises" edited by Karyn Hall.

Karyn will call a spade a spade in an irreverent, non-judgmental way.  In the training exercises, she was dramatic in the role plays and captured the emotions presented in the dialogue.  With her, there are always teachable moments for reflection and new concepts to incorporate into schema about the therapeutic processes in DBT.  Her expertise in validation was evident, and, by the end of the activity, she had reached all of the levels of validation. 

 

She weaved mindfulness skills into the conversation, while teaching the DBT skills and explaining them in a clear, behaviorally-specific way. 


During the first training session at the Menninger Clinic, Karyn led one of my favorite mindfulness activities: Observe and Describe Your Thoughts.  DBT has a specific language that you adopt as you learn the skills and treatment protocols.  The What and How skills of Core Mindfulness are a good place to start. 

 

Mindfulness is about paying specific attention in a particular way on purpose. 

 

In Observe, you are directed just to notice your thoughts without attaching words, judgments, or preferences, as though you're watching waves come and go at the beach.  A wave is a wave. 

 

In Describe, you attach words to your thoughts. 


This is a place for the How Skills of Core Mindfulness. 


Shari Manning's explanation started in the heart of English grammar. 

• The What Skills (Observe, Describe, and Participate) are the verbs. 
• The How Skills (Non-judgmentally, One-Mindfully, and Effectively) are the adverbs.   

Adverbs are connected to verbs, in that adverbs provide context or thorough descriptions to show time, manner, place or degree.  
 

 The wonderful aspect about the Core Mindfulness skills is that you learn something new about yourself, your client, and your world outside your office. 

Factors to Consider in Finding a DBT Treatment Center

A parent may ask, “In doing research online, I’ve seen and heard about cognitive behavioral therapy. What is the difference?”  Dialectical behavior therapy began as a cognitive behavioral therapy that soon added dialectics and validation.  CBT principles are used to target suicidal and other problem behaviors.  However, the unique foci of DBT are on dialectics, validation, and the dialectic of acceptance-oriented and change-oriented skills and strategies (Manning & TIC, 2013). 

In looking at selecting a treatment center for the individual, be sure to ask the center if their clinicians are members of a DBT consultation team who have attended the Core Clinical Training© in DBT, use diary cards in sessions to monitor behavioral changes over time, and follow the processes in Linehan’s treatment manuals (1993a; 1993b).  

There are inpatient and outpatient options in Houston, Texas.  The Menninger Clinic uses a combination of clinical approaches, including mentalization-based treatment (MBT) and DBT.  The Dialectical Behavior Therapy Center offers outpatient treatment with an intensive outpatient program (IOP) with skills groups and individual therapy with a DBT therapist, skills groups that meet each week, individual therapy, and medication management with board certified psychiatrists.  There are treatment sites in other locations across the U.S. and Canada.  There are often waiting lists to join a DBT program. 

In DBT, individual therapists focus on targeting specific behaviors that the client has agreed to work on changing, as arranged in the following hierarchy: life-threatening behaviors, therapy-interfering behaviors, and quality of life behaviors.  “You only get what you target. . . and what changes is what you work on” (Manning & TIC, 2013).  In adolescents with borderline personality disorder, common behavioral targets include: cutting, intentional overdosing, suicidal ideation, driving over the speed limit, purging, and restricting.  Consider the individual's concerns and behaviors when looking for the treatment plan that is a good fit for her.

The relationship between the individual and her therapist is essential in pushing for change while simultaneously accepting the adolescent in the moment and helping her radically accept herself; acceptance is not approval or agreement with the behavior or thought.  “Those who practice DBT are compassionate and dedicated to understanding the experience of BPD but at the same time believe, unwaveringly, that the most compassionate thing we can do is help people with BPD to change” (Manning, 2011).