How to Get into Wise Mind (An Idea from Dialectical Behavior Therapy)

Wise Mind is an idea from dialectical behavior therapy (DBT) that helps us to integrate the analytical or logical parts of our minds with the emotional part of our mind. Neither is “good” nor “bad” but we can recognize the truth in each perspective or point of view. Wise Mind helps us to find the balance we need to make effective choices.

In her book, DBT Skills Training Handouts and Worksheets, Marsha Linehan, PhD lists many different ways in which we can access our Wise Mind.

I love her ideas and I also like for my clients to think about what works for them so I frequently ask, “What helps you to find your own Wise Mind?” or “How do you know when you are in Wise Mind?” There’s no right or wrong answer.

Below you’ll find just a few suggestions that have helped my clients get to that place where they can make wise and healthy decisions based on their values and life worth living goals.

• Allow yourself to become really quiet for five minutes and listen for your own wisdom.
• Pray—and, again, listen.
• Imagine what a wise person would do in a similar situation.
• Go for a long walk in nature.
• Make a list of pros and cons of acting from a place of Emotion Mind.
• Be creative. Write, paint, dance, or play an instrument.
• Wait. Wait an hour or two before you do something out of Emotion Mind.
• Call someone for help. You could call a therapist, sponsor, friend, or help line. Talking it out can help us get back into Wise Mind sooner rather than later.
• Ask yourself, “Am I in Wise Mind now?” Keep asking until you are in Wise Mind.
• Do something “thinky” like a puzzle, word search, or logic problem.
• Go to a place that bring you a lot of peace.
• Use a guided meditation to help you pace your breathing.
• Make a list of 25 things you’re thankful for.
• Journal.
• Practice self-compassion.
• Embrace a nonjudgmental stance.
• Do something kind for another person.

Wise Mind isn’t really a final destination. There are times when we are in Reasonable Mind or Emotional Mind for valid reasons. We aren’t looking for some kind of all-knowing perfection when we are using this skill. You aren’t a robot and Marsha Linehan doesn’t expect you or anyone else to be perfectly wise at any given moment.

Practicing this skill once or twice a day can make a difference in how you think or feel.

Is this a skill or idea that has helped you? What ideas help you to access your own Wise Mind?

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Want more? Check out these resources about BPD and DBT:

• My Dialectical Life

• BPD Crisis Resources

• What Does it Mean to be Dialectical?

• Coping Statements for Self-Harming Behaviors

How to Listen to Music Mindfully—An Idea from Dialectical Behavior Therapy

Mindfulness Exercise with Music

You may already know that mindfulness begets more mindfulness. When we start with just a little mindfulness, it becomes easier to be more mindful about lots of different things.

Can you be practice mindfulness with just one song or one piece of music? Of course!

This is a nice change from simply being mindful of our breath, body position, or some other traditional mindfulness practice.

Here are the steps to practice mindfulness with music

1. Pick a relatively short piece of music or a song that isn’t too short or too long.

2. Get in a comfortable position and reduce the opportunity for distractions. For instance, you may want to turn off your phone, listen with earbuds or headphones, or go into a quiet room.

3. Make a decision about keeping your eyes open or closed. (There is no right way to do this.)

4. Listen to the music with your full attention but expect to be distracted. 

5. When you are distracted, gently bring your attention back to the music.

6. Notice just one thing you can observe through your senses. For instance you could observe a particular instrument, rhythm, melody, harmony, any kind of vocal vibrato, or little pauses of silence within the music.

Sometimes music can bring up a lot of memories and emotions. You can be mindful of those experiences as well.

Remember, there's no perfect way to be mindful with music and trying counts. You can always experiment with shorter songs or music with which you are already familiar.

Think about all the dialectical behavior therapy (DBT) skills you can use in this short exercise:
• observe
• describe
• participate
• nonjudgmentally
• one-mindfully
• effectively

For more ideas about practicing mindfulness with music, you might find inspiration by reading Aaron Copeland’s What to Listen for in Music or Oliver Sacks’ Musicophilia: Tales of Music and the Brain.

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Additional information about DBT:

DBT Self-Help

DBT-inspired Art Journaling Prompts

16 Inspirational Quotes by DBT-developer Marsha Linehan

How to Be Gentle with the GIVE Skills

Podcasts for People Who Love DBT

Do you enjoy learning more about dialectical behavior therapy? Listening to podcasts is one way for you to teach yourself about this important therapy or maybe it’s more of a reminder to practice the skills you already know and love.

Below are five of the podcasts I listen to regularly. I hope that you find them to be helpful as well.

T-Talk

T-Talk is a fun podcast created by Shaelene Lauriano, LPC at DBT of South Jersey. Her podcast isn’t just about DBT, however. Shaelene also talks about trauma, grief, and other mental health topics. Be sure to listen to her episode called What it Truly Means to Be Grateful.

You can find T-Talk by clicking here.

All Therapists Are Jerks

Many years ago, DBT-creator, Marsha Linehan observed that “all therapists are jerks.” It’s true. We all have the capacity to invalidate others, get things wrong, or make judgments. Therapists are far from perfect.

Check out this great podcast by Erik Ulland, MD and Jo Fritz, MSCP, LPC.

Charlie Swenson: To Hell and Back

Dr. Swenson has been training DBT therapists and has been writing about this evidence-based treatment for years. He’s one of the most trusted experts in the field and is even mentioned in Marsha Linehan’s memoir.

This podcast is mix of interviews with therapists, mental health researchers, and also people in recovery from borderline personality disorder. Dr. Swenson keeps it real with relatable and inspiring stories episode after episode.

Take a moment to bookmark and share To Hell and Back.

The BPD Bravery Show

Fay has a terrific podcast where she interviews experts in the field and individuals in recovery from BPD. She loves the DBT skills and believes in Marsha Linehan’s goal of creating a life worth living.

You can find The BPD Bravery Show on Apple Podcasts and YouTube. Check her out and subscribe today.

Bay Area DBT and Couples Counseling Center: The Skillful Podcast

This is a really smart podcast!

The Skillful Podcast features therapists from Bay Area DBT and Couples Counseling Center in California. With each episode, they weave skills from both DBT and an approach called Radically Open DBT. You’ll love the wisdom they share.

Be sure to check out their episode titled How Do You Talk to Yourself? and you can find other topics by clicking here.

A Therapist Takes Her Own Advice

I love this podcast by DBT therapist Rebekah Shackney, LCSW.

Rebecca shares lots of good ideas about how to use DBT skills. If you are new to DBT or are getting reacquainted, these short episodes (most are less than 10 minutes each) will give you ideas that you can use today.

You can find this podcast on Rebekah’s web site.

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Want more? Check out these resources about dialectical behavior therapy:

• My Dialectical Life

• How to Get into Wise Mind

• Changing Your Emotions with Music

• The Quotable Marsha Linehan

31 Treatment Plan Ideas for Reducing Self-Injury and Self-Harming Behaviors

Self-injury or self-harming behaviors can be difficult to treat.

While self-injury may be an indicator of borderline personality disorder diagnosis, the behaviors may also be a part of depression, anxiety disorders, eating disorders, psychotic disorders, and even addiction. Self-harm may be a way to cope with overwhelming emotions, disturbing thoughts, or acute stress.

Although self-harming behaviors are referred to as non-suicidal self-injury (NSSI), I believe that it’s crucial to also assess for suicidal thinking or planning when addressing self-injurious behaviors. I strongly recommend Dr. David A. Jobes’ book Managing Suicidal Risk (2nd edition) for graduate students and licensed health care professionals. I also love recommending How I Stayed Alive When My Brain Was Trying to Kill Me to my clients and their family members.

Below I’ve listed 30 treatment planning ideas—but many of these ideas could be used a homework assignment in therapy or treatment.

Ideally, all of our clients would create their own treatment goals but I’ve found that clients (and even therapists or case managers) may need to start with a list of ideas for inspiration.

My hope is that graduate students and mental health professionals will be inspired to find solutions that may help their patients. Please keep in mind that not every idea will be appropriate for every client who struggles with self-harm. You can personalize your client’s treatment plan when you integrate their values, beliefs, and long-term goals.

Many of the ideas below are adapted from or are a part of dialectical behavior therapy (DBT) but clients may also benefit from a treatment like cognitive behavior therapy (CBT) or mindfulness practices (a curriculum like mindfulness-based stress reduction can be a good place to start).

Note: Self-harming behaviors can be serious and should not be ignored. Please do not dismiss these behaviors as manipulative or attention-seeking.

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☐ Create a safety plan

☐ Address self-harm from a psychoeducational perspective

☐ Create a pros and cons list of reducing self-harming behaviors

☐ Learn how to self-soothe

☐ Make a list of reasons to stay alive

☐ Keep a gratitude list to help increase desired emotions

☐ Use coping statements when urges to self-harm are high

☐ Identify crisis resources

☐ Read Freedom from Self-Harm

☐ Create an art journal as a way of coping

☐ Practice self-compassion

☐ Create an hourly, daily, or weekly reward system for reducing self-harm

☐ Track progress with a Days Since app

☐ Celebrate very small successes

☐ Practice urge surfing

☐ Identify pro-recovery resources on Facebook, Instagram, YouTube, and TikTok

☐ Increase capacity for self-forgiveness

☐ Address vitamin or mineral deficiencies that may increase self-harm urges

☐ Use the DBT skill of radical acceptance to help manage thoughts or emotions

☐ Reach out to a friend when urges are strong

☐ Reduce reliance on alcohol or drugs to manage emotions

☐ Use the DBT skill of Check the Facts

☐ Read (or listen to) Viktor Frankl’s Man’s Search for Meaning

☐ Improve sleep hygiene

☐ Practice tolerance of the present moment

☐ Reduce shame, guilt, and self-judgments that may be contributing to self-harming behaviors

☐ Practice grounding exercises for dissociation or symptoms of psychosis

☐ Focus on client strengths and values

☐ Create written one year, three year, and five year goals

☐ Find ways to increase feelings of hopefulness

☐ Use a chain analysis tool from DBT to understand behavioral patterns

For additional information about dialectical behavior therapy (DBT), check out:

DBT Self-Help

Online Family Skills Course

101 Ideas for Self-Soothing

Art Journaling Prompts for Self-Harm

Please note: Amanda L. Smith, LCSW participates in Amazon's affiliate program.

Treating Borderline Personality Disorder Without Drugs

Note: Abrupt discontinuation of medications may lead to serious symptoms that require emergency care. Do not stop taking psychiatric medications without the supervision of a doctor or nurse practitioner.

Can you treat borderline personality disorder naturally and without medication?

Borderline personality disorder (BPD) is a cluster of symptoms that may include any combination of depression, anxiety, disturbed sleep, impulsive behaviors, obsessive thoughts, intense anger, emptiness, self-hatred, and a compulsive need to act on self-destructive urges.

Currently there is no FDA-approved medication to treat borderline personality disorder or self-injurious behaviors. While medications can target certain symptoms related to BPD, there is no one drug that helps to treat every intense mood swing or disruptive thought that someone with BPD might have in any given day.

Drugs can not only be costly for individuals diagnosed with borderline personality disorder but side effects can often introduce even more problems leaving everyone feeling discouraged and hopeless.

Although there is no "cure" for BPD, below I've listed some ideas for nutritional supplementation that may help to reduce the intensity or duration of many of the symptoms associated with borderline personality disorder.

• Omega 3 Fatty Acids: For many years it's been known that deficiencies in Omega 3 Fatty Acids are correlated with a number of mental health diagnoses such as depression, bipolar disorder, ADHD, and schizophrenia.

The good news is that supplementation with Omega 3 Fatty Acids appear to be an effective treatment for adolescents and adults with a diagnosis of borderline personality disorder. In research conducted by Drs. Mary Zanarini and Frances Frankenburg, supplementing with 1000 mg of Omega 3 Fatty Acids daily over the course of 8 weeks resulted in a significant decrease in both depression and aggression.

A scientific article published in 2021 also noted that there may be a link between a deficiency in Omega 3 Fatty Acids and impulsive or aggressive behaviors. Supplementing with foods higher in Omega 3 may help reduce some of the behaviors that can be a part of borderline personality disorder.

Sources of Omega 3 Fatty Acids: Salmon and other cold water fish, cod liver oil, walnuts, grass-fed beef, brussels sprouts, cauliflower, flax seed, hemp seed, and hemp oil.

• Magnesium: Supplementing with magnesium—a natural muscle relaxer—may benefit individuals who are diagnosed with borderline personality disorder and are experiencing migraines, depression, high anxiety, or have a co-occuring diagnosis of generalized anxiety disorder.

In 2015, the authors of one study noticed a correlation between very low magnesium levels and the symptoms of BPD. Other research looked at the potential benefits of higher levels of magnesium, folate, and zinc in women with depression and anxiety. A study published in 2017 also recommended supplementing with magnesium for the treatment of depression.

Some interesting research published in 2021 looked at low magnesium levels in children with “callous-unemotional” (CU) traits. The article suggests that nutritional supplementation or diets higher in magnesium “…could improve CU traits in children.”

Sources of magnesium: Epsom salt baths, leafy greens, dark chocolate or cacao, avocados, and salmon. Magnesium-supplemented products such as Natural Vitality Calm (and magnesium gummies) may also reduce insomnia when taken before bedtime.

• Vitamin C: Vitamin C may also be beneficial in treating individuals with BPD whose symptoms are manifested through anxiety, restlessness, or nervous energy. One research study showed that supplementation of 500 mg of Vitamin C significantly reduced anxiety among college students.

Research published in 2017 revealed that "High-dose sustained-release vitamin C was effective in reducing anxiety and blood pressure in response to stress." Another study noted that Vitamin C may be beneficial in reducing anxiety among individuals with type 2 diabetes.

Sources of Vitamin C: dark leafy greens, tomatoes, strawberries, and citrus fruits.

• Vitamin D: Upwards of 40% of adults in the United States may be Vitamin D deficient and individuals with darker skin tones are particularly at risk for low Vitamin D. Deficiencies in Vitamin D are also well-documented among those diagnosed with mood and anxiety disorders such as dysthymia, schizophrenia, and depression.

In 2018, a study concluded that adults who supplemented with Vitamin D showed improvement in both anxiety and depression. Another recent study showed that supplementation with Vitamin D for a period of three months helped to reduce the severity of depression.

Another recent article looked at how correcting a vitamin D deficiency (2023) could be a potential way to reduce suicide risk and self-harming behaviors.

Persons who believe that they may have a Vitamin D deficiency and are getting little sunlight most days can ask their doctors for a blood test to determine their current levels.

Sources of Vitamin D: Adequate amounts of sunshine (you can calculate your Vitamin D exposure through sunlight with this smart phone and Apple watch app), wild-caught salmon, mushrooms exposed to ultraviolet light, cod liver oil, and fortified foods such as milk.

• Cacao/Chocolate: For people with borderline personality disorder who have trouble with their memory or are frequently distracted or overwhelmed by new information, supplementation with chocolate may be something to consider. One study published in 2019 looked at the benefits of dark chocolate in reducing depressive symptoms.

Adding dark chocolate to your diet may help reduce symptoms related to depression.

Another study looked at the use of cocoa flavanols to potentially improve symptoms related to mental fatigue. A promising study from 2013 suggested that increased chocolate consumption may "ameliorate the symptoms associated with clinical anxiety or depression."

A more recent study published in 2022, looked at the benefits of mood improvement with 85% dark chocolate. The researchers concluded that dietary intake of dark chocolate may also improve gut health—a potential link to better emotional and physical health.

Sources of cacao and chocolate: Dark chocolate (as opposed to milk or white chocolate with higher sugar content) and cacao (which is different than cocoa) are rich sources of important antioxidants that are key to emotional and physical health. A teaspoon or two of powered cacao can be successfully added to your favorite smoothie and cacao nibs can be added to unsweetened yogurt for a nice boost of flavanols and magnesium.

Can nutritional changes help treat borderline personality disorder?
Decades of research suggest that better nutrition can help improve our emotional and physical health.

You can start by asking your general practitioner or family doctor to run a comprehensive vitamin and mineral panel to screen for nutritional deficiencies. A psychiatrist, psychiatric nurse practitioner, or registered dietician will also be able to order these important lab tests. This information is vital for both your emotional and physical health. The next steps are up to you.

How long will it take before I see benefits in my mood after eating healthier or supplementing with vitamins and minerals?
Most individuals with a diagnosis of borderline personality disorder or have traits of borderline personality disorder will not always see benefits in a matter of days or after a few weeks of dietary changes. Additionally, individuals with a history or a current diagnosis of eating disorders, alcohol abuse, or illegal drug use may also be at risk for severe vitamin and mineral deficiencies. For people who are correcting long-standing or significant nutritional deficiencies, patience and self-compassion will be a necessity.

Years ago when I learned that I had a vitamin D deficiency, it took six months for me to raise my levels from 18 to 36. After lots of experimentation, I now know that I’m at my healthiest when my vitamin D levels are around 75 but I still need to monitor those levels at least twice a year.

I encourage my clients to be kind to themselves while their bodies heal and recover from the nutritional deficiencies that may have caused (or exasperated) many of their symptoms. During this period, it’s important to remain hopeful. Please count any small reduction in symptoms as a success to celebrate.

What’s next?
Healthier lifestyles—paying greater attention to diet, exercise, and sleep—combined with an evidence-based treatment for BPD (such as dialectical behavior therapy) can make a profound difference.

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If you are interested in reading more about treating the symptoms of BPD without psychiatric medications, I can highly recommend the following books: 

Nutrition Essentials for Mental Health: A Complete Guide to the Food-Mood Connection by Leslie Korn

Depression Free, Naturally by Joan Mathews Larson

The Anti-Anxiety Food Solution by Trudy Scott

Depression and Other Mental Illnesses Caused by Medical Diseases: It’s Not All in Your Head by David Skaer

Other articles that may be beneficial to read

Evolution of Well-Being and Happiness After Increases in Consumption of Fruits and Vegetables (2016)

Food and Mood: How Do Diet and Nutrition Affect Mental Wellbeing? (2020)

Is Exercise a Treatment for BPD? (2020)

Should People with BPD Drink Alcohol? (2021)

Looking for evidence-based treatment for borderline personality disorder, self-harming behaviors, or emotional dysregulation? I'd love to help. Email me today at amanda@hopeforbpd.com.

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Is "Quiet BPD" Real?

No, as a licensed health care provider, “quiet BPD” is not a description we would use in dialectical behavior therapy (DBT) or when I’m diagnosing someone with borderline personality disorder (BPD) or describing traits of BPD.

However, it may be true that:

• DSM-5 diagnostic criteria is imperfect and does not always encompass all that someone with BPD might experience. People with a diagnosis of BPD are unique and are inherently worthy of love and healing. A mental health diagnosis is only a very small part of that individual’s story.

• people may have different, neutral traits that help describe their personality or temperament (such as introverted vs extroverted). Again, BPD isn’t just one thing and the same is true for people with the diagnosis.

• just as individuals are neither “good” nor “bad,” we can imagine that symptoms or characteristics of BPD are also neither “good” or “bad.” Understanding ourselves and others with less judgment and more compassion may be an important part of recovery from BPD.

• using descriptors such as “quiet BPD” may imply that others experience “loud BPD.” This kind of differentiation might feel judgmental or hurtful to others.

• even though “quiet BPD” is not a diagnosis, a person could understand some of their symptoms related to BPD by describing something like, “When I feel rejected, I sometimes get very quiet and it can be hard for me to speak.” Or they might observe, “I often shut down when I’m angry and—most of the time—my family doesn’t know when I’m frustrated.”

As a DBT therapist, my hope is that this kind of mindful description can help increase understanding for family members and friends while also providing some self-validation for the person diagnosed with BPD.

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Want more? Check out these resources about dialectical behavior therapy:

• My Dialectical Life

• How to Get into Wise Mind

• Changing Your Emotions with Music

• The Quotable Marsha Linehan

The Power of Natural Consequences: Family Help for Borderline Personality Disorder

In dialectical behavior therapy (DBT), we often think about the wisdom of allowing natural consequences to occur as a way to help facilitate change. This is the opposite of stepping in and trying to fix something that isn't ours to fix.

Many years ago, I had a smart young adult client who had three speeding tickets in one semester. I think that she had four tickets in the first six months of working with her. Each time she told me about a ticket, I would say something like, "Wow. Speeding tickets are so expensive. Will you complete the defensive driving course to reduce the fee?" I remember that my client would look confused and tell me, "I'm not paying the ticket. I gave it to my parents, and they paid it."

Several years later, something similar happened with a wonderful adult client in her late 20s. She had been in a minor car accident where, thankfully, no one was hurt but she received a citation for reckless driving. When I asked about a defensive driving course to offset the fees associated with the citation and potential increase in car insurance costs, my client said, "I'm not doing that. My husband will just pay it." I, however, saw the car accident as an opportunity for my client to increase her self-respect by taking responsibility for an accident she caused—without any excessive shame, guilt, or embarrassment.

While these examples aren't specific to the diagnosis of borderline personality disorder nor any personality disorder for that matter, they demonstrate an attitude that is not always conducive to emotional health and the goal of taking responsibility for our actions.

When we do for others what they can do for themselves, we send a message that may invalidly communicate:

·    You are helpless.

·    You need my help.

·    You are not responsible.

·    You are not trustworthy.

or

·    I need to take care of you.

This type of invalidation is the opposite message I want for my clients to be receiving from family members, friends, work colleagues, and employers. I'm working hard to send the message, "You are responsible for creating a life worth living. No one can do this work for you!"

A life worth living isn't just about increasing our capacity for joy, meaning, or connection. It also means that we use our DBT skills to help ourselves do the hard job of "adulting" and taking on challenges that will help us to become more independent and self-sufficient.

Many of my terrific clients take these steps on their own, but others may need a gentle nudge toward a temporary uncomfortableness that may only last for a few minutes at a time. The relatively boring (but often stressful) task of paying a speeding ticket or traffic citation may be such a catalyst for many other acts of responsibility and self-care.

When we ask people to take small, reasonable steps to care for themselves and others, we validate them by communicating, "You can do this. I believe in you."

That nudge toward the uncomfortableness of natural consequences is not meant to be:

• punishing or punitive

nor

• a way to throw your loved one into the deep end of the pool so that they almost drown.

Natural consequences, when we allow them to occur, can be expressed by you in a way that is neutral, non-judgmental, and without shame. You are communicating, "These are the facts."

Sometimes we learn best when we are allowed to make mistakes or experience the painful moments where we are faced with a problem only we can solve. If that's been true for you, it may also be true for your family member.

There may be a role in allowing for natural consequences with your family member. How are you empowering your loved one with borderline personality disorder today?

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For more information, check out:

My Hopeful Life

Family DBT Course

Setting Limits with People Who Have BPD

Art Journaling Prompts for Self-Harming Behaviors

In a time of destruction, create something. -Maxine Hong Kingston

Do you value creativity as a part of your recovery story?

Engaging in any kind of art practice is a healthy alternative to self-injury or self-destruction.

Many people find that they can safely communicate thoughts, emotions, and experiences through art. Art is often a self-validating and affirming way of recognizing our struggles and successes as we grow in self-love.

Art journaling can be a way to compassionately document your past, understand current challenges, and cope with urges to engage in self-harming or self-sabotaging behaviors.

You could use your art journal to visually explore topics like:

• Your values in recovery
• Reasons why you want to reduce self-harming behaviors
• Self-compassion and self-love
• Family members, friends, and others who inspire you
• Your resilience
• How you respect your body
• Your hope in recovery
• The difference between you a year ago and you today
• Self-acceptance
• How recovery is messy
• Why you want to recover
• Your life five years from now
• Meaning and purpose in recovery
• Your support team
• Coping successfully with urges
• Healthy ways of coping
• Your commitment to self-care

You, of course, may have dozens of different ideas. What is most important to you?

When you’re ready, you can share your work with a safe person or you can keep your art journal private.

I love this particularly pretty art journal (and this one is my second favorite) but if you have another favorite way to preserve or share your work, I’d love for you to let me know by writing me at amanda@hopeforbpd.com.

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Interested in learning more about dialectical behavior therapy (DBT) to treat self-harming behaviors? I’d love for you to check out My Dialectical Life or my course for family members and friends by clicking here.

Coping with Shame and Borderline Personality Disorder

What You Should Know About Shame

Shame is a normal emotion everyone experiences at one time or another.

We experience shame when:
• we are rejected or excluded by others
• remembering a time when we felt exposed, rejected, or abandoned
• someone shares something about us that we’d prefer to keep hidden or secret
• others avoid us
• we need help
• our emotions are invalidated, dismissed, or made fun of
• someone tells us that our values or beliefs are “wrong”
• we are judged inaccurately because of our values or beliefs
• we share something personal or private and that revelation is met with rejection

We may also experience shame around taboo or sensitive topics like sex, money, religion, appearance, race, culture, political beliefs, and a mental health diagnosis.

Shame often goes hand in hand with emotions like guilt, embarrassment, sadness, and anger. For instance, we may lash out at others in anger but underneath that anger is shame.

You may not be surprised to know that some research suggests that individuals with a diagnosis of borderline personality disorder may experience excessive shame.

Like all emotions, shame can sometimes be adaptive or helpful when it helps us to identify important values and beliefs. Instead of running from shame or pushing away feelings of shame, we can respond with a healthy curiosity and ask ourselves, "What's bringing up this emotion right now? What can I learn from this shame that I’m feeling?" or "Is shame justified? Will people really reject me if I share this with them?"

As a therapist, I don't always hear about behaviors that create shame in my clients unless we have established a relationship with a lot of trust. My clients need to know that I won't reject or judge them for behaviors that may be destroying their lives or relationships.

They also need to know that family members and friends will not be rejecting.

For family members, friends, and even therapists, the first instinct may be to rush in and try to soothe or reassure the person who is experiencing shame and that's just what Peter Levine, PhD addresses in this video. Because we love, we want to make things better. We say kind words, and may try to tell the person that we're proud of them for sharing something so difficult. 

And, of course, there's a time and a place for soothing others, but when shame is most intense, we may want to simply sit quietly with the person instead of trying to find all the "right" words or doing something to help that person feel better. In that moment, family members and friends with a diagnosis don't need fancy psychological interventions, admonishment, or judgment. 

Skills and Strategies to Help Reduce Shame

I share with my clients that they can reduce (but not necessarily eliminate) the shame they are experiencing by sharing their story with others.

A support group can help and a 12-step program for addictions can consistently help reduce shame while gently encouraging participants to resist behaviors that might create a cycle of shame.

Psychologist Marsha Linehan suggests using the DBT skill of opposite emotion for shame so we can share our stories about what has created shame in our lives. A good DBT therapist can help you take steps to:

• normalize the emotion of shame
• mindfully observe and describe shame, guilt, and embarrassment
• check the facts and help determine if shame is justified
• reduce self-judgments about things that create shame
• self-validate emotions like shame, guilt, and embarrassment
• grieve the things we cannot change
• create healthier, more trusting relationships

As a dialectical behavior therapy (DBT) therapist, I've seen how a skills group can also reduce shame among members. When people feel loved and accepted, the emotion of shame becomes more manageable.

Finally, I know that forgiveness and self-forgiveness therapy can help people heal from the wounds that keep them mired in shame and self-compassion work may also reduce excessive shame.

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Interested in learning more about DBT? I’d love for you to check out My Dialectical Life or my course for family members and friends by clicking here.

101 Ideas for Self-Soothing (That Cost Less Than $25)

Bookmark or save this page now. You may need it in the future.

One of ways we help ourselves is to engage in consistent self-care. There’s nothing wrong with prioritizing your physical, emotional, and spiritual needs if it means that you are taking care of yourself while your are working toward important goals.

If you are familiar with the distress tolerance and self-soothing skills from dialectical behavior therapy (DBT), you may already know about many of these ideas. Ideally, you’ll want to create your own list of healthy coping strategies for when you need them the most.

Remember: Self-care is not selfish. You are worthy of love and healing.

1. Meditation is free and there are tons of YouTube videos for ideas
2. Practice gentle stretching
3. Take a hot, steamy shower to help relieve stress
4. Apply a scented moisturizer to your arms and legs
5. Recite coping statements and write them on your mirror with colored markers
6. Paint your nails the color of your choice
7. Write down your goals you want to achieve
8. Listen to soothing music and create a soothing playlist
9. Watch your favorite movie and or explore new movie options
10. Listen to a podcast
11. Sit outside on a sunny day to promote the release of beta endorphins
12. Light scented candles
13. Bake special goodies for yourself
14. Make yourself chocolate avocado pudding
15. Follow a pretty account on Instagram
16. Text, call, or FaceTime your friends
17. Love your current emotion
18. Drink warm fruit-infused tea
19. Listen to motivating and positive videos
20. Start a DIY project or craft
21. Draw a picture
22. Start a puzzle
23. Organize your week’s schedule to relieve stress
24. Write down a checklist of things you need to get done
25. Clean up and organize your house
26. Drop some essential orange or lemon oil in some water, let the water come to a low boil on your stove
27. Read a new book or re-read previous favorites
28. Indulge in a non-alcoholic beverage like sparking apple cider
29. Listen to nature (birds chipping, leaves rustling, etc.)
30. Walk barefoot on soft grass
31. Pray and give thanks
32. Listen to ASMR videos
33. Use a hot water bottle
34. Go to a very quiet place to sit and listen to your breath
35. Cuddle with someone (friend, spouse, family member) or something (pillows, stuffed animals)
36. Play with your pet
37. Listen to one song mindfully
38. Try sewing or knitting
39. Play a board game or cards
40. Plant a kitchen garden
41. Try scrapbooking
42. Sit by the fireplace
43. Test out different makeup looks and watch makeup tutorials
44. Get 10 minutes of fresh air outside your home
45. Do an at-home workout
46. Take a nap without setting an alarm
47. Play an instrument
48. Sing a song
49. Listen to a sound machine (relaxing sounds of rainfall, ocean waves crashing, etc)
50. Chew gum
51. Squeeze a stress ball
52. Look at a lava lamp
53. Soak your feet in peppermint epsom salts
54. Spend time online shopping (limit your spending to $25)
55. Practice a head stand
56. Create a deeper connection with your inner self by allowing yourself to become very quiet
57. Learn a new language
58. Dance and watch dance video tutorials
59. Wash your bed sheets
60. Ask for help
61. Go to bed early
62. Plan future trips you have been wanting to take
63. Watch something that will make you laugh
64. Remind yourself that things could be worse
65. Think about all the positive people and things in your life
66. Count your blessings
67. Write and or read a poem
68. Make or watch YouTube Videos
69. Make or watch TikTok Videos
70. Look on Pinterest for inspiration for your home or dorm room
71. Look up and write down motivational quotes
72. Wear fuzzy socks
73. Allow yourself to be very quiet and still for five minutes
74. Use a facial roller and massager
75. Binge trending Netflix shows
76. Wear your cutest shoes
77. Start a blog
78. Develop a plan to be more health-conscious
79. Stretch your arms high above your head, hold the pose for as long as you can without locking your arms
80. Start collecting adorable things
81. Look through old photos
82. Watch home videos
83. Drink a cup of hot chocolate
84. Daydream
85. Look at photo or art books in a library
86. Take deep breaths for five minutes (time yourself)
87. Make a vision board
88. Watch inspiring Ted Talks
89. Make an art journal
90. Do a random act of kindness
91. Find a way to show love
92. Research your ancestry
93. Watch online tutorials of things you want to learn to do
94. Color
95. Have a stress-relieving cry
96. Unfollow judgmental people on social media
97. Say no
98. Use foam rollers on your body to decrease soreness, stress, and pain
99. Swing on a swing set at the park
100. Treat yourself to one cupcake
101. Look at the stars or watch the clouds


For more healthy living ideas, consider:

• DBT Self-Help ideas

• Ways to Help Ground Yourself

• Learning New Ways of Coping with DBT

• Finding Reasons to Stay Alive