Mindfulness and Acceptance for Trichotillomania and Dermatillomania
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An overview of mindfulness and acceptance techniques for the treatment of Trichotillomania and Dermatillomania
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Mindfulness and Acceptance for Trichotillomania and Dermatillomania
- 1. Mindfulness and Acceptance for Trichotillomania and Dermatillomania ~ Elena Fasan, MSW and Lauren McMeikan, MA ~ OCD Center of Los Angeles
- 2. What is Mindfulness? • Present moment awareness without judgment. • Meditation is not mindfulness – it is a means to mindfulness. • Mindfulness is a way of relating to one’s experience. • Third Wave Behavioral Therapies: ACT, DBT and MBCBT http://ocdla.com OCD Center of Los Angeles (310) 824-5200
- 3. • Thoughts • e.g., “This one has to go” • Feelings • e.g., Anxiety, sadness, boredom • Sometimes feelings are informed by thoughts • Sensations • e.g., An itch or a tingle • Urges • e.g., A strong desire or impulse Internal Experiences http://ocdla.com OCD Center of Los Angeles (310) 824-5200
- 4. Mindfulness Challenges our perspective towards, and our reaction to, our thoughts, feelings, urges, and sensations, rather than the content of these normal experiences http://ocdla.com OCD Center of Los Angeles (310) 824-5200
- 5. • Over-Attending • Over-Valuing • Over-Responding We Get Into Trouble Three Ways http://ocdla.com OCD Center of Los Angeles (310) 824-5200
- 6. • Paying too much attention to something • We Over-Attend to Negative Stimuli for Evolutionary Reasons • We look for trouble and we find it. Over-Attending http://ocdla.com OCD Center of Los Angeles (310) 824-5200
- 7. • Because we are over-attending to unwanted experiences, we tend to Over- Value them. • Often our experiences are just mental “trash…not worth the gray matter they rode in on” (Jeffrey Schwartz) Over-Valuing http://ocdla.com OCD Center of Los Angeles (310) 824-5200
- 8. • Our natural reaction to unwanted experiences is to try to reduce discomfort. • A more effective response is to do nothing. • Let our unwanted experiences exist without taking them so seriously or trying to modify them. Over-Responding http://ocdla.com OCD Center of Los Angeles (310) 824-5200
- 9. • Over-attending, over-valuing, and over- responding to our experiences are the problem. • Over-responding by trying to control or avoid uncomfortable thoughts, feelings, sensations, or urges is the problem. • Over-responding by giving into urges is the problem The Problem http://ocdla.com OCD Center of Los Angeles (310) 824-5200
- 10. • Old French: To take what is offered. • Not just tolerating an unwanted experience. • Allowing that experience to exist without bias, judgment, or reaction. • To have the experience without the intention to change it. • Embrace it – “Ask for more”. Acceptance is the Solution http://ocdla.com OCD Center of Los Angeles (310) 824-5200
- 11. • Thoughts, feelings, sensations, and urges are neither good nor bad – they just “are” • These experiences are transitory • Goal: Peaceful co-existence with unwanted experiences • Goal: To be able to have unwanted thoughts, feelings, sensations and urges without caring so much about them or doing anything about them Acceptance http://ocdla.com OCD Center of Los Angeles (310) 824-5200
- 12. • Thoughts • Thoughts aren’t intrinsically important, meaningful or true and don’t require a response • Feelings • Sitting with feelings is more effective than fighting them • Sensations • Accepting sensations is more effective than fighting them • Urges • Surfing the urge Applying Acceptance http://ocdla.com OCD Center of Los Angeles (310) 824-5200
- 13. • Kids naturally live more in the present moment than do adults • However their abstract reasoning skills are far more limited than are adults (Metacognition) • Must adjust mindfulness training to the child’s developmental age • Kids respond well to rewards Mindfulness for Kids http://ocdla.com OCD Center of Los Angeles (310) 824-5200
- 14. • Stop • Take some deep breaths • Observe • Proceed STOP http://ocdla.com OCD Center of Los Angeles (310) 824-5200
- 15. • Present moment awareness without judgment • Exercises: • 3x3 • What do you see, hear and feel? • The Five Senses • Daily Mindfulness Activity • e.g. Mindful Toothbrushing Sensory Grounding http://ocdla.com OCD Center of Los Angeles (310) 824-5200
- 16. • Radical Acceptance by Tara Brach • When Things Fall Apart by Pema Chödrön • The Miracle of Mindfulness by Thich Nhat Hanh • The Happiness Trap by Russ Harris • Get Out of Your Mind and Into Your Life by Steven Hayes • Sitting Still Like a Frog by Eline Snel, Jon Kabat-Zinn, Myla Kabat-Zinn Books http://ocdla.com OCD Center of Los Angeles (310) 824-5200
- 17. • Mindful Awareness Research Center (MARC) at UCLA • Guided meditations and mindfulness talks: • Jack Kornfield • Trudy Goodman • Kristin Neff • Sharon Salzberg • Noah Levine • TLC Foundation for BFRBs - bfrb.org • OCD Center of Los Angeles - ocdla.com Resources http://ocdla.com OCD Center of Los Angeles (310) 824-5200
- 20. 1 ocdla.com • Individual therapy • Online therapy via webcam • Group therapy ~ two weekly low-fee Dermatillomania / Trichotillomania groups • Intensive Outpatient Treatment Program • Four locations in Southern California • Brentwood • Woodland Hills • Fullerton • Santa Barbara OCD Center of Los Angeles
- 21. 1 This slide presentation was created for a webinar produced and presented by the TLC Foundation for Body Focused Repetitive Behaviors (BFRBs). If you would like to watch a recording of the entire one-hour webinar, you can join the TLC Foundation on their website at: bfrb.org
Hinweis der Redaktion
- For ease of communication we will refer to picking and puling when speaking of body focused repetitive behaviors or BFRBs in this presentation. If you struggle with another BFRB, please replace picking or pulling with the word that describes your behavior.
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- L So we are encouraging you to have present moment awareness without judgment of your internal experiences. Internal experiences break down into four major categories. Another example of a thought – “I won’t be able to concentrate if I don’t pick or pull this”
- E By challenging our perspective toward and reaction to our internal experiences we mean questioning their importance instead of immediately taking them seriously and acting upon them.
- L So from a mindfulness perspective we get into trouble in three ways: by over-attending, over-valuing and over-responding. Over-attending and over-valuing relate to our perspective toward our internal experiences. Body-focused repetitive behaviors are an over-response. So what do we mean by over-attending, over-valuing and over-responding?
- L Over-attending simply means to pay too much attention to something. From an evolutionary perspective, over-attending to the negative was beneficial. In fact, we over-attend to the negative because our ancestors who survived over-attended to negative things – like lions and tigers. The people who weren’t afraid of lions did not survive to pass their genes onto the next generation. Our minds evolved to think negatively, and research shows that about 80 percent of our thoughts have some degree of negative content. Harris, Russ (2008-06-03). The Happiness Trap: How to Stop Struggling and Start Living: A Guide to ACT (p. 43). Shambhala. Kindle Edition. But these days we pay too much attention to negative thoughts, feelings, sensations and urges as though they were threats. BUT they pose no danger whatsoever.
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- E Avoid/Control thoughts, feelings, sensations and urges by performing BFRB.
- L So again, the internal experiences aren’t the problem – it’s our perspective toward and reaction to them that is the problem. It is paying to much attention to them, giving them too much value and then trying to get rid of or change internal experiences. People with BFRBs tend to pick and pull their compulsive behaviors as a direct result of over-attending to or over-valuing thoughts, feelings, sensations and urges. E.g. If I pay attention to and value the thought “This one has to go” I am more likely to respond by pulling or picking. E.g. If I pay attention to and value an anxious feeling then I am more likely to require self-soothing and turn to my BFRB. E.g. Pay attention to your big toe- think too much about it, over value sensation and over-respond by going to the hospital (Elena) E.g. If you have an urge, you might overvalue it by thinking will never go away and then feel like you have to do something about it leading to an overresponse – picking/pulling.
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- L So how do we apply acceptance? First off, we don’t mean that you have to like the internal experience. Chances are you aren’t going to like certain thoughts, feelings, sensations or urges. The only thing we are asking that you do is accept that they are occurring. Thoughts Acceptance doesn’t mean accepting the content of thoughts Happy Birthday Feelings Better to accept the feeling than to have a negative feeling and to have to deal with the fight against the negative feeling state as well. Body Scan/How to sit with feelings Naming feeling feeling going away more quickly Sensations Accepting sensations because sensations in the body come and go and will actually go more quickly if we accept them, Urges Urges come and go, just like thoughts, feelings and sensations. All of these experiences tend to slowly increase and peak and then dissipate over time. We can imagine surfing the urge as we might surf a wave knowing that it will increase and then decrease naturally.
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- Teletherapy New BFRB in person group in Fullerton – call Lisa with questions. In person BFRB group in Brentwood. Four offices local to Southern California for individual therapy.
- Free and can be accessed here
- Free and can be accessed here
- Free and can be accessed here
- Free and can be accessed here