The following is a synopsis of a weekly Dialectical Behavior Therapy (DBT) group lesson, based on the work of Marsha Linehan out of the University of Washington.
Disclaimer: I LOVE doing this, I think it is desperately needed, and I WANT to do it. However, I have zero time to do it so, while I am committed to giving it my all, I may fall behind or skip a week or two. I apologize in advance for that, and for the fact that I will not be spell checking, fixing formatting, or doing a read through before I post. No offense, but I gotta draw the line somewhere!
Distress Tolerance Skills Module: Willingness vs. Willfulness
Within DBT there are several practical, concrete skills, especially within this module. We have to remember though that none of them really are going to be effective unless we do them mindfully. In addition to mindful practice, we need to also do them Willingly.
One of the things I like about the DBT model is the way it parallels the Alcoholics Anonymous (AA) approach to recovery. For example, Linehan uses a lot of acronyms to help us remember skills. AA has a lot of slogans, sayings, and acronyms to assist with recovery, one of which is the H.O.W. principle.
H.O.W. Principle of AA
According to AA, there are 3 things we need to recover from Alcoholism. I maintain that you need theses 3 things to recover from anything.
Honesty: Just like mindfulness has to start with observe, recovery has to start with honesty. Whether we are recovering from Borderline Personality disorder, depression, addiction, trauma, grief…whatever it is….we can’t begin the process of recovery unless we are honest with ourselves and others. If we don’t begin to be honest with ourselves about our problems, and what it takes to recover, we cannot get better. Similarly, we need support to get better, and lying to our therapists, our families, or any supports we have will only impede our recovery. Lying can be unconscious or conscious, by omission or commission. No matter what type of dishonesty we use, it will interfere with our recovery… no matter what.
Open-Mindedness: Once we decide to get honest, next we have to be open to hearing what we need to hear. Open mindedness means that we are LISTENING. Taking in the information we need to get better, and considering what may help us even if the idea sounds wrong, crazy, hard, or stupid. Being open minded means that we listen to others, and that we refrain from making judgements about whether or not we need something. It also requires us to trust in someone, and something that we fear.
Willingness: The final requirement for recovery is willingness. If open-mindedness is listening and being ready to practice skills that are hard or seem irrelevant, then willingness is doing those things.
Let’s take an example that people commonly struggle with: medications. Imagine someone is coming to me for therapy because they just can’t get out of bed anymore, and, through honest reflection and discussion, we realize that this person is struggling with clinical depression. He then goes on to say that he will do therapy, but does not want to take any medication, due to potential side effects. This person may not want to take medicine, but by being open to considering how it may help him, what the pros and cons are of doing so, and making a plan for how to proceed, he just may change his mind. Now suppose he still doesn’t want to take medicine, or after reflection, doesn’t want to take medicine even more than when he first came to me. If he is honest and open, he may come to the conclusion that he needs to do this, and by taking medicine he is practicing willingness. So what are the steps to being willing?
What is Willingness?
Willingness is doing just what is needed in every situation in an unpretentious way. This means that we are constantly assessing what is EFFECTIVE (the last skill of mindfulness), and putting aside our own agenda, needs and desires, etc. so that we are meeting the needs of the moment the most efficient way possible, rather than focusing on less important things.
Willingness is listening very carefully to, and following your wise mind. When we are willing, we are able to tap into our instinct, be aware of our emotions, and problem solve. We are mindful of the moment and aware of what we think, feel, and physically respond to.
Willingness is allowing into our consciousness our connection to the universe, to the chair we are sitting on, the community we are in, etc. Becoming as willing as possible means that we are not denying, or minimizing, our impact on the world. We can fully see that we are connected to everything and everyone, recognizing that what we choose in each and every moment is important, not just to us, but to the world at large.
What is Willfulness?
So if willingness is those things, willfulness is the opposite of those things.
Willfulness is refusing to tolerate the moment. When we run from the moment, and anything in it, we are being willful. Right now, writing this, I am freezing because the heat is too low. I am hungry because I need a snack. I am tired because I need some sleep. I am stuffy because of allergies, and I am taking too long because my cat keeps messing with my keyboard. I also am in my bed, safe, at peace, and under the covers, doing what I love. Every moment has good and bad, and I am willing to tolerate the bad rather than trying to avoid it.
Willfulness is trying to fix everything. Problem solving is an essential skill to effectiveness. Fixing things is necessary sometimes. SOMETIMES. I can get up right now and turn the heat up, and that is a great thing to do. It is self soothing, and I have a right to make myself more comfortable. But I don’t have to fix every uncomfortable situation I am in. I can do it when I get up, or not at all. I am willing to be a little uncomfortable right now, i don’t need to fix it.
Willfulness is giving up. While sometimes we need to tolerate things without fixing them, we also can’t give up. When we get the “fuck its”, that is giving up. Life is hard. It is also very unfair at times. We all feel hopeless, helpless, and misery at times. But we can’t give up. That is willful, we need to be willing to make our life better.
Willfulness is sitting on your hands when action is needed. It is the opposite of effectiveness. I need to turn the heat up to be comfortable. I have a solution to make me more comfortable. If I sit here and complain about how cold I am, wallow in self pity, or use it as an excuse to not write my blog. THAT is willfulness. I need to be willing to do what is needed to be effective. If the cold is so bad that it is making me ineffective, I need to focus on being effective. While my cat playing with my keyboard may be an explanation for why I am not finishing my blog, it is not an excuse. When we are full of excuses, that is willfulness and that is not recovery.
Turning the mind toward willingness and away from willfulness is essential to our next week’s lesson, ACCEPTANCE. I need to be willing to accept painful and difficult things in my life in order to recover from them. I need to empower myself, rather than remaining a victim of my mental health.