Acceptance and Commitment Therapy
Acceptance and Commitment Therapy, known as “ACT” (pronounced as the word “act”) is a mindfulness-based therapy that incorporates elements of Buddhist mindfulness meditation and newer behavioral therapy techniques. ACT is quite different from traditional cognitive behavioral therapy (CBT) in that it teaches people how to accept and embrace unpleasant thoughts, feelings and sensations rather than trying to control or eliminate them. The rationale behind this, is that a great deal of human suffering is the result of not engaging vitally in life due to trying to reduce feelings such as fear, anxiety, frustration, etc. These emotions are necessary parts of working toward what you hold dear, your values, and to try to avoid them is to avoid those aspects of life which bring meaning and vital involvement. Through this process of embracing unwanted feelings in the service of achieving goals, often the negative feelings are significantly reduced.The paradox is, the more you try to avoid certain feelings, the more they hang around and negatively influence your life.
Although a relatively new treatment, there is significant research that ACT IS effective in working with a diverse range of clinical conditions, including depression, anxiety, OCD, workplace stress, chronic pain, PTSD, substance use, and even schizophrenia.
Cognitive Behavior Therapy (CBT)
Cognitive behavioral therapy (CBT) is the most well researched therapy available, with over 500 studies demonstrating its effectiveness for numerous psychological and medical problems. CBT operates on the idea that thoughts, feeling/body sensations, and behaviors are interconnected, and focuses on helping you change your thoughts or relationship to them in order to feel better. By targeting your reactions to situations, CBT can help you react more effectively in challenging situations, and even learn to feel better when you are unable to change situations happening around you.
Cognitive Processing Therapy (CPT)
Cognitive Processing Therapy (CPT) is an evidence-based Cognitive Behavioral Therapy recommended by the National Center for PTSD shown to be effective in treating symptoms of PTSD and trauma. It is a time-limited psychotherapy, consisting of 12-20 sessions. CPT recognizes that trauma tends to impact beliefs and emotions related to 5 areas:
Through this structured treatment, you will learn how to identify and modify trauma-related beliefs or “stuck points,” (e.g. "I am a bad person" or "I did something to deserve this”) that contribute to current life difficulties, which leads to changes in how you feel.
Dialectical Behavior Therapy (DBT)
Dialectical Behavior Therapy (DBT) is a cognitive behavioral treatment developed by Marsha Linehan, PhD. DBT can be provided individually and in a group setting to help people learn and use new skills and strategies to develop a life that they experience as worth living. DBT emphasizes these four skill modules:
DBT was originally developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD), and it is now recognized as the gold standard psychological treatment for this population. In addition, research has shown that it is effective in treating a wide range of other disorders such as substance dependence, depression, post-traumatic stress disorder (PTSD), anxiety, and eating disorders.
The goal of DBT is to help clients build a life that they experience as worth living. In DBT, the client and the therapist work together to set goals that are meaningful to the client. Often this means they work on ways to decrease harmful behaviors and replace them with effective, life-enhancing behaviors. Problematic behaviors evolve as a way to cope with a situation or attempt to solve a problem. While these behaviors might provide temporary relief or a short-term solution, they often are not effective in the long-term. DBT assumes that clients are doing they best they can, AND they need to learn new behaviors in all relevant contexts. DBT helps enhance a client’s capabilities by teaching behavioral skills, and these skills help people develop effective ways to navigate situations that arise in everyday life or manage specific challenges.
Dr. Deniz provides DBT-informed therapy to individuals, as well as offers a DBT Skills group for women survivors of trauma.
Mindfulness & Self-Compassion
Treatment is often integrated with my advanced training in Mindfulness-Based Stress Reduction (MBSR), the gold standard 8-week mindfulness program developed by Jon Kabat-Zinn, and Mindful Self-Compassion (MSC). Mindfulness may be defined as “The awareness that arises from paying attention, on purpose, in the present moment and non-judgmentally” (Jon Kabat-Zinn).
MBSR is an intensive training in mindfulness meditation with the goal of creating a structured pathway to relieve suffering and increase wellbeing for people facing a host of challenges arising from a wide range of medical and psychological conditions and the demands and stressors inherent in the every day lives of human beings.
MSC was developed by Chris Germer, Ph.D. & Kristen Neff Ph.D. and incorporates skills of mindfulness and self-compassion to create powerful skills for resilience and wellbeing. Mindfulness is the first step in emotional healing. It is being able to turn toward and acknowledge our difficult thoughts and feelings (such as inadequacy, sadness, anger, confusion) with a stance of openness and curiosity.
Self-compassion involves responding to these difficult thoughts and feelings with kindness, sympathy and understanding so that we soothe and comfort ourselves when we're hurting. Research has shown that self-compassion greatly enhances emotional well-being. It boosts happiness, reduces anxiety and depression, and can even help maintain healthy lifestyle habits such as diet and exercise. Being both mindful and compassionate leads to greater ease and well-being in our daily lives. These approaches may be particularly important to integrate into therapy around shame and self-criticism.
Prolonged Exposure is another evidence-based trauma treatment recommenced by the National Center for PTSD that helps people process the trauma that occurred, and find meaning in the experience. PE has been shown to be an extremely effective treatment that significantly reduces the symptoms of PTSD as well as depression, anger, shame, and anxiety that often accompany trauma. PE also helps you feel more confident and increases the ability to discriminate between safe and unsafe situations, opening you up to improving many aspects of life.
PE works from the premise that the brain is overloaded when a trauma occurs, and this causes problems processing and encoding the information in the brain. PE remedies this through recounting the trauma in session, reducing the emotional dysregulation caused by memories of the trauma, and finding new ways of thinking about how it fits into one’s own personal narrative. Additionally, PE helps people reduce avoidance of situations and trauma reminders that cause fear and anxiety through safe and graded exposure.
Standard treatment consists of 9-15 sessions conducted once or twice weekly for 90 minutes each. The duration depends on needs and rate of progress. This treatment is intensive, and I have helped many patients safely and successfully overcome their trauma. I am happy to discuss whether this treatment may benefit you in our initial consultation.