Dr. Dawn-Elise Snipes is a Licensed Professional Counselor and Qualified Clinical Supervisor.  She received her PhD in Mental Health Counseling from the University of Florida in 2002.  In addition to being a practicing clinician, she has provided training to counselors, social workers, nurses and case managers internationally since 2006 through AllCEUs.com 📢SUBSCRIBE and click the BELL to get notified when new videos are uploaded. 
If this video has helped you, please consider donating to support the channel Cashapp: 💲DocSnipes  Paypal: https://DocSnipes.com/Donate  YouTube:  DocSnipes.com/Join
💻 Online course based on this video can be found at 
https://AllCEUs.com Unlimited continuing education CEUs $59 
⭐ Specialty Certificate Programs and Masterclasses in Case Management and Counselor Certification beginning at $89 https://AllCEUs.com/certificate-tracks

#mindfulness #selfawareness #strategies
#selfhelp #cognitivebehavioraltherapy #tips #counseling #counselling

NOTE:  ALL VIDEOS are for educational purposes only and are NOT a replacement for medical advice or counseling from a licensed professional.

Video by Dr. Dawn Elise Snipes on integrative behavioral health approaches  including counseling techniques and skills for improving mental health and reducing mental illness.

AllCEUs.com provides multimedia counselor education and CEUs for LPCs, LMHCs, LMFTs and LCSWs as well as addiction counselor precertification training and continuing education on many of the videos on this channel.  Unlike other providers like CE4Less, AllCEUs includes a weekly LIVE Stream Webinar with your unlimited continuing education and professional development membership.

I'd like to welcome everybody to today's presentation of 12 strategies for mindfulness and self-awareness using contextual cognitive behavioral therapy.

In this presentation, we're going to define and review the concepts of contextual cognitive behavioral therapy, explore the impact of context on people's phenomenological reality or their personal reality.

We'll explore how addiction and mental health issues can be influenced by context and explore how acceptance, awareness, mindfulness, and psychological flexibility can all be used to address issues including mental health issues, addiction issues, and physical health issues, which is what we call transdiagnostically.

Well, addiction and mental health issues are often intergenerational, and they are strongly correlated with each other.

Adverse childhood experiences, impaired occupational and social functioning, and health problems in general.

But it's important for people to develop an awareness of their current context.

Because if they grew up in an environment with adverse childhood experiences or ACEs, then they may be expecting the world to still operate in that function.

They may still be operating based on schema they formed in an unsafe environment when in the current context, they're actually much safer.

They may be forming schema or may have formed schema based in the past when they were clinically depressed, whereas in the current situation, they are asymptomatic or in remission or whatever you want to call it.

Contextual approaches encourage mindfulness in the present moment.

When we are mindful, we are aware of what is going on in the present moment in ourselves as well as in our environment, in our context.

Contextual approaches accept each person's truth is constructed from their schema and the resulting interpretation of the current moment.

And that's what we call phenomenological reality.

Every person can experience a situation differently based on their prior experiences, their prior experiences shade or impact how they interpret things.

For example, some people interpret very large hand gestures and a lot of gesticulating, as they say, as being threatening because that's associated with arguing and violence.

Other people associate that with people that are happy and just being simply emotive.

So 2 different people can see the same thing happening and have 2 very different assumptions or interpretations of the situation.

Neither person's truth is necessarily wrong.

Their truth is based in that moment is saying, okay, based on my past experiences, this is a threat or this is not a threat.

Contextual CBT says, okay, let's acknowledge that that is your truth in that moment, then let's explore it a little bit further.

Let's explore the current context and see if that truth still is accurate.

The goal is to consider the context and function of the past and present issue and empower the person to make conscious choices toward their valued goals, to examine their, their truths, to examine their interpretations and say, okay, I can understand how I might have this interpretation based on my past.

However, is this the interpretation or is this the reaction that is currently what I want to use?

Remember that the prefix re means to do again.

If we repeat something, we're doing it again.

If we regress, we're going to an earlier age.

If we relapse, we're doing something that we had stopped doing and we're starting to do it again.

And if we react, we are acting the same way that we've acted in the past.

And I know you were like, what, what did those first ones have anything to do?

I want you to get to the re point for reaction.

Reactions are often based in our default mode network, are often based in autopilot And contextual cognitive behavioral therapy says, all right, let's start empowering people to choose their action, to be proactive instead of reactive.

The family context can be a preventative or a risk factor for the development of mental health and addiction issues.

If the child grew up in an environment where there was secure attachment and high emotional intelligence and all kinds of good stuff.

Then they form their schema based on that and the schema that they use based on that context, they carry forward into the present, which generally doesn't lead to a lot of problems.

Children who grew up in adverse environments form their schema and they grow up and continue to expect people to be untrustworthy, uncaring, abusive, neglectful, whatever.

So it's important to recognize that the context in which the original schema were formed is really important, but it's also important to empower people to recognize their current context.

When you were 8, you couldn't do anything about it.

You had to rely on your caregivers as crappy as that situation was.

Now that you're 28, how is this context different?

Children develop schema about themselves, others, and the world through these early interactions.

In later life, people continue to develop their schema that is influenced by their past learning.

What they're saying there is unless we stop and actually intentionally evaluate our schema, then we are making, forming future schema based on past assumptions, whether or not those assumptions are accurate in the present context.

So contextual CBT really says we need to get into our wise mind.

Turn off that default mode network, turn off that autopilot and get into that wise mind.

Now we've talked about this before, but it's important to recognize that at the heart of a lot of mental health and addiction and even physical health issues is attachment trauma.

And people need secure attachment in order to feel safe.

They need consistency in their caregivers or in their loved ones if they're older.

They need people who are responsive and they need to be responsive to their own needs.

And consistency and responsiveness are things that people start to develop when they become more mindful.

When people are not mindful, then they only pay attention to what they need, kind of, sort of, some of the time, if ever at all.

Consistency means the person is regularly mindful, regularly checking in with themself, regularly compassionately responding to themselves and addressing their needs in the best way that they know how.

Responsiveness in others kind of goes along the same way.

It's important to recognize that some caregivers just didn't have the skills.

If they didn't have emotional intelligence, they can't respond with it and they certainly can't teach it.

If they didn't understand age appropriate communication or age appropriate intervention, they may have been trying to respond to the child, but they were responding to this 5 or 6 year old like they were 25.

They were talking to them like they were adults and not understanding that children actually think completely differently.

Attention is Also important, whether it is mindful attention to yourself, paying attention to yourself, spending time with yourself, figuring out what you like, what you need, or attention from others where people are proactively spending time with you.

They're not doing it to help you feel better.

It's not a reaction to distress, but they're proactively saying, Hey, I want to spend time with you.

See what what's in what you are interested in.

Validation is another important concept And this goes along with understanding that phenomenological reality.

Children's perspectives are very different than adults' perspectives.

What a child or a tween may think is the complete end of the world is a non-issue for adults because we've been through so many more things and we've experienced so much more.

We can look at that particular issue and go, Oh, in 10 years, you won't even think about that anymore.

The child at that point in time, that is a huge big deal for them compared to other things they've gone through.

In that context for that child, based on their reality, their phenomenological reality and their limited experiences, it's a big freaking deal.

So validating that it's a big deal for them is important instead of invalidating and telling them to get over it or, oh, you just, it won't be a big deal later.

Providing encouragement is also important for the self.

You know, if we're being mindful, if we're engaging in self-awareness and self-acceptance, encouraging ourselves to step outside of that comfort zone, step outside of that safety area to try new things, but recognize we can come back to that safe home base and receive unconditional love.

Now, hopefully the person can provide unconditional love to themselves, recognizing that, hey, I'm not perfect.

I'll make mistakes, but I'm still a good person.

And hopefully they have other people in their environment to whom they have or with whom they have secure attachment that can provide that same thing.

But It's important to recognize if people were in an environment, were in a context that did not have these things that promoted insecure attachment or neglect or abuse, then They often don't have the skills and don't know how to do these things to create secure attachment.

Think about what it's like for a child growing up in a house in which 1 or both caregivers has either an addiction or a mental health issue.

Now these are only 2 of the identified quote adverse childhood experiences, but if you think about it, a lot of the other adverse childhood experiences like abandonment and violence and neglect and abuse.

Caregivers who are engaging in those types of things often have an addiction or mental health issue.

You're not going to have a mentally healthy, physically healthy caregiver that chooses abuse or neglect.

You know, that's, you know, if we're talking about mentally healthy, that means non-narcissistic, of course.

So think about what it's like because caregivers with addictions or mental health issues are doing their darn best most of the time or a lot of the time to put 1 foot in front of the other and take care of themselves.

Now when I'm saying these things, what I'm talking about is an uncontrolled addiction or mental health issue.

People who have been diagnosed in the past with depression or addiction or something else and they're in remission, if you will, That's not what we're talking about.

What we're talking about is caregivers that have active issues going on.

Common characteristics in the addicted household.

So what the child learns, and I want you to think about it, pick 1 of these because in an hour we don't have enough time to go through each 1, but think about it maybe from the toddler's perspective or the elementary school child's perspective.

If the caregivers are having difficulty dealing with life on life's terms, then they certainly can't teach that to the child.

So how does the child feel when they're seeing their caregiver struggling and they're not getting the skills and tools they need.

Difficulty dealing with distress, poor coping skills.

Well, for the child, they see the emotions overwhelming their caregivers.

And again, they're looking to their caregivers for structure, for stability, for safety.

And if their caregivers are being overwhelmed by emotion, then that's got to be pretty scary.

And it's also interesting in these households to examine how the child reacts to these things.

Because sometimes children will act out and develop behavioral problems in order to sometimes say, hey, look at me, focus on me.

Then you won't have to focus on this other stuff.

Other times, children become what we call the hero.

They decide that they are going to be the absolute very best so they don't add any more stress and so maybe they can help their caregiver feel happy.

So there's lots of different ways that children respond to this, which is why it's important to use context.

Thinking about the environment they grew up in and the behaviors that they have, how did those behaviors make sense in that context?

Back to the addicted household, There is impulsivity, lack of patience, and distress tolerance.

People with addictions often are struggling with impulse control, struggling with emotional dysregulation.

There can be neglectfulness, not only of the child, but also the caregiver is maybe neglectful of themselves.

If they are clinically depressed, if they have another mental health issue or addiction, they may not be showering every day.

They may not be getting out of bed to feed themselves, let alone take care of the child.

There can be hostility and defensiveness, blaming, or manipulation.

When there is someone with an addiction, there's often a, someone else who is enabling that addiction and there's a tension dynamic between the 2 of them.

The enabler is trying to fix or control the person with the addiction.

The person with the addiction is trying to cope with life on life's terms the best they can because they are completely overwhelmed.

A lot of people with addictions become terrified at the threat of recovery because none of that other crap's ever worked before.

But that is what I hear from people when they are considering early recovery.

They're like, I've tried that stuff before and it hasn't worked.

And the addiction is the only thing that has helped me survive until now.

So the thought of giving that up is terrifying.

So I'm going to defend it as much as I can.

There can be withdrawal from others leading to disconnectedness or just withdrawal because there's no pleasure in other activities.

Justification, minimization, denial, low self-esteem, guilt, shame.

You know, there's a lot of stuff that happens in the addicted household.

And it's also important to recognize that most people with addictions also have co-occurring mental health issues.

You know, you start messing with those neurotransmitters, it's going to have an effect on mood.

It's going to have an effect on the stress response system.

So thinking about what it's like for a child to grow up in an environment where their caregivers are evidencing, are showing these behaviors.

And at this point, the caregivers probably are oblivious at least part of the time to the child's needs because they're having some so much difficulty taking care of themselves.

Common characteristics in households where somebody has a uncontrolled mental health issue.

Again, difficulty dealing with life on life's terms, difficulty with coping, impulsivity, distress intolerance, Neglectfulness, hostility, irritability, withdrawal, low self-esteem, guilt, and shame.

Remember that people who have anxiety, anger, depression, obsessive compulsive disorder, ADHD, In many, many times they recognize that their behaviors or the disorder, however you want to phrase it, is causing distress in other people, is keeping them from doing what they want to do, is keeping them from being the person they want to be, which can impact their self-esteem and they can feel guilty and ashamed of the fact that they can't do that right now.

And there can be a sense of hopelessness and helplessness.

The end product, people's reactions, remember they're repeating actions from the past People's reactions in the present, their autopilot in the present is based on prior learning plus the present moment.

So something in the present moment triggers those schema from the past and their brain says, oh, this is how we react.

And it's important to help people develop the skills to be able to, as Linehan would say, get into their wise mind so they can evaluate the accuracy of their schema and the effectiveness of their old reactions in the present context.

And is my current reaction the 1 that I want to use in order to use my energy to move toward my rich and meaningful life.

When people grew up in a chaotic, stressful environment, they may not know how to let things go.

They may not know how to let, you know, let things go.

They may not know how to experience calm or contentment.

When people's self-esteem was damaged when they were growing up, then they may react from a place of feeling bad about themselves even if objectively they may say, okay, I'm a pretty good person.

That sometimes we talk about inner child and that's kind of what we're talking about with some of the schema is, are the schema from the past effective in the present?

Mindful self-awareness with contextual CBT.

So now we're getting down into the nitty gritty and the 12 or so techniques that can help people start becoming more mindful, aware in the moment, and aware of the context so they can more effectively implement cognitive behavioral strategies.

Well, that's kind of a no-brainer there, given the title of the presentation.

Mindfulness improves people's ability to be present in the present.

It encourages people to shift from automatically reacting to thoughts and feelings based on their schema, to being aware of experiences in the present moment in order to get more flexibility.

Observing and describing what's going on without reacting in the present moment.

And I'm going to say that a couple times today.

And if it, you know, gets under your skin, I'm sorry about that.

But radical acceptance and mindfulness starts out with accepting the present moment for what it is.

How you act in response to it is changeable.

And Every time you observe a moment, as soon as you've observed it, the next moment is happening, and then the next moment is happening.

Change is constant, which is really awesome, especially when people start feeling like they are agents of change.

When people start feeling like they can say, all right, I identify what's going on here.

I don't like the way I'm feeling right now, or I don't like what I'm doing right now and I can improve the next moment.

So general awareness, encouraging people to reflect on what are they feeling physically.

And this can be stressful for people with a trauma history.

Don't start diving into super deep sensations.

You don't need to get down into deep sensations like in your gut right away, especially if you have a history of trauma.

What thoughts are going through my head, whether they're ruminations or, you know, all kinds of different thoughts or nothing at all.

You know, that's very general mindfulness, general awareness of the present moment for the person.

How has this been helpful or protective in the past?

So how is this feeling or these thoughts or these urges, how have they been protective or helpful in the past?

Once you identify their function, then you can say, all right, I see that this behavior was designed to protect me.

However, it's not producing the results that I want in my rich and meaningful life.

You know, what is the function and what are other options to achieve that same end?

What is similar in this situation to the past?

Recognizing what I'm feeling physically or emotionally or thinking or my urges, What's similar in this situation?

And what is different in this situation than in the past?

You may be engaging in a discussion with somebody that becomes somewhat heated and you've engaged in those types of discussions in the past and it ended badly.

In the present situation, what is similar is there is tension or anger in this discussion.

Well, Hopefully the person you're having this discussion with is a safe person.

However, they are passionate about whatever they're talking about.

We also need to accept our quote, internal experiences, radically accept our feelings, thoughts, and urges without having to act on them.

I can accept that I had this fleeting thought or maybe I'm ruminating on something right now.

Okay, I'm having this repeating thought that is just driving me bonkers.

It means I'm having that urge and I need to be curious.

Think of feelings, thoughts, and urges like road signs.

Take them under advisement and then decide what to do.

So your speed limit, you know, remember anger and anxiety are responses to a threat and anger is the fight.

Your body's dumping all kinds of energy to make you, to prepare you so you can fight or flee.

So you have all this energy, you have all this gas in your gas tank.

The speed limit sign says, hey, let's go 120.

Or can you just keep plugging along at 45?

Is there a need to ramp up what's going on?

Construction signs means you can't get through this way.

Are you just going to turn around and go back home?

Or are you going to find a way around it?

Are you going to give up or are you going to persevere?

You start having this urge, you know, sometimes you get behind a really slow driver and you just have this urge.

You're like, oh my gosh, I need to get around this person.

Do you have to do it Or can you respect that no passing zone and not pass?

Accept thoughts and feelings without having to act on them by unhooking.

We've talked about this in other presentations.

Unhooking means recognizing that thoughts, feelings, and urges are fleeting.

And unhooking, I always forget to have something to hold here.

Unhooking says I'm having the urge to instead of I have to do this saying I'm having the urge that I want to have more coffee.

So I'm holding this urge about having more coffee, knowing good and well I probably shouldn't have more caffeine this late in the day.

I'm having the thought that I'm a horrible person.

Do I want to, do I want to keep it with me or do I want to change it?

Do I want to morph it like Plato into something else?

And this is really helpful to unhook from feelings because we can feel anxious.

It doesn't mean we have to hold on to that anxiety.

Anger and anxiety are our body's way of saying, hey, there might be a threat.

Dialectics are another tool for accepting internal experiences.

I can be a good person and take care of myself.

So many times I hear people telling me, if in order to be a good person, I have to be there for everybody all the time.

And my response is usually, well, if you're there for everybody all the time, how does that impact you?

See all Doc Snipes transcripts on Youtube

12 Strategies for Mindfulness and Self Awareness in Contextual Cognitive Behavioral Therapy