DBT, Chronic Invalidation & Finding Queer Joy with Dr. Kiki Fehling (309)

0:02When we struggle with emotions and we're in that 10 out of 10, when we're in emotion mind, it's so often, again, this is what we can all experience, but for my clients, they feel out of their minds and out of their bodies often. It's overwhelming. And in those moments, it's so hard. You can't process grief in those moments. You can't communicate effectively in those moments. Like the point is in those moments, it's so useful to have the concrete skills that might feel like a little derivative or too simple outside of those moments. But in those moments, that's what you need. And then with more practice, more experience, you start gaining confidence, you start learning, oh, I can do this.

0:45These emotions don't last. They're a part of my experience and I can respond to them. And it's just, again, this back and forth of across time of then that decreases your emotional intensity. It increases your emotional abilities like 100%. I think it is about learning how to tolerate, learning how to trust yourself, learning how to trust your emotions and your ability to relate to them so that you have more hope for the future and hope in yourself, trust in yourself. Welcome to Therapist Uncensored. Building on decades of professional experience, this podcast tackles neurobiology, modern attachment, and more in an honest way that's helpful in healing humans.

1:26Your session begins now with Dr. Ann Kelly and Sue Marriott.

1:35Hey, you guys.

1:36Ann Kelley: While we know relationships are wonderful. They are also really hard. Many of us believe that they shouldn't be, that if we have good connection and good communication, things will just go smoothly. But it's really that belief that can make us feel stubborn and even more hopeless. So relationships take work. It does for Sue and I. We can make it look easy. It's not. And one of the ways is because many of us, we differ. We differ in what activates us, what makes us feel threat, the expectation. And it's these differences that are held in our body, not our thoughts. And they influence how we talk, how we love, how we fight.

2:12Ann Kelley: So holding that belief, if he or she or they could just understand me, if they love me, they do something different, is not really true. And we're talking about relationships with your partner, your teenager, your mother-in-law. So Sue and I have created an online course that can help you understand yourself and those you love in a different way. This is not just for therapists. It's for everyone. Although the good news is if you're a therapist, you can get CEs along the way and all of you can use the visuals and the worksheets individually, or you could even use them in your own private practice.

2:46Ann Kelley: So while the course is based on our book, Secure Relating, Holding Your Own in an Insecure World, it is definitely not a replication of the book. We talk directly to you. You learn how to understand more deeply your attachment, those you love, the neuroscience behind it, and how to build secure types of connections right now in your everyday relationships. Rather than changing one another, y 'all can shift together in very important ways. It's very powerful. We're getting great reviews. Check it out. It's at therapistuncensored.com slash BAS, therapistuncensored.com slash BAS. The BAS stands for Beyond Attachment Styles, the Science of Growing Secure Adult Relationships.

3:33Ann Kelley: And by the way, the cost of the course is about the amount of one individual therapy session. And yet you get hours and hours and hours of what we think is extremely valuable information. So check it out. Every one of us at some point has emotions that are just too much. They're too big, too fast. We can't think our way fast enough through them. It's just part of being human. But some of us live closer to that edge than others. In our last two episodes, we had an expert talking to us about narcissism and borderline personality and describing both as having a struggle with regulation. With narcissism, it's regulating self-esteem.

4:17Ann Kelley: And with borderline traits, it's the difficulty in regulating emotion. So today we turn to that emotional side on its own, to a simple question, when feelings get bigger than we are, what do we really actually do? So here's the idea at the heart of our guest, Dr. Kiki Failing's work. when someone is wired to feel intensely and keeps getting the message that what they feel is wrong, that they're too much, that something about them is off, those emotions get harder and harder to carry. There's a name for the message. It's chronic invalidation. So this can happen inside a family in so many different ways with no cruelty at all.

4:59Ann Kelley: Possibly maybe a sensitive child with parents who don't quite know what to do with all that feeling. But the source of invalidation isn't only coming from families. Whole cultures do it too. We've talked on this show about the racial version, what it's like being watched and doubted and still somehow never fully being seen and the impact of that. So today, Dr. Failing brings the queer experience of invalidation and its significant impact to mental health, to relationships, to how you see yourself, and what's nice about what queer joy can do in the other direction. So Kiki is a clinical psychologist and one of the small number of certified DBT experts.

5:45Ann Kelley: She's the author of Self-Directed DBT Skills, Regulate Intense Emotions and Create Lasting Change with Dialectical Behavioral Therapy. It's a self-help book that anybody can use. And she has a brand new work LGBTQ plus mental health workbook. Highly recommended. By the end of our talk, you'll understand one of the deepest reasons emotions become overwhelming. We talk about what DBT offers and where to find such skills yourself. And you'll see also what's really nice is the parts of us we were taught to doubt might be exactly where our joy lives. All right. Hi, Kiki. Welcome. I am so glad you are here on our show today.

6:30I'm so happy to be here. Thank you for having me.

6:32Ann Kelley: I loved our conversation before, so I'm excited to jump back in and get deeper with you. So before we jump in, I'm really excited to have somebody on that has some expertise in DBT, and we're going to get into that, and you have so much more to offer. Before we jump in, Can you just share with the audience who you are? What drew you to this particular corner of the work, emotions that overwhelm, and just how we've learned to carry them? Yeah. So I am a licensed psychologist. I live in Western Massachusetts. And I'm also a speaker, content creator, writer, all focused on getting the accurate mental health information and specifically information about dialectical behavior therapy or DBT out into the world.

7:21At this point, I'm not practicing therapy, and I entirely focus on that dissemination standpoint, because I have personally seen the ways that learning DBT principles and DBT skills can really change people's lives. It certainly has changed mine and helped me get through some of the toughest part of life. So I'm passionate about getting it into the hands of people because you can do that outside the therapy room, which makes it really special, too. And I think I got into this area, DBT, specifically because I feel like an emotionally sensitive person. I've struggled with my own mental health and always felt like I had really big emotions.

8:01And learning DBT and teaching DBT has helped me so much in improving my mental health and improving my emotional resilience. And when I was practicing, one of my specific areas was in helping LGBTQ plus or queer people. And I saw the ways in which dialectics and DBT were particularly useful for that population. And as a queer person myself, they were helpful there. And so that's how I got into LGBTQ plus mental health of trying to prevent suicide in this population that has particularly high rates and generally just hoping to decrease suffering in the world with this therapy and skill set that I really believe in.

8:43Ann Kelley: Well, our audience has just heard two episodes that are focused on regulation issues, whether it be through self-esteem or emotions, because we all can struggle in those areas. And he really basically said DBT is the way to go when you are dealing with difficulty regulating oneself on an emotional level and that the research is highly supportive of it. So it's going to be a great dovetail at the end of that. And for somebody that's not familiar with DBT and they just know it as a buzzword, what is it really? So DBT is a therapy that was created to help people struggling with intense emotions and specifically suicidal behaviors and self-harm behaviors, and eventually applied specifically to borderline personality disorder or BPD.

9:35Since then, it has been shown to be helpful for people struggling with lots of other types of mental health difficulties, even disorders, substance use, disorders, anxiety, depression, emotion, dysregulation in general.

9:48Ann Kelley: I know that we tend to kind of, in psychology as therapists, to think about it as, you know, mental health issues, but like, it's also been found to be deeply just helpful for anyone out there with emotional, you know, like the times when we have emotional dysregulation that are just flooding us. So these strategies are not, are for really for all of us in a way, would you agree? 100%. I'm really glad you said that because I was about to say one of the things that makes DBT so useful for so many different types of mental health struggles is the fact that it teaches concrete skills to help with emotion regulation, mindfulness, distress, tolerance, interpersonal effectiveness, which if you read between the lines are life skills, right?

10:35Like these are things that anyone could benefit from. And so that's where I have found it so useful. My colleagues find it useful. Like we practice what we preach. I do think DBT skills are going to be particularly helpful for anybody because we all feel a big emotion sometimes, as you say.

10:50Ann Kelley: And it's so frustrating, right? Because we think that cognitively we can like, oh, why did I do that? The next, why did I scream at my kid when I love my, you know, so it's, it's such a vulnerable thing, especially in our culture here, isn't it? Like, we're not supposed to be emotional. We're supposed to be rational. And when we lose it, there's such shame and belief that we're supposed to always be able to have it under control. So much shame. I think the way that we talk about emotions in most cultures in America right now, there's definitely a denial of intense emotions and avoidance of talking about hard things, painful things, like negative, quote unquote, bad things.

11:26And that can lead to exactly shame and more stress and fear of emotions, which then just falls back on itself and makes those emotions worse and more strong in the first place.

11:38Ann Kelley: Well, what is the dialectical part? I understand the behavioral therapy, but it starts with dialectical. Can you kind of explain to us what that means? Yes. So dialectics is a philosophical framework that just refers to the fact that two seemingly opposite things can be true at the same time. So dialectics were brought into DBT because for people who feel emotions really intensely, who have BPD, been diagnosed with BPD, or who struggle with their emotions, it's really common to get stuck in really intense, negative or black and white thinking, because of strong emotions. So again, I'm sure any listener can think about the last time they did feel very angry or very scared or just very upset.

12:26Their thoughts were more likely to be very intense in those moments, very like all or nothing, very extreme. So everyone has extreme thoughts when they're feeling intense emotions. So for folks who feel intense emotions, they're more likely to kind of go back and forth and really struggle with finding the nuance in the world that is, we want it to be black and white sometimes, that it's very much gray or plaid, you might say, rather than black and white. And so dialectics is a way to help us integrate black and white, to find the gray, and to sit more comfortably in the fact that things change, the fact that we don't know everything, the fact that there's a lot of uncertainty in life.

13:06Ann Kelley: Boy, just sitting with that is sometimes very nerve wracking. The uncertainty, isn't it? Yeah. And I always kind of laugh about the relief of getting black and white when you're really mad because it's just so right, wrong. And the idea of needing to pull out of that into uncertainty and to not be in the black and white, it's not an easy feat. Yeah, it's a lot easier to just be mad at someone and yell at them or give them feedback rather than expecting or diving into the ways in which they had a reason for doing the thing that hurt you. And you might even understand it, even if you still wish they hadn't done it.

13:44It's a tricky balance. How does it differ from maybe many people are familiar with cognitive behavioral therapy?

13:52Ann Kelley: And I know I'm referring to therapy, and I want people to continue to remember to think we're thinking about practices in general. not just in a therapy office. But if you look at cognitive behavioral therapy, how does DBT differ? Yeah, so DBT actually on the title of the initial treatment model is actually cognitive behavioral therapy for borderline personality disorders. I will say that. DBT is heavily based on CBT, which at its core is just recognizing the ways that emotions, thoughts and behaviors all influence one another. And DBT is different by specifically adding on those skills that I mentioned, but also bringing in acceptance and mindfulness based practices.

14:38So CBT, at least traditionally, historically was very change focused, very problem solving, challenging negative thinking, changing your behaviors. And DBT came in and gave a whole another like column of skill set more focused on actually kind of, not kind of, developed and inspired by Zen Buddhism, and other kind of acceptance based philosophies and principles to help us balance out that change. And so that's one of the core dialectics of DBT. Also, how can we accept ourselves, our lives, the things that we don't like, acknowledge that those things are true and real and reality is the way that it is while still working to change our reality, our world, our lives, ourselves, the way that we want to because of the way it causes us pain.

15:28So constantly going back and forth between those two things, DBT offers lots of techniques and skills and principles to try to help us do that.

15:37Ann Kelley: So walk us through that. That sounds like so inspirational. Like, I mean, in a beautiful way, right? This idea of cognitive behavioral therapy. I mean, any therapy that's focused on let's get you to change the way you think directly is not so easy, right? Especially if underneath there's a lot of shame about who you are and how you're being with your emotions. And so helping somebody move to acceptance seems huge, right? It's not like let's change you to be the better person, but let's help you accept who you are, but also work at change. Is that what you're saying? Like, am I catching that? Yeah, you went right for another one of the main dialectical tensions that we're often helping folks integrate and synthesize in that a person who feels emotions really intensely, who feels like they're more emotionally sensitive, maybe even from birth, that can cause a significant amount of pain and difficulties interpersonally and dysfunction, problems in life in various ways.

16:42And so it can feel like all a negative thing. And I can be working towards change, change, change, change, change. How do I decrease this emotion? How do I get rid of it? How do I be better, quote unquote? How do I improve? But in the meantime, as you said, that's causing shame. And so acceptance might include validation, it might include more self insight, more understanding of, okay, wait, it really is this way that I feel things intensely, and maybe exploring why is that? What are the causes for this? And not necessarily needing to know for sure why, but exploring, why does it make perfect sense that I struggle the way that I struggle?

17:21Because it does. If I struggle, there's a reason I struggle. And so there might be a constant coming back to, in order to better change this thing that I want to be different, how do I come back to, well, it is what it is, and why is that? And sitting with just that first and processing the grief around that. The thing that can be hard to explain until you experience it is so often, well, on one hand, acknowledging and accepting something is the way that it is when you don't like it is necessary for change. But sometimes just sitting with the acceptance, the acknowledgement of something being the way that it is, changes it.

18:02And that's not the goal. But when you accept, oh, I was born this way, potentially, or for whatever reason with my life experiences, I'm now more sensitive. There can be a softness that happens around it that then makes it feel less intense to have to change. And like you have less suffering around it, even if you have the same intense emotions and pain. And so, man, I wish I could dive into where this is like maybe the work of an entire therapy course, right? Or a lifetime, really. But there's a way that you just dance and go back and forth between acknowledging what is validating and affirming that and sitting in it, just letting it be.

18:45And then working towards changing what you want changed to the best of your ability.

18:49Ann Kelley: Well, I think about people that grow up in their families often hearing, you're too sensitive. Are you still thinking about that? Seriously? Like, can you not get over it? Like, getting messages when you are born with a higher sensitivity towards feeling emotions. and I think about all the messaging that probably goes with that you're too much. You're overwhelming. That message is so much about you and containing you. I imagine as you talk about acceptance, that would be really hard if you've gotten so many messages that you're the problem and your emotions are the problem. I imagine that really moving to acceptance is a difficult step.

19:38Ann Kelley: Is that true? Is that your experience in working in this? Yeah, definitely. I think perhaps it's worth clarifying here. I've been hinting at this, but not saying it explicitly. In DBT, when we talk about radical acceptance and acceptance broadly, we don't mean acceptance in the colloquial way, as in I am okay with this. I like this. This is good. this is how I want things to be. It means more like acknowledgement that this is the way that it is. And it might be beneficial to include more affirmation and acceptance in that kind of way. So for example, with emotional sensitivity, the thing that I have often pointed out to clients, and I keep in mind for myself, is that emotionally sensitive people, that emotional intensity can help you create great art, that emotional sensitivity can make you really empathetic and a really lovely friend and spouse and parent, that emotional sensitivity can make you feel anger really intensely at social injustice, which then can motivate social change.

20:48So there are benefits to emotions. We know this. And there are benefits, therefore, to being emotionally sensitive. So it's not like denying the painful or unwanted parts of being emotionally sensitive, but it's recognizing the full picture, acknowledging the full picture, acknowledging what is no matter how you feel about it, and then moving forward from there. What do you find or what have you found in your experience as like the biggest block to that for people, do you think? the acceptance part yeah the acceptance because except i find acceptance some often even for

21:29Ann Kelley: myself i find it the radical acceptance is sometimes the hardest because we fight so hard to want to be different or to to change and so what i hear you saying is that it's a radical acceptance not oh this is great that my emotions get really really intense you're saying it's this acceptance that it is who I've grown to be either like you mentioned, either I was born that way or I was brought into this. And so that radical acceptance is powerful. But I imagine when you've gotten so many messages, don't be that way, that moving to, it brings me something. It's, it's also this part of me who I am.

22:15Ann Kelley: I imagine that that step is a, is a difficult one. but powerful. And I wonder for you in all your experience, if you could share kind of what do you see the blocks are and then have you seen DBT help with that block? Yeah. So the thing that comes to mind immediately, and this is what makes it so tricky working with folks who do feel like I struggle with intense emotions is the block to accepting being emotionally sensitive is so often strong emotion. So specifically fear. Oh, if this is true, then that means I can't change it. If this is just the way that it is, then what does that mean about my future kind of getting caught in catastrophizing and not recognizing another dialectical principle that changes constant?

23:04Or maybe it's fear of grief, of feeling grief, feeling overwhelmed by grief about like what kinds of life you could have had in your head if you would have been different or if things could be different or were different or grief about how you've struggled yeah can we slow

23:22Ann Kelley: down in that one because as you said that that just really hit me like what you're saying is like the the grief of had i not been this way what i would have had that is a tough step because is, isn't that part of why we won't accept things? Because this belief that if we could have changed it, we'd have had this life. So we keep trying to conform or change or be mad at this part of us because we want that thing that we wish we could have. And when you said that, it was just really hitting me like, oh wait. So this acceptance that, oh, I would have to let go of what I could have had. And that's not so easy.

24:02No, it's definitely not easy. And when we think about radical acceptance as a skill in DBT, one of the skill sets we're often trying to help people practice and build up is the skill of letting yourself feel grief. because it is so painful. It is so hard. So I think that it's a natural part of radical acceptance. It's baked in that grief processing, that grief feeling, because there might be something that we know we've lost out on or haven't been able to get that we've wanted because of emotional sensitivity or whatever it is that we are trying to radically accept. But then there's also all of the what ifs and the potential and the ideas and the dreams that we have that we feel are now unattainable because of this truth that we have to acknowledge.

24:55And people are uncomfortable sitting with I mean, I'm uncomfortable sitting with grief often still, right? Because there's all sorts of fear and shame and hopelessness that can come up with grief. And so that's why we keep coming back to can I just sit with sadness, grief around loss, whether actually experienced or theoretically experienced in like the life or the experience that I was unable to get that I wanted because of the way that things are because of what I have been through because of the way that I am right now. It's not easy. And it's one of the foundational skills of DBT being able to sit in emotions, whatever they are, without changing them.

25:40To recognize that that is just a part of being alive and needing and building a life worth living is recognizing when it's painful. Wow.

25:51Ann Kelley: Yeah. I can feel that with you and feel my own struggles at times to just live in the grief of something instead of, I'm an eternal optimist, which is a disadvantage because there's this part of me. But if we could just then, right? And there's this, but it keeps you in a cycle, doesn't it? So just the idea of just helping somebody go, wait, I just really have to accept this is who I am and how I deal with my emotions and the impact it's had. But you're also saying that it doesn't necessarily mean that you're not wanting or going towards change. Is that right? That's right. I was just about to add on, this is the way my life has been.

26:40This is the way I am right now, I would add on, right? And maybe we have every reason to truly believe this is the way it's going to be. But all we have to radically accept is actually just this moment, like what is true in this moment. And so the grief and letting ourselves feel grief doesn't require us to accept that it's always going to be this way, that we're never going to get things that we want, that we're not going to be able to create the world that we want to create. Like if we believed that we'd be in trouble as like a collective, I think of like not believing that things can change because they can.

27:21But in the meantime, we need to accept and acknowledge how they actually are right now fully and not just doing it as like a checking it off my list to get moving forward. It's actually letting yourself feel what's there and what's real.

27:34Ann Kelley: and sitting with the real. I guess I think about how often we want to avoid that depth of pain by our emotional intensity coming up, right? Because at least if I'm mad or I'm scared, then I'm not in grief. Then to hold back on the emotions, is that when the grief? So this is an exercise of working with emotional regulation. That's what we think of DBT, right? So how does DBT treatment actually get into the skills of the dysregulation? Like if I'm in an emotional intensity at the moment, I'm not able to deal with my grief. I'm up here, I'm on the ceiling, I'm red hot, and my whole body is on fire, let's just say, and I'm feeling really intense.

28:26Ann Kelley: How do you help me? Like what skills, how do I learn in that moment of that intensity to do something different? It's a beautiful question because you're getting at the way that grief is so often underneath other intense emotions like anger, right? Other secondary emotions that feel much more present in the moment and feel much more empowering or at least controllable than grief can feel. And so what a common situation is, is for folks who are in DBT for help with intense emotions. It's like in those moments when I'm feeling 10 out of 10 or 11 out of 10, if you will, emotions where I'm having urges to self-harm, where I'm having urges to use substances, or just again, we all can get there sometimes of just urges to act on our emotions in ways that we would know in our wisest mind, as we might say in DBT will cause us problems, that we only want to act in those ways because we're feeling the 10 out of 10 emotion.

29:25In those situations, that's where the module of DBT distress tolerance skills come in, of the skills for crises, emotional crises, the most intensely painful moments. How can I in that moment, it's not even the goal of getting rid of emotion. I think that's a common misperception. It's how can I live with this emotion and feel this emotion without it taking control of the wheel, without it making me act in ways that I will regret later. So it's skills like nervous system regulation skills, distraction skills, self-soothing skills, and more that help us just get through those most difficult moments because we know eventually the emotion will come down.

30:10So it's going to differ for different people. But when you get to seven out of 10, or five out of 10, and that emotion after using those distress tolerance skills, you still feel that emotion. But then you feel like you're in that wiser place that less emotionally dysregulated place. And you then have emotion regulation skills to understand that emotion, to feel that emotion more deeply, to look at what's causing this emotion? Why do I feel this way? What is this emotion making me feel like doing? And would that be helpful for me? So based on that answer, we then go into figuring out, oh, actually, I'm angry at my partner for the thing that he said to me, but really, I'm hurt underneath, right?

30:59And so, oh, and that feels really valid. and like a problem that I want to address with him, the thing that he said to me, how can I now take that emotion of hurt and maybe even the anger that was there initially and use it to problem solve and create change and communicate and assert my needs to him? And that's where we get into interpersonal effectiveness. So it's not all skills, but it's trying to break down and make these lived moments of overwhelm more understandable, more tolerable. So then we can touch back into those emotions and use either problem solving and change or acceptance and like acting opposite to our emotions, not following them when they wouldn't be helpful for us to follow in that moment to keep building towards this overall goal of DPT of building a life worth living.

31:51How can I use my emotions to help me build a life that is full of joy and meaning and peace overall, even when I know painful emotions are going to be here in the meantime.

32:03Ann Kelley: Also, so much like, I guess the word that came to my mind as you were speaking was like mentalizing this idea of being able to have an eye of what's happening rather than have the emotions control me. All of a sudden, like, it sounds like you are teaching people to like, okay, wait, that emotion is real and it's yours, but you have other aspects of yourself that you can engage with without it leading the show. I love that, that bringing in like the mentalization of like yourself in some ways, like your different parts, right? And I think that totally, we don't talk about mentalization very much in DBT, but I think that's very accurate.

32:44What we do have is a concept called states of mind. And the main states of mind that we talk about are some of the ones I've already mentioned. There is emotion mind, where our emotions are driving the car of our lives, they are driving our behaviors, they feel hot, they feel intense, they might lead to impulsive behaviors, they feel like they're in control. There's a state in mind called reasonable mind, where we are feeling like cool, calm, collected, super analytical, like emotions don't matter, we're just focused on facts. And then we have wise mind, the state of mind that integrates all of these things.

33:20But a thing that I'm often talking about with my clients is the ways in which there isn't just one emotion mind, like every single emotional experience might be its own little emotion mind part. And so understanding in that moment, what is this emotion mind saying? How about this emotion mind? What about this reasonable mind to get to a place of wise mind of integrating all of these different parts of ourselves and understanding the different parts of ourselves, so that we can make that choice that benefits the collective me to the best of our ability.

33:55Ann Kelley: As you're speaking, Kiki, just thinking of the different ways that people that have done DBT, one of the impact, and now I can feel why that is, is a sense of agency and confidence, right? Like I think it's not that their intense emotions have gone away, but there's this like different relationship to them. And so instead of that pressure you're describing when we're at a 10, like when I'm at a 10, I feel like I have to do something right now. And it's an insistent moment. And I think if I don't, what? But when you're describing the different parts of that, to be able to go and look at that self and calm it down to say, is the action really necessary?

34:39Ann Kelley: It just feels like it just adds agency. It says, oh, wait, I'm not just my emotions. I have all these different layers. and I could see why the skills have been so effective. I've seen it be really effective in that idea of like, oh wait, there's all these different parts of me. I'm not just that too much and I really can have these different layers. And it immediately kind of gives you more agency and hope. You're not the emotion itself. That's just part of you. Absolutely. Yeah, no, beautifully said. And I think the folks who are often coming to DBT for therapy rather than just the skills, right, are folks who feel out of control.

35:19Folks who feel like emotions are driving the car of their lives, to say that again. And when we struggle with emotions, and we're in that 10 out of 10, when we're in emotion mind, it's so often, again, this is what we can all experience. But for my clients, they feel out of their minds, like and out of their bodies often, it's like overwhelming. And in those moments, it's so hard, you can't process grief in those moments. You can't communicate effectively in those moments. Like the point is in those moments, it's so useful to have the concrete skills that might feel like a little derivative or too simple outside of those moments.

36:00But in those moments, that's what you need. And then with more practice, more experience, you start gaining confidence, you start learning, oh, I can do this. These emotions don't last. They're a part of my experience and I can respond to them. And it's just, again, this back and forth across time of then that decreases your emotional intensity, it increases your emotional abilities, like 100%. I think it is about learning how to tolerate, learning how to trust yourself, learning how to trust your emotions and your ability to relate to them, so that you have more hope for the future. And hope in yourself, trust in yourself.

36:36Ann Kelley: Trust is so huge. And when you I just yes, when you when you're speaking about just being able to have some trust in self, especially if you've gotten the message through much of your life to not trust who you are, being able to start developing trust in your own capabilities instead of going external and listening to people. Am I too much or not? It's like, wait, you know, you're kind of turning it much more internal.

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40:08Ann Kelley: I want to kind of turn to what helps us. So what we've been speaking to is for those individuals that we all have the emotional dysregulation and too intense emotions. So we could all gain from these experiences. And that's part of what I loved about your workbook, which we'll talk about later, is that I feel like it gives some really good skills, ideas about how to activate these things. And I want people to think of it as something for all of us. And then in those times or how to help partners and think about partners or kids when they're dysregulated from a more accepting, loving place than a, you need to shut that down.

40:50Ann Kelley: I would like to turn if we could though to the part that what creates that sense of the emotional overwhelm being the primary go-to for safety. I read somewhere where just I think it's DBT says and see if you would validate this that emotional dysregulation is born where a biological sensitivity meets a chronically invalidating environment. Unpack that for me. That is getting at the very basic foundation of the way that DBT conceptualizes this type of emotion dysregulation that it specializes in treating. So DBT is founded on the biosocial theory of emotion dysregulation, which was just captured in that sentence.

41:41So the biosocial theory says people start struggling with their emotions, having emotional dysregulation, as in these emotions are out of control, and I'm struggling with impulsive behaviors because of it, because a combination and an interplay between the bio and the social. So the bio is the biological predisposition to feeling emotions intensely with sensitivity and for long durations of time. So we think about this as some people really are just born more emotionally sensitive, or because of trauma or accidents or just life experiences, their brain and their body then biologically feel emotions more intensely than the typical person next to them.

42:26When that kind of child grows up in an environment that is chronically invalidating, so this is the social part of the biosocial model, that's when that biological sensitivity becomes a problem. So chronic invalidation can run the gamut of what it can look like. So on one end, there is like it might be abuse or neglect, like a very direct behavioral communication that your inner needs don't make sense. But it also can look just like a mismatch or benign invalidation from caregivers to child. Maybe the caregiver themselves is emotionally sensitive and doesn't know how to handle their own emotions, so then they can't help the child figure out how to handle theirs.

43:11Maybe the parent isn't emotionally sensitive, so just doesn't quite get it when the child is. Or maybe the parent just has their own vulnerabilities and lack of resources, like they work multiple jobs or they're caring for a high needs, another high needs family member that they can't devote the time the child needs to giving them validation and support around their emotional sensitivity.

43:35Ann Kelley: So what happens with chronic invalidation? So why is that so impactful? I mean, we can make it simple. With that chronic invalidation, I'm having emotions, I'm having an experience and I just can't get it met I can't get it validated what happens for the child in dbt again we think about this very behaviorally and we think about it in this like interactive dynamic way so the common ways that it goes and starts to develop into emotional dysregulation rather than just emotional sensitivity is you'll have a child feeling intense emotions and communicating them to the parent. And if the parent responds with invalidation, like calm down, that's not a big deal, you're overreacting, you're being dramatic, any kind of invalidating comment, one of two things usually happens where the child learns, oh, that emotion is too much.

44:36My emotions are untrustworthy. I'm too much. I'm untrustworthy. And so they quiet down and suppress their emotions and never like let them out or communicate them, learn how to communicate them effectively, learn how to cope with them effectively, such that then it's just bottled and bottled and bottled until it explodes into the dysregulation. regulation.

44:57Ann Kelley: So they never actually, in that context, they never, you're saying they never actually sort of learn to metabolize the emotion that they're having because it's going to truncate it. So you're having it and then it's going to cut off. So there's no metabolizing it and okay. Or the child communicates their emotion at a certain level, the parent invalidates it, and the child escalates because they're like, wait, you must not get it. I'm in a lot of pain here. And because of the back and forth, there can be this dynamic of then the child escalates to the point of self harm, or just an intense, impulsive emotional reaction that then the parent responds to, of like, Oh, I didn't realize you were that upset.

45:40I understand. And then that gets reinforced. And so it's the same thing of the child doesn't learn how to communicate that emotion at the actual level it's at, it just keeps escalating. And they don't learn how to cope except with that escalation. So it leads to a person, an adult now, right, feeling like their emotions are untrustworthy at lower levels, such that they suppress, dissociate, deny until they explode, or they immediately escalate, because it's what's reinforced. It's because it's the only way they've learned to understand, communicate, and cope with that emotion. Wow.

46:19Ann Kelley: As a parent, I can be out there imagining, oh my God, how do I validate their emotions at just the right level? Not too much. I guess the thing that hits my mind in that it's not because I didn't respond favorably and validate the child laying on the floor wanting that candy at the checkout line. is the chronicity of it. Is that what you're saying? Like, it's not that we all are going to be invalidating or over-validating or, I mean, that seems, but how do you get it right? Yeah. So 100%, first off, like just invalidating every once in a while, not only is it not going to cause emotion dysregulation as a, like a chronic mental health problem, but it's also like, it's normal.

47:06It's natural. We all invalidate each other all the time sometimes. So there's a balance of in dbt we talk about validating the valid of like the emotional experience but being sure not to validate the invalid like if a child is upset because of or anybody is upset because of a misinterpretation we don't want to validate like that they're viewing things accurately if they're not so that's just dance and but that's a skill in dbt we teach validation for what it's worth. But it comes back to, we can all only do the best that we can. And we're all living within the same water that you and I already kind of highlighted earlier of a culture that often demonizes emotional sensitivity and downplays a lot of emotional expression.

47:52So we can all just do the best we can. And it's about this like consistent pattern of communicating to the child that their needs, emotions, preferences, desires, identities, internal experiences don't make sense. It's the chronicity that matters for creating or leading to BPD or other types of mental health difficulties.

48:13Ann Kelley: That's so helpful to really understand kind of the depth of it. You know, one of the things that we've alluded to, but I would love to dive into now, we've talked on our podcast a lot. And it's one reason I'm very excited to have you as the guest talking about DBT because a lot of people could talk about DBT. Not a lot. That's a pretty wonderful specialty. But what I mean is this kind of impact on our system is not just through parents. We've done a lot of parenting conversations, right? And psychology is always focused on parents and we miss the idea of what other things impact our emotional regulation, our sense of self, our sense of validation, or a sense of chronic invalidation.

48:53Ann Kelley: And one thing I love is you reached out after listening to one of my favorite episodes that Sue did with Prentice Hemphill about racial invalidation and the impact. And you wanted to jump on the show to talk about queer invalidation. And that is so relevant right now. It's been relevant our whole lives, but I really, when we're talking about chronic invalidation, man, how are you seeing the impact on queer identities and this idea of the experience of chronic invalidation? So it might help by starting outside of invalidation in the biosocial model, just briefly. Within the field of LGBTQ plus mental health, one of the most like studied theories there is called minority stress theory.

49:42And this is the idea. We know actually from research that queer and trans people experience significantly high rates of mental health difficulties, self-harm, depression, anxiety, a lot of different things. And this theory that's now been shown to be true based on decades of research is that these disparities are directly connected to minority stress. Experiences that queer and trans people face because of their marginalized queer and trans identities, discrimination, internalized homophobia and transphobia, biphobia, queerphobia in general, and other stressful experiences that are direct consequence of being a queer person who lives in a world that stigmatizes queerness.

50:29So really, what minority stress is, is chronic invalidation, right? It's growing up in a culture, in a community, maybe in a family, unfortunately, where a queer child might be hearing negative messages about being queer or trans, gay or bi or ace or anything specifically, and experiencing or witnessing other queer people being discriminated against, and learning, oh, this part of me, this queer part, this is not okay. This is wrong. This is bad. This is too much. The same type of messages we think about for chronic invalidation of emotions, but now applied to this identity, this who I am. So it's a specific form of chronic invalidation that we call traumatic invalidation as well of like, it's not just my emotions that are a problem, it's me, it's this queerness.

51:25So queer stigma comes in as the chronic invalidation. And we now know that that can also lead to emotional sensitivity, emotion dysregulation through the same type of feedback loop that we just described talking about with emotion, dysregulation, and sensitivity in general.

51:45Ann Kelley: The chronic feeling that you don't belong, that you don't fit, so something internal to you is off, right? Whether it's having intense emotions in a family that cuts emotions off or having a queer identity that you start to get a sense of, but all the messages you get are just so painful. and how permanent, I can relate to it as a growing up just with my own sexuality and just seeing, you know, in the 80s, just how negative a view and it's like, how can I be this if people feel so contemptuous and disdain and disgust, which gets expressed a lot in today's culture, the return of disdain and disgust towards this identity.

52:32Ann Kelley: And people think they're talking theoretically out there about is gay right or gay not or is queerness okay and yet what's being communicated is a sense of disdain or disgust or unacceptability of a core sense of so many people and so many youth and if there's a communication of even like non-existence in the case of like executive orders that say there's only two biological sexes like where do intersex people belong. If you know that you live in this in between, or in all you hear are these messages that do not fit your lived experience. If you hear those messages over and over, first of all, you might start to believe them.

53:16But also, then you're left, where do I fit? There's something wrong with me then. And what can I do to hide this part of myself, deny this part of myself, overcome or challenge this natural part of myself in order to fit in, because that's what we all want. We want love and support, especially when we're children. So that leads to, and over time, a growing of shame, of hopelessness, of depression, of suppression and dissociation from your broader self and your emotions in general, potentially, because of needing to deny, hide, or dissociate from queerness.

53:55Ann Kelley: In your practice, do you work a lot in this realm with your, I guess you're not doing clinical practice right now, but this has been part of your motivation is what you've shared to be out there is to have an impact for people who might not recognize this. Because if you don't recognize that the chronic invalidation from your community, you may be looking and go, I had this great childhood. I don't understand why I chronically feel like I don't belong and I have worthiness issues. And to name something that's a feeling and to have that validated is just such a huge piece to be doing out there right now.

54:33Yeah. So when I was practicing most recently, so much of my practice specialized in providing DBT to queer and trans folks for exactly this reason. Minority stress, chronic invalidation causes queer and trans folk or leads to queer and trans folks often struggling with the exact types of things that dbt can help with but then all dbt starts with teaching clients directly the biosocial model as a way of that radical acceptance that validation that self-insight we talked about towards the start of the episode giving them the knowledge and the understanding to stand firm in like, oh, wait, it's not like I'm not a problem.

55:14Like this is what I've been through leading to this, to then give them the power, the control, the hope, like we were talking about before, again, to say, oh, okay, and I still live in this world that stigmatizes a part of me. Now what do I do to still go on and build a life as a queer person that feels joyful, peaceful, fulfilling all of those things I talked about. Like this is foundational for queer people to understand. And I think it's maybe worth mentioning, this is again, supported by research. And we think about parents, we know that children growing up in states with anti LGBTQ plus laws face higher levels of mental health difficulties.

56:01And their caregivers and parents, if they are affirming, can be protective against some of those difficulties, but it's still in the water that that child is living in. And they still have slightly elevated risk for mental health difficulties. So again, even if you grew up in a family that was completely affirming of your queerness and your transness, just who you are, and you live in a country, which then we all have in the past few decades that has queer stigma, it would make sense if you've internalized some of this, if you do struggle with self-doubt or shame or anxiety because of it. So you're getting back to helping people in the acceptance piece that you spoke earlier.

56:50Ann Kelley: This time, it sounds like what you're saying is part of the work is the acceptance of the world, not the acceptance of the world you live in, the acceptance of the impact of the world you've lived in on your body and your sense of self, and that that is real. Is that what you're saying? Like, that that's like, ugh. Yes. And you're probably also getting at that distinction I made earlier. That's very important when it comes to this. It doesn't mean we're okay with the world being this way, but there's an acknowledgement that the world is this way, that my life has been this way. And this has impacted me in X, Y, or Z ways.

57:28Ann Kelley: How freeing, though, to be able to see that some of this internalized shame is this experience of doubt, internalized shame. Especially, I guess, also if you've moved into the world where you think you're being very accepting of self, that doesn't, of your queerness. If you think on this external level, because you've really fought hard to get there, that doesn't mean that the internalized, the implicit part of what you've grown up with, your whole life is there. as well, right? Like, even if I'm outwardly going, I feel proud, etc, etc. If inwardly, I've had this chronic thing that is in my body, that has said, you don't belong.

58:07Ann Kelley: It's really so important to like pay attention to that. Yeah. And I think that's one of the reasons why finding queer community or very explicit queer affirming community is so powerful, because it allows you to be in a space where your body feels more safe being there, to get that experience of, oh, I am okay, at least here, exactly as I am around these people. So you get to have some experiences of correction, of safety, of attachment, regardless of knowing how the greater culture might be in this moment. Yeah, I think about even, I think about different things like race and having your community that's strong and affirming.

58:51Ann Kelley: And then also being out there to not have you, to have you prideful. I mean, that's part of what gay pride is or what queer pride is, right? It's like, it's not just please accept us. It's like finding a sense of worthiness and pride in who you are. I think people misconstrue that as it's finding this sense of belonging and welcoming that's so important for our internal world that it's so hard to hold on to right now. You make me think about a point that I often make too about queer joy. I think queer joy is often talked about as like, how can I find joy in being queer despite living in a queerphobic world?

59:34But it's actually just like, how do I find joy because I'm queer or joy in queerness as it is, regardless of what the world is. Like that is also there. And the culture ignores that part for the most part, like the broader culture. And I think that's another beautiful thing about DBT, where, as I mentioned earlier, the overall goal of the therapy is helping clients build a life worth living. So there's this immediate focus on positive, on fulfillment, on peace and joy. And then for queer and trans people, it's like, okay, and queer joy is a part of that. How do we help you find queer joy, whatever it is that you have going on in your life and world right now?

1:00:16Ann Kelley: Ah, what a great turn. Because often we're working on the shame and that's continuing that impact of trying to change what has been out there in the world. And you know what? It makes me think of an interview I've done recently about memory reconsolidation and worth. And that the healing is not just going back. The healing is being in. And like having these, as you're speaking about really helping people get in touch with the historic shame inside their body, but as part of a community of acceptance and talking about queer joy, it's such a wonderful way to sort of reorganize that memory in a different way, like to restructure it into this place of worthiness and acceptance and excitement instead of just healing from the harm, but the excitement.

1:01:11Ann Kelley: of being who you are. Yeah. So it's not just accepting that I grew up in a home or a community that stigmatized queerness, that didn't let me express my gender the way I wanted to, that didn't let me express my queerness the way I wanted to. It's not just accepting and acknowledging that and validating that. It's okay, right now, how do I find gender euphoria? How do I feel queer joy? How do I be who I am and get what I want from life now and be joyful and fulfilled and peaceful? I hope that listeners out there are learning so much about themselves if they're queer and so much about their neighbors if they're not and they're understanding.

1:01:54Ann Kelley: I'm just having this fantasy of people seeing queer pride and the pride parades and how exciting and how much joy is expressed during it. It's not just a march, right? It's not just a march for rights. It is, and it's more and more like people of all gender identities and sexualities, et cetera, want to go because it's a celebration. And you're bringing to life how beautiful it is to have it out there celebrating queer pride rather than just marching for rights because it's so joyous. It really, really is. I'm so grateful to have found my joy in it. And it's a process though, isn't it? getting through your own socialized shame and finding the empowerment and the joy inside is so important.

1:02:46Yeah, it's a journey. And there are so many ways to find it, obviously, and therapy and DBT are not the only ways. And that is where I have found DBT to be so helpful in understanding yourself, in figuring out what do I want? What do I like? What feels good to me? Because emotions give us that information? And then how do I get more of that? And how do I change things that I don't like? And how do I do that for everyone? Because we're all collected. Like, I think the thing that really I love about pride, and I encourage everyone, whether you're queer or not, to appreciate queer pride is like, it's freedom of expression.

1:03:23It's freedom of joy and getting what you want from life. And everyone, no matter your gender or sexuality, has a gender or sexuality to explore and to better understand and to connect with yourself and then celebrate yourself, whoever that is. And queer pride is a unique chance to get to explore and celebrate that.

1:03:45Ann Kelley: You just brought my day up. I just feel the joy. I feel the joy as you're speaking. What's the queer joy you're practicing right now for yourself? I mean, I will say the book you mentioned that I wrote about the LGBTQ plus mental health workbook that only came out about two months ago. So that still feels so fresh, like I'm talking about it, I am reaching out to queer bookstores and doing events with them. And that is still very much the queer joy that I'm feeling of feeling the support of queer community, even people I don't know, by like, supporting this book by getting it in front of other people by by expressing gratitude.

1:04:24Like, I think this I feel very much a part of queer resilience and queer community really broadly and historically by like giving this information to people who might need it through this form that I feel like a very connected to that collective resilience in a way that is giving me a lot of queer joy recently.

1:04:45Ann Kelley: Oh, I'm so happy about that. In any way I can be helpful in that. I would just be honored to do that. I was thinking of the local bookstore here. Yeah, right now you are. So thank you. Yeah. Absolutely. I'm so glad that you reached out and you wanted to come on and spread your resilience message because it's so needed right now in every aspect. So I really encourage people with your, you have two workbooks, right? You have two books out. The newest one that you just mentioned and you have another as well, right? Do you want to talk about that one? Yeah, my first workbook is called Self-Directed DBT Skills.

1:05:21And it's really basic DBT skills, getting it out to people in book form, the way that I teach them in my skills groups. So DBT, as you already mentioned, is not as available as we wish it would be. And so this book is my attempt to try to make it more accessible for folks who might benefit.

1:05:41Ann Kelley: And lots of folks would benefit. But I benefit just this idea, don't think as well. I know we started this talk about borderline, how to help people that are struggling with emotional dysregulation that is significant, that it's interfering. But boy, do we not, especially with just mentioning all the stuff you've mentioned, we need help regulating ourselves in so many ways. And some of those exercises are very powerful and very helpful for so many. So thank you for writing the books. for those of you that are interested. Of course, we will put both references to those books in our show notes. And if somebody wanted to reach you, how could they?

1:06:19You can find everything about me, including a way to contact me on my website, which is kikifailing.com, my name.

1:06:27Ann Kelley: All right, Kiki, thank you so much for coming on. It was just such a pleasure to talk with you and for bringing your wisdom to our audience. Much gratitude. So much gratitude for having me. Thank you so much. All right, you guys, thank you so much for joining us. Please take a moment, rate and review us. We forget to ask for that. It really, really does help us be seen and help messages like this get out. Also, send this on to people that you know could use this kind of information that Kiki has brought to us today. Thanks so much for joining us and I'll see you around the bend.

1:07:08Therapist Uncensored is hosted by Ann Kelly and Sue Marriott. This podcast is edited by Jack Anderson.