Review of Emotionally Healthy Woman in Singapore

Last month my husband and I spent a week in Singapore assisting Pete & Geri Scazzero as they shared the wisdom of Emotionally Healthy Spirituality with leaders from all over Southeast Asia.  Eagles Leadership Institute hosted the Scazzeros as they presented different components of EHS over 4 days.  Pete & Geri invited Kelly & Shirly Ng and my husband & I to demonstrate skills and facilitate group processes during the experiential seminars.   I was privileged to assist Geri as she challenged the audience to stop pretending everything is fine and change their lives.  Geri described her experience as a pastor’s wife whose life was overfull and out of control in her book Emotionally Healthy Woman.  Through her experience she learned that she needed to “Quit” many unhealthy habits to regain control of her life and joy in her ministry.  Geri identifies 8 different unhealthy habits that need to be given up in order to find one’s God-given path.  She challenged the ladies (and some men) in attendance to begin a journey toward emotional health in the midst of tremendous pressures they face in their lives and ministries.  Personal application of the Biblical truth described in Emotionally Healthy Woman requires a paradigm shift from cultural and worldly norms to living life God’s way. 

The point that really caught people’s attention and reaction is the Quit being afraid of what others think.  Geri was asked lots of questions during this session probably because this poses a much greater challenge in Asian Culture compared to Western culture.  Although Geri showed how this is also a struggle in Western cultures, the reaction of the group was quite strong.  You could see the puzzle in the faces of the participants.  “If I quit being afraid of what others think – then who will I become?”

Asian cultures have a strong tendency to listen and pay attention to significant people around them.  Some cultural norms include ancestor worship, karma and beliefs that you can easily be cursed if you displease someone. These cultures teach the value of oneness and group loyalty: “we are one and we belong to each other.”  The desire to please and submit to authority has been inculcated in our minds.  To undo this tendency is almost impossible because it is considered disrespectful, bad and ungodly to not do what those around you expect of you.  To varying degrees Asian cultures tend to be other-directed, thinking:  “How will others view my actions?”  Instead of self-directed:  “What do I think of my action?”  People in Asian cultures tend to be more sensitive to how others are affected by their behavior.   They tend to want to align their behavior to keep order and are even willing to sacrifice themselves for the good of the group.  If they are to quit being afraid of what other thinks of them, it will shatter the cultural norm of altruism and being loving and shake the very core of who they are. 

In Filipino culture families prefer to live close to each other.  Among Filipinos (whether Chinese, Muslim or Christian), it is common to see families live in one compound or one house.  In-laws have to live with the expectations their husband’s family of origin.  Singles do not leave their parents and are under the authority and approval of their parents for everything. 

It is normal to hear parents tell their children, “If you do that, what will others think of us?” The shame is too much to bear so they avoid anything that will bring shame to themselves and shame to others.  Filipinos try to be experts of sensing the social weather.  Therefore they can constantly shift and must be alert to detect when the social mood changes.  You need to be able to read people’s minds and be able to deliver what people want even before it is asked. 

In fact it is safe to say that people are suffering from a phobia of what will people think.  They will even give up a better position, privileges and personal freedom if they think that it will elicit negative thoughts toward them.  For example: My neighbor, who was a manager, lost her job and had been out of work for several years.  Recently a friend helped her find a job where she worked.  Because of her experience and competence she was offered a higher position, but she refused to accept the position because the friend who helped her get the job was not getting the same privilege.  She preferred to stay in a lower position with less compensation because she was afraid that her co-worker would think she is “mukhang pera” (money face - greedy).  Though she would imagine life would be easier if she took the offer, she is also very happy she did not because she cannot bear the pain of the thought of her friend thinking bad about her.   

In spite of some resistance, the audience was convinced that even though it is a cultural norm, it is not Biblical to be controlled by what others think and it is not how God intended us to live.  Geri carefully made the distinction that to quit being afraid of what people think is not to forget or ignore the very self that God created in you.  God created you, with a self that feels, thinks and values something.  God is coming to you through the movement of your heart.  What you feel and think and how you react matter to God.  It is important to consider what people think and how they will react.  To have some fear of what others think of you is normal.  However, to be driven by such fear is detrimental to your personhood and your relationship to these people.  Only when your identity is firmly grounded in the love of God will you have the power to resist the temptation of getting validation of your “okayness” from the approval of other people.  

To become an emotionally healthy woman, there are things we do that we need to stop doing.  Quitting those things that are damaging to our souls is the path to true freedom and becoming the very person God created you to be.  Quitting takes a tremendous amount of courage.  Only the soul whose identity is founded in the love of God will take the risk to attempt the impossible mission to quit being being afraid of what people think.

For more information on The Emotionally Healthy Woman book, clink the link below:  

http://www.emotionallyhealthy.org/ 

Dialectical Behavior Therapy Workshop with Sara Dhuse, PhD.

I have been privileged over the last 4 years to work with and be mentored by Mrs. Sharon Dhuse.  She has been serving Baptist Theological College (BTC) for the last 10 years with her husband as a second career missionary.  After serving many years as a social worker in the foster care system in Chicago, she is now investing her life in training Christian workers here in Cebu.  Since this will be her last semester here in Cebu, we thought it appropriate to invite her daughter to Cebu to share her training and skills.  And thankfully Dr. Sara R. Dhuse accepted our invitation to share her gifts with us.  

BTC hosted an all-day seminar Dialectical Behavior Therapy Workshop on August 17, 2013.  We had about 40 attendees including pastors, Compassion case workers, social workers, guidance counselors and counselors working with trafficked children here in Cebu.  The following is a short summary of the material presented:

Dialectical Behavior Therapy (DBT) is a very structured model of counseling that teaches the clients to be self-aware and keep track of target behaviors and emotions, as well as urges to do self-harm.  It also teaches skills to evaluate their situation and do chain analysis in order to cope well with stress, regulate their emotions and improve their relationships with others.  This method combines standard cognitive-behavioral techniques and a person-centered model of intervention and mindfulness activities. 

The methodology is based on the assumptions that these clients lack the skills they need to:

• understand and regulate their emotions (Emotion Regulation Skills)
• cope with distress (Distress Tolerance Skills)
• communicate effectively with others (Interpersonal Effectiveness Skill)
• pay attention in their lives and make good decisions (Core Mindfulness Skills)

Dialectical Behavior Therapy (DBT) was originally created by Marsha Linehan to treat people diagnosed with Borderline Personality Disorder, but it has also been found helpful for any person with emotional dysregulation problems.  Recent research has found DBT to also be helpful for individuals with substance abuse, bulimia, binge-eating, depression and anxiety.  It has also been adapted for use with children and adolescents. 

People with Borderline Personality Disorder usually have problems with:

• Emotional dysregulation (intense emotions)
• Chaotic relationships and fear of abandonment
• Impulsivity with suicide attempts, self-harm and other damaging behaviors
• Lack of sense of self and feelings of emptiness
• Dissociation

Most people who suffer from emotional dysregulation have been exposed to invalidating environments where: Normal expression of emotion is ignored; Extreme displays of emotion are intermittently enforced; And complicated problems are presented as easy to solve.  In treatment, the crucial point where healing can occur is when a therapist creates a validating environment.

In the creation of this validating environment a therapist must pay attention to the dialectical transaction.  (Dialectical means incorporating two different views that appear opposite and find ways to integrate both, which is called synthesis).  There are three dialectical patterns that we usually engage in:

• Emotional vulnerability vs. self-invalidation
• Active passivity vs. apparent competence
• Unrelenting crisis vs. inhibiting grieving

What would a dialectical transaction of emotional vulnerability vs. self-invalidation look like?  The client might start with self-invalidation, saying something like, “I should not be afraid.”  The counselor would validate that statement, but also open the possibility that it’s ok to be afraid by saying something like, “I see that you’re not afraid, but I also notice that you hesitate when say that so I wonder if you might have a little fear.  Many times people that are in that situation has a tendency to be afraid.”  This will help the client toward self-validation which leads to the emotional vulnerability piece, beginning to open the client to the vulnerability of their emotion of fear.  Then the client can begin to be honest enough to accept his need instead of staying in self-invalidation (when the person denies, ignores or cannot accept what they truly feel or think about themselves).  Emotional vulnerability is a must to healing and allowing clients to accept their real situation without judging themselves is a key factor in achieving this.  How does this look in counseling?  Accepting a person with unacceptable behavior can result in this person knowing he or she is loved and accepted and not forced to change.  This will help them begin to overcome their resistance to change. 

The personal acceptance of the therapist is also very important here.  She needs to acknowledge and embrace her personal limitations and feeling of inadequacy.  Without this internal work she will be blaming and projecting her own discomfort and intolerance to the very person she is trying to help, and this person will feel judged and unaccepted by her.  The personal acceptance of the therapist translates into safety and emotional validity to her client.  When the client feels safe and accepted by the therapist they will also learn to accept themselves.  Then they can begin the work of understanding who they are, developing self-control by regulating emotional reactions and choosing to live their lives congruent with their values and with purpose.  Their experience with their therapist transfers to their current relationships.  As they trust their therapist, they learn to trust themselves with their progress, and eventually they can create a new validating environment for themselves and for others around them. 

People that choose Dialectical Behavior Therapy as a model of intervention require their clients to be in a one year DBT program.  DBT has four modes of intervention: Weekly Individual therapy;  Weekly Skills Group; Skills Coaching and Consultation Group.  Since this is a skill based approached the clients learn to pay attention to what is going on inside and outside of them.  This is done by developing mindfulness skills.  They also learn to focus on target behaviors for change with Diary Cards that are checked weekly by the therapist.

In the structure of individual session, the therapist leads you to these 3 main processes

1.  Review Diary Card

2.  Set Agenda  -  The agenda is based on the hierarchy:

• Life Interfering Behavior
• Therapy Interfering Behavior
• Quality of Life Interfering Behavior
• Topics Client would like to discuss

3.  Chain Analysis – a thorough step-by-step description of the chain of events leading up to and following an unhelpful behavior.  Basically asking the questions: “What made you do that? And what made you do the things that led up to that?  What was the result?  And what was the result of that result?”  These questions help the client identify the cycles of unhealthy behavior in which they are engaging.

Dr. Dhuse presented a very helpful paradigm for us mental health practitioners here in Cebu.  Thanks so much!!