Interview with Jennifer Eaton (Excerpts)

Jennifer Eaton, Director of Dialectical Behavioral Therapy Training and Consultation at the Bridge Institute in Worcester, MA, is presenting Communicating Effectively with Children and Families: Key Strategies from Dialectical Behavior Therapy on Wednesday, October 9 in Worcester. She was interviewed by Jeremiah Gibson, NEAFAST President, about the intersection of DBT and family therapy. These are the highlights from the interview.

Jeremiah Gibson: There are some really neat things going on in the Worcester area. I'm curious, Jen, if you could talk for a few minutes about what's happening at the Bridge Institute? 

Jennifer Eaton: One thing that we started doing and we're going to do again next year is a specialized training in using DBT (Dialectical Behavioral Therapy) with families, and particularly adolescents. Certainly DBT with children is becoming an increased specialty, as well. One thing we just kicked off was a very small experiential training in chain analysis and's a two-part series and the second part of the series is going to focus on using DBT within the family system, with's going to be very experiential.

Jeremiah: What are some of the ways that you use DBT to inform and enhance work with families?

Jennifer: The goal is to get people skills so they're more effective with life – with family, at school, at work, and so forth. A lot of the families eat the skills up and the parents are thrilled to have them. There's also a lot of focus on bringing DBT to families, so there's an extension called – it's kind of a spin-off of DBT – "Family Connections" for individuals who are supporters of DBT clients, so for instance, parents or spouses, and like, "Let's give you new skills to help build your relationship for those who may not be in DBT but could benefit from DBT." DBT really targets emotionally-sensitive people and if you have a family member who like, they really don’t get it, they don’t understand the person’s internal process, it can really disconnect families. And by giving families new skills to interact, because this kid, for example, is different or...I even had a, when I was at the training, a girlfriend who was there to improve her relationship with her boyfriend, so obviously this was an important relationship, and by improving one person in a family or the parents in a family, shifts the entire family beyond even the "identified patient" in DBT. So a lot of focus on families.

Jeremiah: What are some of the commonalities that you notice between DBT and family systems work?

Jennifer: One thing that often happens...say if you have an argument between parents or a disconnect between parents and their child or children, there's a lot of tension between different parties and something that's similar with DBT is they look dialectics within relationships. So for example, if you and I have a conflict or we disagree with something or have different values about a situation, we polarize. We get really stuck in our own position and can’t move back to the middle. So if we get stuck on one side and a partner or a family member are stuck on the other side, that creates conflict. And dialectics is certainly bringing ourselves to a new synthesis of understanding each other and saying, “Ok. What’s the new way of thinking that brings both of us together?” So that can be really helpful because it breaks the polarized experience.

Jeremiah: One of the things that I'm thinking about is this idea of when someone develops new skills that the system changes. And sometimes that's definitely true. Sometimes that's also not true; sometimes a person can develop new skills and the system which has a goal of maintaining homeostasis will do whatever they can to pull the person back into whatever the familiar role is. I'm curious how DBT in family therapy would address that process.

Jennifer: In family therapy it's really bringing up the dialectics of those two pieces and trying to help people synthesize and come to the middle. In DBT, anytime you can bring a new skill to the moment, you've just improved the moment. So you can bring the skills within the family therapy, saying, "Ok, let's practice that again using this skill," and bringing the skills alive in the session which will increase the likelihood that the family might rebalance outside of it because everyone's practicing as opposed to one person practicing the skills and the others are not.

Jeremiah: You're doing a presentation called "Communicating Effectively with Children and Families: Key Strategies from Dialectical Behavioral Therapy" in October, and that's at the Bridge Training Institute. Is that a part of the longer series you were talking about or is that separate?

Jennifer: It's separate; it's actually a skin-off. Although a lot of people who take the series come because they work with families or they work with couples, they work with teenagers... So both. Sometimes it's a lot review for those who are well-versed in DBT, and it's great new knowledge for someone who isn't well-versed in DBT. And both are true; you can be a great individual therapist and do DBT really well and get really lost in how to bring it into the family sessions. And a lot of family therapists who come to that training only leave with a boat-load of skills.

Jeremiah: When you use the term "dialectic" what specifically are you referring to?

Jennifer: The most simple explanation I give — and this is after spending a number of weeks with my consultation team when I first learned DBT — is: "Two opposing truths are both true." And the goal is to synthesize two truths to make a new truth. So "truth" means someone's perspective, someone's view on something, someone's values...and this is huge. So the polarized two truths are there over and over again. Most family therapy is: “How do you synthesize these family members together to make a new family system that functions more effectively?” Explaining dialectics can really bring it alive using language like: "So, that was your experience, and that was your experience," say bringing say two people into the room and their experiences…bringing just the word “and” to bridge them can be really helpful because it’s not one negates the other, it's like: "How can both stay alive?" And that alone can change the dynamics.

Jeremiah: I love that language shift, moving "but's" to "and's." It seems like there's an emotional processing that happens within the relationship when you use the word "and" that allows for different outcomes.

Jeremiah: You've talked about validation, you've talked about keeping both voices alive. I'm curious what are some other theoretical ideas from DBT that you teach to family members, and particularly parents in family therapy.

Jennifer: Certainly, the "B" in DBT is Behaviorism. So there's this piece that we’re wired as humans to look for the problems — we look for dangers; that’s why we’re alive today. Helping all of us rethink to notice the positive changes takes actually a lot more effort. We can come through and have a really effective conversation about something we disagreed on...we're going to leave saying, "Wow, that felt good." But we're going to be on the lookout for the next bad fight we have, because that's what we do: we fight a lot. So really helping them highlight that with each other, saying, "That was really helpful. I appreciate the fact we finished this conversation and were able to, both of us." That can be really helpful if everyone's looking for the good in each other and reinforcing that — the family's going to do more of that instead of going back to look for the danger signs.

Mindfulness is huge too. If you're bringing more mindfulness — whether to be more aware of ourselves and more aware of each other, than that's changing everything. You see a look on someone's face, and you're like, "Hey, what happened?" Someone comes home from a bad day and we're just so focused on our own bad day, we don't stop and say, "Whoa, are you ok?" Families become automatic. If you have things to do, you have to cook dinner, try to get lunches ready for tomorrow, and so forth, they're caught up in five, ten tasks; they might miss the moment to say, "Hey, she just asked nicely to talk to me. I'm going to engage." They're thinking, "I don't want to burn dinner." So really increasing mindfulness to each other can be really helpful. Mindfulness is often taught as: "How can it improve ourselves?" So it's like "We want to be in the present moment. We have to have thoughts without judgment." Great, and how do we use that with each other? The last module in DBT is called "Interpersonal Effectiveness" and it's bringing basically concrete skills and concepts to individuals on: "How do you communicate more effectively?"

To watch the full interview, check out our Youtube channel.

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