by Tom Horvath, PhD If guilt is the bad feeling I get after doing “something wrong,” then shame is the bad feeling I get about being myself. Shame might arise along with guilt (“I’m not good enough, and a bad person, for doing something that terrible”). However, shame might arise by itself. In the extreme I might think “I do not even have the right to exist. I’m so bad and foul and awful that I don’t deserve to belong to the human race. I should not be allowed to have the air I breathe, the food I eat, and the time and attention I get from others.” Understanding Shame vs. Guilt Simply stated, guilt is about what I did. Shame is about who I am. When I behave wrongly or badly, and feel guilt or regret, there are often ways I can resolve these feelings: Make it up to someone, apologiz...

by Tom Horvath, PhD When we talk about having boundaries, we can talk about managing external boundaries and we can talk about managing internal boundaries. This blog will discuss the management of external boundaries. To better understand external boundaries, it helps to understand the concept of interpersonal boundaries. Interpersonal boundaries are the rules we establish for ourselves about how we interact with other people. We can compare interpersonal boundaries to having a house. The house, with roof and walls, protects us from the outside, and keeps our possessions together. But there are also doors, windows, window coverings, pipes, wires, vents, and so forth, which allow us to be flexible about what comes in and what goes out. In this blog we focus on protecting ourselves fr...

by Tom Horvath, PhD A well-lived life needs to have significant and possibly considerable amounts of discomfort in it. For instance, do you want to exercise well, maintain a certain weight, get up early, work hard at something, or hold your tongue in an intense discussion? You are likely to feel uncomfortable! The key, then, is to learn skills for managing discomfort that will inevitably come. You might also be interested in: Coping with Stress in Addiction Recovery In particular, if you want to stop an addictive problem, you are likely to have a transition period as you change how you live. Cravings might die off almost entirely after 90 days (although there is no guarantee they will completely), but other challenges might last much longer. Maybe you should just give up now? Fortu...

by Thaddeus Camlin, PsyD As cannabis crawls toward federal legalization, the 11th hour panic push is in on.  Last week saw the introduction of the Cannabis Administration and Opportunity Act, which seeks to federally legalize cannabis in the U.S.  For those opposed to legalizing cannabis, ‘cannabis-induced psychosis’ and ‘ultra-high potency THC products’ are the buzz words working most effectively to enliven the embers of cultural pot fears.  Cannabis-induced psychosis is something to take seriously, as are ultra-high potency THC products, but neither is a reason to keep pot illegal. You might also be interested in: Drugs Don't Cause Addiction Cannabis-induced psychosis (CIP) refers to an individual experiencing delusions, hallucinations, disorganized speech, or grossly abnorma...

by Thaddeus Camlin, PsyD Let’s call a spade a spade.  The war on drugs is a euphemism for a war on personal freedom.  The hypocrisy inherent in a war on personal freedom in the self-proclaimed land of the free is more than a tad embarrassing (insert cringe emoji here).  The number of lives ruined with criminal scarlet letters and families torn apart because someone dared possess psychoactive compounds is beyond measure.  Even on the very day of writing this article a U.S. Olympian was kicked off the track and field team because she tested positive, not for a performance-enhancing drug, but for cannabis detected in her bodily fluids after she inhaled the plant’s smoke to ease the pain of the death of her mother.  This Independence Day, as America celebrates the passing of the drug war...

by Tom Horvath, PhD, ABPP Dialectical Behavior Therapy (DBT) places a primary focus on improving distress tolerance. One of several tools DBT offers for tolerating distress is radical acceptance. The context of using any of the distress tolerance tools is the recognition that life will have distress, and that we need to learn how to bear up under it. Life is worth living even if it can be painful. DBT distress tolerance skills are designed to help us get through a crisis, but these tools benefit from practice in advance. These skills can help us accept the discomfort or pain that occur in a crisis, while preventing that discomfort or pain from rising to the level of suffering. Radical = “going to the root,” like a radish. Radical acceptance does not mean we approve of reality. ...

by Tom Horvath, PhD, ABPP Dialectical Behavior Therapy (DBT) is an approach to psychotherapy designed for individuals who are highly emotionally sensitive, who struggle with depression and anxiety, and who may at times become suicidal. DBT tools, which focus on distress tolerance, interpersonal effectiveness, emotion regulation, and mindfulness, can be helpful to anyone. You can remember these 4 categories as DIEM, as in carpe diem (seize the day). DBT is part of the larger family of CBT (cognitive behavior therapy). Marsha Linehan, a psychology professor emeritus at the University of Washington, Seattle, developed DBT as a result of coping with her own emotional problems. Linehan, born in 1943, revealed in her late 60’s the personal connection to her professional work. Distres...

by Tom Horvath, PhD, ABPP Dialectical is a word with a long history (back to the Greeks), but for now let’s define it as “focusing or acting on the interaction of opposing forces or ideas.” Dialectical Behavior Therapy (DBT) identifies and addresses three common dialectical dilemmas, in order to improve emotional self-regulation, one of the primary goals of DBT. DBT can be helpful for individuals in whom large and rapid emotional swings (e.g., from love to hate) are common, painful, and harmful. The first of the dialectical dilemmas involves being emotionally vulnerable (either at present, or over a lifetime as a result of being emotionally more sensitive than average), but then downplaying the intensity of emotions. Typical self-statements are “this won’t be that hard” or “I shou...

by Tom Horvath, PhD, ABPP Interpersonal boundaries are part of the rules we establish about how we interact with other people. In this blog we focus on protecting ourselves from the outside. In a parallel blog we focused on keeping inside what needs to stay there. In both cases we can compare interpersonal boundaries to a house, which protects us from the outside, and keeps inside what needs to be there. We prevent violations to ourselves by establishing and managing boundaries. For instance, who can touch us and how, who can enter our living space and how far, whom we respond to online and whom we do not, whom we will accept advice from and whom we won’t, and so forth. The challenge often is that these boundaries need to be communicated and enforced, and communication and enforce...

by Tom Horvath, PhD, ABPP Interpersonal boundaries are part of the rules we establish about how to interact with other people. We can compare interpersonal boundaries to being in a house. The house protects us from the outside, and on the inside we protect our warm or cool air, our possessions, and our privacy. Houses have walls, roofs, doors, windows, window coverings, pipes, wires, and vents, which allow us to be highly flexible about what comes in and what goes out. In this blog we focus on keeping inside what needs to stay in. In a parallel blog we focus on keeping outside what needs to stay out. In either case, I am the one ultimately responsible for managing the boundary. I need to be prepared for others who may not know or respect the boundary I have established. I need to kno...