An important part of a “life worth living”, says DBT, is identifying your values. Sure. But, the latter causes me no end of grief – as you can tell from the fact that I keep promising to post about my values, and keep failing to do so.
A big part of the problem is that, since my teens, I’ve been seeking out the deepest, grandest values. Ones which can ground everything else. I arrive, inevitably, at existential despair (which is, of course, the very opposite of “life worth living”). That’s because I think: my life gets its meaning only from what I contribute to others’ lives; whose lives get their meaning from how they help others; whose lives… A vicious regress with no bottom.
What Dr. D has me working on presently is setting aside pro tem the quest for my “mega-values”, instead approaching things in stages. Identifying do-able things to aim for here and now. The approach takes ideas from Dr. Charles Swenson of UMass Medical School. He suggests a metaphor of a ladder of DBT goals.
A first stage, which I’ve already managed, is simply getting on the ladder. This is getting in control: i.e., minimal behavioral regulation, to even allow treatment (including doing homework like this). No treatment plan is even possible while in constant crisis, whether feeling suicidal, suffering from psychosis or severe behavioral dyscontrol (e.g., violent aggression), using heavily, or what-have-you.
DBT is suspicious of the idea that mental illness is just another disease, requiring just another kind of pill. Nonetheless, its practitioners accept that there’s an important role for meds when it comes to the goal of getting in control. (Ditto for Transcranial Magnetic Stimulation. My start date has been postponed by the way, due to a COVID outbreak at the hospital.)
Climbing up a wrung, you arrive at getting in touch, i.e., being able to describe your emotions rather than immediately pushing them away. Getting in touch is coming to understand your feelings better, partly by recognizing their function, partly by being aware of the misleading “stories” that come to mind as you feel. (See my earlier post on downward spirals. It’s the stories that drag you down.)
Meds, especially alone, won’t turn the trick here. Crucial instead, for setting and working on this level of goal, were the basic DBT skills of effective rethinking, chain analysis, radical acceptance, etc.
A quick theoretical/philosophical aside. Stages one and two look mutually inconsistent: moving onto the ladder = getting into emotional control; moving up that first step = letting go of emotional control. This is where the “dialectical” aspect of Dialectical Behavioral Therapy comes in. As DBT sees it, the perfectly balanced state – Aristotle’s “golden mean” as applied to emotions – isn’t possible. Rather, the Buddha (and Hegel?) got things right. The way forward involves continually bouncing between opposite poles, but lessening the distance. That’s what working on managing emotional experiencing looks like. Rather than equilibrium, at this point the thesis-goals (control) and antithesis-goals (letting go) are to come ever closer to each other.
Wrung three on DBT’s ladder of goal setting – only reachable once you’re no longer terrified of feeling! – is getting a life, which is to say: accepting the risks of grief and fear for the trade-off of living well; embracing challenges and even back-sliding as opportunities to learn.
Swenson’s “getting a life”, in other words, is aiming for ordinary happiness — as opposed to reaching the top of his DBT ladder, i.e., deep fulfillment and joyful living. My task for next week is to prepare a list of such “ordinary” objectives – ones that feel valuable, even if I can’t give an ultimate, rational justification of their value at this stage.
[Dr. D: Get a life, Rob. Me: I’m trying.]