World Experts on Advanced Behavior Therapy Address St. John’s Psychology Students

According to recent research, self-injury is the fastest-growing health problem among teenage girls today. Fifty percent of those who self-injure — most often in the form of “cutting” — do so before reaching the age of 15. Some studies suggest that up to 7 percent of teenage girls have engaged in self-injurious behavior at least once.

These were the disturbing statistics laid out November 16 on the St. John’s Queens campus by psychologist Adam Payne, Ph.D., and social worker Burton Silverman, Ph.D. Happily, the lecture soon assumed a positive tone as the two internationally known clinicians began educating the audience on the attributes of Dialectical Behavior Therapy (DBT), a clinical approach that is rapidly becoming one of the most hopeful forms of treatment for patients with destructive or self-injurious proclivities.

In broad terms, DBT combines traditional behavioral therapy with a form of psychotherapy that emphasizes tolerance and validation. Specifically, it encourages patients to accept their own emotions, however irrational, without acting on them. The therapy also distinguishes itself by employing components of Buddhist psychology, namely mindfulness.

The lecturers explained to the audience that emotional impulses are like unscratched itches; they have a beginning, a peak and an end. The key to DBT, said the clinicians, is the patient’s ability to accept and remain mindful of his impulse to self-injure, trusting that that impulse will eventually fade away.

“Emotions are the 18-wheelers of the highway; they’re tough, big and unwieldy,” said Payne as he paced the front of the lecture hall. “But we tell patients that emotions are not the enemy.”

The lecture was held in St. Albert Hall and attended by approximately 75 individuals — most of whom were graduate students enrolled in clinical tracks, though many undergraduates majoring in psychology were present as well.

“Many of the students [in attendance] currently treat, or will treat, adolescents who exhibit self-destructive behavior, so we wanted to give them a special presentation on this topic to acquaint them with a state-of-the-art treatment approach,” says Richard Morrissey, Ph.D., Director of the St. John’s Center for Psychological Services, which sponsored the lecture.

Payne and Silverman are considered to be among the world’s leading practitioners of adolescent DBT. They teamed up 15 years ago at Schneider Children’s Hospital when they each became apprentices under DBT founder Marsha Linehan. Currently, they operate a private practice in Lake Success, NY.

In his opening remarks, Silverman explained that teenagers most often cut themselves to distract themselves from emotional pain; to “bleed out” their negative emotions. “The truth is that it actually works — very effectively,” he announced to a stunned crowd. “But that’s why DBT is effective — because patients realize that we validate their emotional desires.”

“We honor the truth of both pain and acceptance,” added Payne.

Though DBT originated as a therapy to combat cutting and other forms of self-injury, it is now used to treat any individual diagnosed with Borderline Personality Disorder, which is characterized by interpersonal, self, behavioral or cognitive dysregulation and often accompanied by fear of abandonment, chaotic relationships and feelings of emptiness or anger.

There are additional components of DBT that make it a unique therapy. Patients, for example, are required to attend weekly classes over the course of a 27-week session to learn the regulation skills needed to resist self-injurious and other destructive behavioral impulses. Group classes are followed up with individual therapy sessions and, if the patient requires, telephone consultations.

As the lecturers whizzed through PowerPoint slides and hands-on demonstrations, audience members, such as 4th-year psychology graduate student and group psychologist Ellenge Denton, looked on with appreciation.

“This lecture was a big deal for me,” says Denton, who works in an inpatient psychiatric unit at Jamaica Hospital. “[Payne and Silverman] hit on a few key, salient points — like mindfulness, validation and emotional regulation — that will really help me work with my patients who have personality disorders.”