DBT Made Simple – by Sheri van Dijk

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This book offers very clear explanations of DBT. In fact, a more fitting title might have been “DBT made clear”, because it does it without oversimplification.

This is a way in which van Dijk’s work stands out from that of many writers on the subject! Many authors oversimplify, to the point that a reader may wonder “is that all it is?” when, in reality, there’s rather more to it.

This work is, therefore, refreshingly comprehensive, without sacrificing clarity.

Van Dijk also takes us through the four pillars of DBT:

  1. Mindfulness
  2. Distress tolerance
  3. Emotional regulation
  4. Interpersonal effectiveness

Each of these can help an individual alone; together, they produce a composite effect with a synergy that makes each more effective. Hence, pillars.

On the topic of “an individual”, you may be wondering “is this book for therapists or the general public?” and the answer is yes, yes it is.

That is to say: it’s written with the assumption that the reader wants to learn DBT in order to practice it as a therapist… and/but is written in such a fashion that it’s very easy to apply the skills to oneself, too. As it’s an introductory guide—a comprehensive one, but without assuming prior knowledge—it’s a perfect resource for anyone to get a good grounding in the subject.

Bottom line: if you’ve been hearing about DBT (possibly from us!) and wondering where you might start, this book is an excellent place to begin.

Click here to check out DBT Made Simple, and start making many parts of life easier!

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Recommended

  • Zero Sugar / One Month – by Becky Gillaspy
  • How Are You, Really?
    The government initiative surprised the author with its ability to elicit personal responses and provide personalized replies through a rapid-pace multiple-choice test.

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  • Blueberry & Banana Collagen Baked Oats

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Good news for vegans/vegetarians! While we include an optional tablespoon of collagen powder in this recipe, the whole recipe is already geared around collagen synthesis, so it’s very collagen-boosting even with just the plants, providing collagen’s building blocks of protein, zinc, and vitamins C and D (your miraculous body will use these to assemble the collagen inside you).

    You will need

    • 2 cups oats, whence the protein and zinc
    • 1 cup milk (your preference what kind; we recommend almond for flavor; whether you choose plant or animal though, it should be fortified with vitamin D)
    • 2 bananas, peeled and mashed
    • 4 oz blueberries, whence the vitamin C (frozen is fine) (chopped dried apricots are also a fine substitute if that’s more convenient)
    • 1 oz flaked almonds, whence the protein and zinc
    • 1 tbsp pumpkin seeds, whence the protein and zinc
    • 1 tbsp flax seeds, whence the protein and zinc
    • Optional: 1 tbsp maple syrup
    • Optional: 1 tbsp collagen powder, dissolved in 1 oz hot water

    Method

    (we suggest you read everything at least once before doing anything)

    1) Preheat the oven to 350℉ / 180℃.

    2) Mix the oats with 2 cups boiling water; allow to stand for 10–15 minutes, and then drain any excess water.

    3) Mix the mashed bananas with the remaining ingredients except the milk and blueberries, stirring thoroughly.

    4) Add the softened oats, and stir those in thoroughly too.

    5) Add the milk and blueberries, in that order, stirring gently if using fresh blueberries, lest they get crushed.

    6) Pour the mixture into an 8″ square cake tin that you have lined with baking paper, and smooth the top.

    7) Bake for about 40 minutes or until firm and golden brown. Allow to cool; it will firm up more while it does.

    8) Cut into squares or bars, and serve or store for later.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    We Are Such Stuff As Fish Are Made Of ← our main feature about collagen

    Take care!

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  • What Flexible Dieting Really Means

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    When Flexibility Is The Dish Of The Day

    This is Alan Aragon. Notwithstanding not being a “Dr. Alan Aragon”, he’s a research scientist with dozens of peer-reviewed nutrition science papers to his name, as well as being a personal trainer and fitness educator. Most importantly, he’s an ardent champion of making people’s pursuit of health and fitness more evidence-based.

    We’ll be sharing some insights from a book of his that we haven’t reviewed yet, but we will link it at the bottom of today’s article in any case.

    What does he want us to know?

    First, get out of the 80s and into the 90s

    In the world of popular dieting, the 80s were all about calorie-counting and low-fat diets. They did not particularly help.

    In the 90s, it was discovered that not only was low-fat not the way to go, but also, regardless of the diet in question, rigid dieting leads to “disinhibition”, that is to say, there comes a point (usually not far into a diet) whereby one breaks the diet, at which point, the floodgates open and the dieter binges unhealthily.

    Aragon would like to bring our attention to a number of studies that found this in various ways over the course of the 90s measuring various different metrics including rigid vs flexible dieting’s impacts on BMI, weight gain, weight loss, lean muscle mass changes, binge-eating, anxiety, depression, and so forth), but we only have so much room here, so here’s a 1999 study that’s pretty much the culmination of those:

    Flexible vs. Rigid Dieting Strategies: Relationship with Adverse Behavioral Outcomes

    So in short: trying to be very puritan about any aspect of dieting will not only not work, it will backfire.

    Next, get out of the 90s into the 00s

    …which is not only fun if you read “00s” out loud as “naughties”, but also actually appropriate in this case, because it is indeed important to be comfortable being a little bit naughty:

    In 2000, Dr. Marika Tiggemann found that dichotomous perceptions of food (e.g. good/bad, clean/dirty, etc) were implicated as a dysfunctional cognitive style, and predicted not only eating disorders and mood disorders, but also adverse physical health outcomes:

    Dieting and Cognitive Style: The Role of Current and Past Dieting Behaviour and Cognitions

    This was rendered clearer, in terms of physical health outcomes, by Dr. Susan Byrne & Dr. Emma Dove, in 2009:

    ❝Weight loss was negatively associated with pre-treatment depression and frequency of treatment attendance, but not with dichotomous thinking. Females who regard their weight as unacceptably high and who think dichotomously may experience high levels of depression irrespective of their actual weight, while depression may be proportionate to the degree of obesity among those who do not think dichotomously❞

    Read more: Effect of dichotomous thinking on the association of depression with BMI and weight change among obese females

    Aragon’s advice based on all this: while yes, some foods are better than others, it’s more useful to see foods as being part of a spectrum, rather than being absolutist or “black and white” about it.

    Next: hit those perfect 10s… Imperfectly

    The next decade expanded on this research, as science is wont to do, and for this one, Aragon shines a spotlight on Dr. Alice Berg’s 2018 study with obese women averaging 69 years of age, in which…

    Flexible Eating Behavior Predicts Greater Weight Loss Following a Diet and Exercise Intervention in Older Women

    In other words (and in fact, to borrow Dr. Berg’s words from that paper),

    ❝encouraging a flexible approach to eating behavior and discouraging rigid adherence to a diet may lead to better intentional weight loss for overweight and obese older women❞

    You may be wondering: what did this add to the studies from the 90s?

    And the key here is: rather than being observational, this was interventional. In other words, rather than simply observing what happened to people who thought one way or another, this study took people who had a rigid, dichotomous approach to food, and gave them a 6-month behavioral intervention (in other words, support encouraging them to be more flexible and open in their approach to food), and found that this indeed improved matters for them.

    Which means, it’s not a matter of fate or predisposition, as it could have been back in the 90s, per “some people are just like that; who’s to say which factor causes which”. Instead, now we know that this is an approach that can be adopted, and it can be expected to work.

    Beyond weight loss

    Now, so far we’ve talked mostly about weight loss, and only touched on other health outcomes. This is because:

    • weight loss a very common goal for many
    • it’s easy to measure so there’s a lot of science for it

    Incidentally, if it’s a goal of yours, here’s what 10almonds had to say about that, along with two follow-up articles for other related goals:

    Spoiler: we agree with Aragon, and recommend a relaxed and flexible approach to all three of these things

    Aragon’s evidence-based approach to nutrition has found that this holds true for other aspects of healthy eating, too. For example…

    To count or not to count?

    It’s hard to do evidence-based anything without counting, and so Aragon talks a lot about this. Indeed, he does a lot of counting in scientific papers of his own, such as:

    How much protein can the body use in a single meal for muscle-building? Implications for daily protein distribution

    and

    The effect of protein timing on muscle strength and hypertrophy: a meta-analysis

    …as well as non-protein-related but diet-related topics such as:

    Does Timing Matter? A Narrative Review of Intermittent Fasting Variants and Their Effects on Bodyweight and Body Composition

    But! For the at-home health enthusiast, Aragon recommends that the answer to the question “to count or not to count?” is “both”:

    • Start off by indeed counting and tracking everything that is important to you (per whatever your current personal health intervention is, so it might be about calories, or grams of protein, or grams of carbs, or a certain fat balance, or something else entirely)
    • Switch to a more relaxed counting approach once you get used to the above. By now you probably know the macros for a lot of your common meals, snacks, etc, and can tally them in your head without worrying about weighing portions and knowing the exact figures.
    • Alternatively, count moderately standardized portions of relevant foods, such as “three servings of beans or legumes per day” or “no more than one portion of refined carbohydrates per day”
    • Eventually, let habit take the wheel. Assuming you have established good dietary habits, this will now do you just fine.

    This latter is the point whereby the advice (that Aragon also champions) of “allow yourself an unhealthy indulgence of 10–20% of your daily food”, as a budget of “discretionary calories”, eventually becomes redundant—because chances are, you’re no longer craving that donut, and at a certain point, eating foods far outside the range of healthiness you usually eat is not even something that you would feel inclined to do if offered.

    But until that kicks in, allow yourself that budget of whatever unhealthy thing you enjoy, and (this next part is important…) do enjoy it.

    Because it is no good whatsoever eating that cream-filled chocolate croissant and then feeling guilty about it; that’s the dichotomous thinking we had back in the 80s. Decide in advance you’re going to eat and enjoy it, then eat and enjoy it, then look back on it with a sense of “that was enjoyable” and move on.

    The flipside of this is that the importance of allowing oneself a “little treat” is that doing so actively helps ensure that the “little treat” remains “little”. Without giving oneself permission, then suddenly, “well, since I broke my diet, I might as well throw the whole thing out the window and try again on Monday”.

    On enjoying food fully, by the way:

    Mindful Eating: How To Get More Nutrition Out Of The Same Food

    Want to know more from Alan Aragon?

    Today we’ve been working heavily from this book of his; we haven’t reviewed it yet, but we do recommend checking it out:

    Flexible Dieting: A Science-Based, Reality-Tested Method for Achieving and Maintaining Your Optimal Physique, Performance & Health – by Alan Aragon

    Enjoy!

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  • 4 Tips To Stand Without Using Hands

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The “sit-stand” test, getting up off the floor without using one’s hands, is well-recognized as a good indicator of healthy aging, and predictor of longevity. But what if you can’t do it? Rather than struggling, there are exercises to strengthen the body to be able to do this vital movement.

    Step by step

    Teresa Shupe has been teaching Pilates professionally full-time for over 25 years, and here’s what she has to offer in the category of safe and effective ways of improving balance and posture while doing the sitting-to-standing movement:

    • Squat! Doing squats (especially deep ones) regularly strengthens all the parts necessary to effectively complete this movement. If your knees aren’t up to it at first, do the squats with your back against a wall to start with.
    • Roll! On your back, cross your feet as though preparing to stand, and rock-and-roll your body forwards. To start with you can “cheat” and use your fingertips to give a slight extra lift. This exercise builds mobility in the various necessary parts of the body, and also strengthens the core—as well as getting you accustomed to using your bodyweight to move your body forwards.
    • Lift! This one’s focusing on that last part, and taking it further. Because it may be difficult to get enough momentum initially, you can practice by holding small weights in your hands, to shift your centre of gravity forwards a bit. Unlike many weights exercises, in this case you’re going to transition to holding less weight rather than more, though.
    • Complete! Continue from the above, without weights now; use the blades of your feet to stand. If you need to, use your fingertips to give you a touch more lift and stability, and reduce the fingers that you use until you are using none.

    For more on each of these as well as a visual demonstration, enjoy this short video:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Further reading

    For more exercises with a similar approach, check out:

    Mobility As A Sporting Pursuit

    Take care!

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Related Posts

  • Zero Sugar / One Month – by Becky Gillaspy
  • Afterwork – by Joel Malick and Alex Lippert

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Regular 10almonds readers may remember that one of the key unifying factors of Blue Zones supercentenarians is the importance of having purpose, sometimes called ikigai (borrowing the Japanese term, as a nod to the Okinawan Blue Zone).

    The authors are financial advisors by profession, but don’t let that fool you; this book is not about retirement financial planning, but rather, simply addressing a problem that was often presented to them while helping people plan their retirements:

    A lot of people find themselves adrift without purpose at several points in life. Often, these are: 1) early twenties, 2) some point in the midlife, and/or 3) retirement. This book addresses the third of those life points.

    The authors advise cultivating 10 key disciplines; we’ll not keep them a mystery; they are:

    1. Purpose
    2. Calendar
    3. Movement
    4. Journaling
    5. Faith
    6. Connection
    7. Learning
    8. Awareness
    9. Generosity
    10. Awe

    …which each get a chapter in this book.

    A note on the chapter about faith: the authors are Christians, and that does influence their perspective here, but if Christianity’s not your thing, then don’t worry: the rest also stands on its own feet without that.

    The general “flavor” of the book overall is in essence, embracing a new period of enjoying what is in effect the strongest, most potentially impactful version of you you’ve ever been, as well as avoiding the traps of retirement “sugar rush” and “retirement drift”, to define, well, a more purposeful life—with what’s most meaningful to you.

    The style of the book is self-help in layout, with occasional diagrams, flowcharts, and the like; sometimes we see well-sourced stats, but there’s no hard science here. In short, a simple and practical book.

    Bottom line: if your retirement isn’t looking like what you imagined it to be, and/or you think it could be more fulfilling, then this book can help you find, claim, and live your ikigai.

    Click here to check out Afterwork, and indeed live a future that’s worthy of dreams!

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  • Elon Musk says ketamine can get you out of a ‘negative frame of mind’. What does the research say?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    X owner Elon Musk recently described using small amounts of ketamine “once every other week” to manage the “chemical tides” that cause his depression. He says it’s helpful to get out of a “negative frame of mind”.

    This has caused a range of reactions in the media, including on X (formerly Twitter), from strong support for Musk’s choice of treatment, to allegations he has a drug problem.

    But what exactly is ketamine? And what is its role in the treatment of depression?

    It was first used as an anaesthetic

    Ketamine is a dissociative anaesthetic used in surgery and to relieve pain.

    At certain doses, people are awake but are disconnected from their bodies. This makes it useful for paramedics, for example, who can continue to talk to injured patients while the drug blocks pain but without affecting the person’s breathing or blood flow.

    Ketamine is also used to sedate animals in veterinary practice.

    Ketamine is a mixture of two molecules, usually referred to a S-Ketamine and R-Ketamine.

    S-Ketamine, or esketamine, is stronger than R-Ketamine and was approved in 2019 in the United States under the drug name Spravato for serious and long-term depression that has not responded to at least two other types of treatments.

    Ketamine is thought to change chemicals in the brain that affect mood.
    While the exact way ketamine works on the brain is not known, scientists think it changes the amount of the neurotransmitter glutamate and therefore changes symptoms of depression.

    How was it developed?

    Ketamine was first synthesised by chemists at the Parke Davis pharmaceutical company in Michigan in the United States as an anaesthetic. It was tested on a group of prisoners at Jackson Prison in Michigan in 1964 and found to be fast acting with few side effects.

    The US Food and Drug Administration approved ketamine as a general anaesthetic in 1970. It is now on the World Health Organization’s core list of essential medicines for health systems worldwide as an anaesthetic drug.

    In 1994, following patient reports of improved depression symptoms after surgery where ketamine was used as the anaesthetic, researchers began studying the effects of low doses of ketamine on depression.

    Depressed woman looks down
    Researchers have been investigating ketamine for depression for 30 years.
    SB Arts Media/Shutterstock

    The first clinical trial results were published in 2000. In the trial, seven people were given either intravenous ketamine or a salt solution over two days. Like the earlier case studies, ketamine was found to reduce symptoms of depression quickly, often within hours and the effects lasted up to seven days.

    Over the past 20 years, researchers have studied the effects of ketamine on treatment resistant depression, bipolar disorder, post-traumatic sress disorder obsessive-compulsive disorder, eating disorders and for reducing substance use, with generally positive results.

    One study in a community clinic providing ketamine intravenous therapy for depression and anxiety found the majority of patients reported improved depression symptoms eight weeks after starting regular treatment.

    While this might sound like a lot of research, it’s not. A recent review of randomised controlled trials conducted up to April 2023 looking at the effects of ketamine for treating depression found only 49 studies involving a total of 3,299 patients worldwide. In comparison, in 2021 alone, there were 1,489 studies being conducted on cancer drugs.

    Is ketamine prescribed in Australia?

    Even though the research results on ketamine’s effectiveness are encouraging, scientists still don’t really know how it works. That’s why it’s not readily available from GPs in Australia as a standard depression treatment. Instead, ketamine is mostly used in specialised clinics and research centres.

    However, the clinical use of ketamine is increasing. Spravato nasal spray was approved by the Australian Therapuetic Goods Administration (TGA) in 2021. It must be administered under the direct supervision of a health-care professional, usually a psychiatrist.

    Spravato dosage and frequency varies for each person. People usually start with three to six doses over several weeks to see how it works, moving to fortnightly treatment as a maintenance dose. The nasal spray costs between A$600 and $900 per dose, which will significantly limit many people’s access to the drug.

    Ketamine can be prescribed “off-label” by GPs in Australia who can prescribe schedule 8 drugs. This means it is up to the GP to assess the person and their medication needs. But experts in the drug recommend caution because of the lack of research into negative side-effects and longer-term effects.

    What about its illicit use?

    Concern about use and misuse of ketamine is heightened by highly publicised deaths connected to the drug.

    Ketamine has been used as a recreational drug since the 1970s. People report it makes them feel euphoric, trance-like, floating and dreamy. However, the amounts used recreationally are typically higher than those used to treat depression.

    Information about deaths due to ketamine is limited. Those that are reported are due to accidents or ketamine combined with other drugs. No deaths have been reported in treatment settings.

    Reducing stigma

    Depression is the third leading cause of disability worldwide and effective treatments are needed.

    Seeking medical advice about treatment for depression is wiser than taking Musk’s advice on which drugs to use.

    However, Musk’s public discussion of his mental health challenges and experiences of treatment has the potential to reduce stigma around depression and help-seeking for mental health conditions.

    Clarification: this article previously referred to a systematic review looking at oral ketamine to treat depression. The article has been updated to instead cite a review that encompasses other routes of administration as well, such as intravenous and intranasal ketamine.The Conversation

    Julaine Allan, Associate Professor, Mental Health and Addiction, Rural Health Research Institute, Charles Sturt University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Understanding Cellulitis: Skin And Soft Tissue Infections

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    What’s the difference between a minor passing skin complaint, and a skin condition that’s indicative of something more serious? Dr. Thomas Watchman explains:

    More than skin-deep

    Cellulitis sounds benign enough, like having a little cellulite perhaps, but in fact it means an infection of the skin and—critically—the underlying soft tissues.

    Normally, the skin acts as a barrier against infections, but this barrier can be breached by physical trauma (i.e. an injury that broke the skin), eczema, fungal nail infections, skin ulcers, and other similar things that disrupt the skin’s ability to protect us.

    Things to watch out for: Dr. Watchman advises we keep an eye out for warm, reddened skin, swelling, and blisters. Specifically, a golden-yellow crust to these likely indicates a Staphylococcus aureus infection (hence the name).

    There’s a scale of degrees of severity:

    • Class 1: No systemic toxicity or comorbidities
    • Class 2: Systemic toxicity or comorbidities present
    • Class 3: Significant systemic toxicity or comorbidities with risk of significant deterioration
    • Class 4: Sepsis or life-threatening infection

    …with antibiotics being recommended in the latter two cases there, or in other cases for frail, young, old, or immunocompromised patients. Given the rather “scorched earth” results of antibiotics (they cause a lot of collateral iatrogenic damage), this can be taken as a sign of how seriously such infections should be taken.

    For more about all this, including visual guides, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

    Don’t Forget…

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