Dear BHBA Community and Colleagues:
All of us at Brooklyn Heights Behavioral Associates, psychologists, social workers, students and administrative staff, stand in solidarity with Black lives and the mission of Black Lives Matter to fight racial hatred, violence and systemic racism. We demand justice for racist hate crimes, demand to convict and root out murderous racist police and stand against institutional injustice and injustice of all kinds. We fight against these atrocities and all kinds of victimization. We are here and strong.
We acknowledge our privilege based purely on our circumstances as middle and upper class white therapists. This significantly limits us. The work we have done thus far as a team is not enough. So, I have rolled out several initiatives within the practice that I share here, to examine these limits, to aid in our efforts and the collective efforts to reduce culturally informed biases, covert and overt racist attitudes and do our part to reduce hate and violence in the world.
I also write to validate and share the horror and despair authentically flowing from realities we see with our own eyes and hear with our own ears. The swirl of emotions, urges and reactions from this Racism Pandemic overwhelm us and the overlay of threats from COVID-19 whipsaw us between two opposite fear responses. Fight - Do Something! Flight - Stay home!
I write to share. There is power and healing in the collective experience. My outrage, fear, hopelessness and helplessness, anguish and grief threaten to overwhelm. My neurological and physiological reactions run wild, while witnessing murder committed by police and hearing more and more stories unfolding in real time. Flashbacks of violence weaken my knees - of racist police and their brutality against blacks, looters harming cities and violent people hurting each other. Fomented by the press and the furthering political divide deepening and unfolding from intolerance and hate within our country and throughout the world. My heart races. My gut is twisted. I can’t sleep or concentrate. My dreams are nightmares. As one of my patients so poignantly described, we are living in a "menacing atmosphere”, while she wondered if our nervous systems could ever adapt. The menacing atmosphere is in the world and is also embodied.
These events traumatize, and at the same time our primitive neurological response systems are garnering energy to fight. It is painfully challenging to override these internal responses and to transform them into actions that align with our ethics, values and morals. Yet, it is the very thing we are demanding from others. It presents a challenge to face with love when we are face to face with the horrors of hate.
I write to share what has been most transformative in my life. What has helped me commit to a life of many decades of purpose and meaningful action - despite the crippling pain I have always felt from acute awareness of endless, insurmountable and abject realities that cause urges to collapse or lash out. My hope is that in the face of your own turmoil, teachings from my healers who have dedicated their lives before us to figure out how to cultivate love towards yourself and others, when we are living in hell, can illuminate then shape your intentional response.
Dr. Linehan is a behavioral scientist, professor emeritus, a Zen Roshi and devout Catholic, and the creator of our specialty Dialectical Behavioral Therapy (DBT). DBT is the culmination of her life long striving to solve how to help suicidal people who suffer from the ongoing brutality of their emotions (a patient population considered untreatable 30 years ago) build lives worth living. She realized the methods used in the Greek philosophy of dialectics (scrutiny) could be a map for what successful treatment looks like and a guide for new behaviors to get there.
The dialectical method encourages discourse with multiple truths, within us and in the world around us. They serve to enrich our learning and therefore, enhance our collective understanding of the world. Through investigation, Dr. Linehan found that it is the inability to tolerate, accept, dialogue with and learn from these multiple realities, that cause our greatest suffering. As a Buddhist Zen Roshi and devout Catholic, she understood threefold, that acceptance with love is the path to peace and transcendence.
Dr. Linehan found that intolerance of reality can manifest as hate towards oneself or others. Hate binds itself with action in the form of impulsivity with one single mission - to eradicate it. If we believe we cannot tolerate or bear reality, we are crushed by its weight, leading to hopelessness, depression, self-harm, and suicide (violence towards self) or, we act in ways that harm others with our violent words and violent actions. Remorse, shame and grief overwhelm in the aftermath of impulsivity and dire consequences are imposed on from the world. The cycle goes on and on pulling deeper and deeper into oppression and what she refers to as "hell".
The solution is simple, yet dialectically, one of the hardest things to do. We must notice our urge to eradicate realities we do not like and instead, open to it, listen to it, and accept it. Acceptance, “it is”, teaches us what is needed. Empathy, grief, fear, horror, hate, can be metabolized into something more sophisticated than our primal ingrained and all too human urges. Yet if we are to be successful, we must have the inner strength to withstand the impact of our emotions and destructive urges that flow from them. This requires a lot of know how, practice and skill.
Dr. Linehan emphasizes the importance of using techniques of Mindfulness to enhance our attention to authentic emotions. She understands that emotions are our wisest teachers and should be used to guide us towards purposeful action. DBT provides tools to move and dance with the dialectical beats of acceptance and change as reality presents itself. By radically accepting, and incorporating tools to tolerate emotions along the way, we become stronger and stronger and more capable of moving forward with intention.
Thich Nhat Hanh, my other teacher, wrote “The Miracle of Mindfulness” in response to and during the Vietnam war. He was exiled and banned by both sides of the warring government because of his role in trying to promote peace, undermining their war efforts. He understood that Mindfulness and Buddhist teaching promoted peace and that each moment offered the promise of understanding - opportunities to dialogue, learn and transform. He encourages engaged Buddhism - to make a commitment to actively applying the teachings in daily life, to intentionally improve social, political, environmental and economic suffering and injustice. Simply put, keep yourself from acting out violently with words and actions and instead live ethically in the world in order to contribute to the greater good.
Thich Nhat Hanh teaches us that understanding is the key to living ethically and he and Dr. Linehan are well aware that this is a practice that requires daily commitment. Accepting with understanding painful truths within ourselves and in the world around us is fundamental to peace and well-being and requires a commitment to effortful non-judgmental listening to oneself and others, tolerating waves of strong emotions that arise from judgments about those differences and setting them aside in the service of true understanding. Once we truly understand, then we have done our part to mitigate some of the pain. And yes, it matters, even though you are only one person.
As your therapists, we live and breathe the principles of DBT and practice Mindfulness to foster resilience and deeper understanding within ourselves. We apply the tools to help ourselves, so that we can be effective teachers with the inner strength to bear witness to your pain in addition to our own. We commit to provide a non-judgmental space for exploration. We will listen deeply and Mindfully. We help you foster a purposeful life. We will help you become stronger in the process, to enhance your ability to withstand the brunt of your emotions from painful awareness of realities in your life so that you can move forward with purpose and intention.
Dialectically, on the other side, as the director of BHBA, I will continue to expand our frame of reference, to promote greater and deeper understanding of truths that are not our own, to open our eyes and hearts to our significant limits as white middle and upper class treaters and healers, and radically accept these limits.
To this end and to do more, I am researching and vetting specialty employee training programs provided by social justice organizations with this expertise, such as the Robert Wood Johnson Foundation, Center for Racial Justice, and Black Emotional and Mental Health (BEAM). Until then, we will engage in a weekly process group where we can begin exploring, challenging, and reckon with our discriminatory, culturally shaped biases, beliefs and explore potentially hidden and corrosive attitudes. We read scientific articles on institutional and systemic racism. In addition, I will work to enhance our assessment tools to be more tuned into the insidious and traumatic impact this is having on our community.
I am checking in frequently and actively engaging in recommendations set forth by the American Psychological Association. Currently, they are developing a three level action plan to combat inequality, racial profiling and police violence and they are pairing up with other institutions that combat social injustice. I am contributing to their cause both financially and with my time. https://www.psychologicalscience.org/topics/racism is also a useful resource that we will explore during our social and racial injustice meeting, and these are resources for you too.
Furthermore, I am redoubling my efforts to find ways to improve access to care, to reach underserved communities to provide evidence-based high-quality treatments that are affordable. Since COVID-19 and in response to my pain witnessing the secondary trauma of essential workers, I initiated the process of becoming in-network for employees of the Health and Hospitals Corporation, which has over 44,000 employees throughout the 5 boroughs and have also been approved by their health and wellness team as a preferred provider. In the past, I have shied away from going in-network because of the administrative time and costs required to engage with insurance companies to get paid and have relied on negotiating rates -even down to zero- to provide care to people with financial needs. However, this will open the door to many more, throughout all departments' employees at the hospital and open access to evidence-based treatment. My practice will now absorb the administrative costs of managing this in order to have greater visibility and reach more people in need.
Finally, please keep your eyes peeled for the opening of BHBA’s Center for Traumatic Stress, which will provide comprehensive evidence-based multi-modality trauma interventions for all ages and be a source for educating the public, training professionals, advocating for access to care, conducting future research and possibly fundraising to help parents cover the exorbitant costs of high-quality residential care for their beloved children.
In the spirit of Dr. Linehan, I leave you to Mindfully dance between dialectical actions. Please - take all the time you need to feel and heal AND never never give up!
Stay well, Mindful, energized and engaged!
Belinda Bellet, Ph.D.
