DOVER — Intense emotions can be overwhelming when challenging situations occur.
Add thoughts about past traumas, and the bad things that could happen in the future, and the results can be tragic, even leading to thoughts of suicide.
In 2020, Tuscarawas County’s rate of suicide completion rose to 16.6 per 100,000 people, above the state’s rate of 13.8 per 100,000 people, according to the Ohio Department of Health.
One in five people suffer from mental health problems, experiencing difficulty coping with everyday demands and disturbances in thought and behavior, according to the Behavioral Health Center of Cleveland Clinic Union Hospital in Dover.
People can be depressed, anxious or isolated, or have altered thinking, mood, or behavior, relationship distress or difficulty carrying out daily tasks.
But it doesn’t have to be that way.
Learning to handle strong feelings
People can learn how to handle their strong feelings by practicing being truly present in the moment, without simultaneously bearing added stressors from the past or future, according to Manager Dawn Abrams and social worker Patricia Miller of Behavioral Health.
Behavioral Health offers intensive outpatient treatment with dialectical behavior therapy for three hours a day, three days a week.
The frequency and intensity of the treatment sets it apart from other outpatient counseling, which may offer patients weekly one-hour sessions.
“By the time suicidal thoughts set in or surface, individual outpatient counseling is not going to be intense enough to meet the needs of the patient,” Miller said. “That’s where we come in.”
Behavioral Health receives patients who are referred by counselors, primary care physicians, as well as those who inquire about the program themselves. Patients may return to other counselors during or after receiving intensive outpatient therapy.
“Dialectical” refers to the concept of holding opposing ideas at the same time, such as “I am struggling with anxiety” and “I am learning coping skills to get better.”
The agency offers skills training in groups that operate more like classes than confessionals.
Handling intense emotions
After an initial assessment in private, clients concentrate on skills training to help them handle their intense emotions.
“We don’t focus as long on the problem,” said Miller, who is both a therapist and a social worker. “From the very first week, they leave here with actual skills. The main key of all these skills is so that a patient can remain functional and emotionally well regardless of what’s going on around them. So they’re able to separate themselves between what’s happening around them and what’s inside of them.”
Each patient has an individual treatment plan, said Abrams, a nurse.
Clients may stay with Behavioral Health for four to six weeks, during which time they are expected to practice their new skills in their daily lives — at work, in their homes and within the community.
Miller said the foundation of the skills is mindfulness, a state of being in the moment, rather than ruminating on the past or worrying about the future.
Dialectical thinking helps to pull people away from all-or-nothing thinking, which encourages wide mood swings that can be emotionally exhausting, according to Miller. She said dialectical behavior therapy tries to get people to think in a balanced way and stay grounded.
Most of the work is done in groups, Miller said.
Behavioral Health has a staff of 10. Two psychiatric practitioners, a physician assistant and a nurse practitioner, work for Cleveland Clinic Akron General.
Miller said dialectical behavioral therapy is effective for treating and managing a range of mental health conditions, such as borderline personality disorder, panic attacks and depression.
Behavioral Health generally gets high ratings on patient surveys after discharge, fours and fives on a scale with a top score of five, according to Miller. She said they rarely get scored lower than a four; most are fives. Clinical measurements of patient symptoms show progress after participation in the program, she said.
She said the therapy takes advantage of neuroplasticity, the ability of the brain to form new neural pathways. Clients are expected to build new coping skills and practice healthy thinking patterns before crises occur.
An example of the skills training offered by Behavioral Health is this five-part grounding exercise based on the senses:
• Look at your surroundings. Observe five things you can see, noticing their color, shape and reflectively.
• Touch four things you can feel. Take note of different textures.
• Listen to three things you can hear in your environment, such as bird song, flowing water or traffic.
• Smell two things.
• Taste one thing.
Miller said the exercise needs to be done for five to 10 minutes every day in a quiet place without interruption for thinking patterns to change.
In times of stress, you can go through the exercise to get in touch with the moment, and avoid getting caught up with racing thoughts that can lead to out-of-control emotions and behavior. The goal of the exercise is to keep the user in a calm mental and emotional state.
“Getting in touch with your five senses, in the surrounding, in the moment that you’re in right now, is what teaches the brain to be in the moment.” Miller said. “That’s what mindfulness is all about.
“You start out by teaching patients to be in the moment and aware of their environment outside of them. Then once they get real proficient at that … you start helping them to be aware of what’s going on inside of them.
“If you’re aware of what’s outside, and what’s going on inside,” Miller said, “you’re going to be able to catch yourself if you have an unhealthy thought because you’re mindful.”
Behavioral Health at Cleveland Clinic Union Hospital may be reached at 330-308-3700.
Reach Nancy at 330-364-8402 or firstname.lastname@example.org.
On Twitter: @nmolnarTR