David Earl Johnson, LICSW

7 minute read

Photo credit: Victoria Nevland Borderline Personality Disorder (BPD) is a much misunderstood, even maligned diagnosis. Therapists and clients often dread hearing those words. My experience has been different. While I don’t deny the challenge, I find working with persons with BPD to be enjoyable and rewarding as well. The DSMIV criteria for BPD includes the following [some paraphrasing]: A pervasive pattern of instability of interpersonal relationships, self-image, and affects [feelings], and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: 1.

David Earl Johnson, LICSW

2 minute read

A common theme in this blog is Emotional Intelligence. This review is on one of several new books on emotion for children, reviewed by an expert on children’s literature with whom I have a close relationship, my wife. HAPPY, SAD & EVERYTHING IN BETWEEN All About My Feelings A book by Sunny Im-Wang, Psy.D., SSP Emotion (Photo credit: rexquisite) Illustrated by Alex McVey This book, written for children ages 4-8, helps kids identify emotions and gives them strategies for understanding and appropriately expressing those feelings.

David Earl Johnson, MSW, LICSW

6 minute read

Mission {.widget-header} The mission of blog.davemsw.com is to (1) advance the knowledge of consumers of mental health services to empower them to to assess the quality and accessibility of mental health services, (2) to disseminate to the general public comments from a mental health professional’s perspective on mental health news, and (3) to share information with other professionals. None of the information contained on this site should be considered a replacement for professional services offered face-to-face by licensed mental health professionals.

David Earl Johnson, MSW, LICSW

2 minute read

Dare to Dream… {.widget-header} Dreams are what we fantasize about as children, they are the roles we play as we pretend to be the heroes in our fantasies, the symbols of the heroes in our lives. They are the substance of the rambling thoughts we think about as we stare out the window. Dreams are what we think about when are feeling encouraged, enthusiastic, and energetic. Dreams are not goals or objectives.

David Earl Johnson, LICSW

7 minute read

This is a cross post from © 2013 ChooseHelp.com who welcomes republishing of their content on condition that you credit Choose Help and the author, David Earl Johnson, LICSW. This article is licensed under a Creative Commons License. How to Break a Bad Habit, Like Cigarette Smoking Bad habits come in many different forms. There are minor and major bad habits. Minor bad habits include procrastination, fidgeting, overspending, and nail biting for example.

Robert Fulghum

7 minute read

Orthodox Academy of Crete What Is the Meaning of Life? “Are There Any Questions?” An offer that comes at the end of college lectures and long meetings. Said when an audience is not only overdosed with information, but when there is no time left anyhow. At times like that you sure do have questions. Like “Can we leave now?” and “What the hell was this meeting for?” and “Where can I get a drink?

David Earl Johnson, LICSW

10 minute read

It seems like whenever there is a breakthrough in wellness ideas, some rush out to incorporate it into their lives, but most of us are “too busy” despite the obvious benefits.  Over time the really outstanding ideas gradually become a part of our health culture and many more make an effort to practice the new skill.

Mindfulness is one of those upcoming ideas that will likely become an important part of our health culture. Its origins can be found in ancient Buddhist insight meditation techniquesI blog for World Mental Health Day known as Vipassana, as a solution to the inevitable suffering of life (Jha et al, 2010).  Marsha Linehan (1993) modernized and popularized the concept as an essential skill of Dialectical Behavior Therapy, what has become an important treatment of persons who are suicidal. The basic idea is that suffering is created in our unconscious mind to help us interpret uncomfortable circumstances. An ancient Buddhist saying goes something like “Pain is inevitable, suffering is voluntary.” In other words, pain is a natural part of our existence. How we react to pain is in our control. If we focus on the pain, tell ourselves how awful it is, lament our predicament, and pine for relief, we suffer and by doing so we create more intense pain.

Embedded in our experience, we are victims of our own self-constructions. Mindfulness lifts us out of embeddedness and gives us the perspective to see our self-constructions as separate from ourselves and our environment. With mentalizing [focusing on self] we see the self, with mindfulness we transcend the self. (Wallin 2007, p159)

Mindfulness is:

·        Non-conceptual.  Awareness without absorption in our thought processes.

·        Present-centered.  Always in the present moment. Thoughts about our experience are one step removed from the present moment.

·        Nonjudgmental.  Awareness cannot occur freely if we want it to be different than it is.

·        Intentional.  Attention is directed, returning attention to the present moment gives mindful awareness continuity over time.

·        Participant observation.  Mindfulness is not detached witnessing, but rather experiencing the mind and body more intimately without emersion.

·        Nonverbal. The experience cannot be captured in words, because awareness occurs before words can arise.

·        Exploratory.  Mindful awareness allows investigation of subtler levels of perception.

·        Liberating.  Every moment of mindful awareness provides freedom from conditioned suffering.

(Germer et al., 2005 cited in Wallin 2007, p159)

Mindfulness fosters integration of the social-emotional right brain and the interpreting left brain. Feelings can be informed by thought and thought by feelings. By repeatedly becoming aware of awareness, we shift the locus of subjectivity from representations of the self to awareness itself. Self becomes a continuous flow of aware experiences. Our reified images of self serve only to constrain the limits of potentials for understanding and growth.  (Wallin 2007, p165)

 Mindfulness helps us reflect on our experience of feelings and thoughts such that our sense of security, ResearchBlogging.orgflexibility, and internal freedom is enhanced.  Mindfulness allows us to make sense of our awareness of feelings and thoughts and offers a calm sense of awareness that is both expansive and focused. Such balance and centerness makes us less vulnerable to confusing our internal experience with who we are.     (Wallin, 2007)

Regular practice of the mindfulness is required. Our minds naturally focus on interesting topics as they flow through, analyze them, evaluate their beauty and relevance and then at some point let go only to again focus on the next interesting topic floating by.  Focusing on the present moment, both thoughts and feelings, information flowing through our senses, without holding onto any one thought, evaluating or judging takes a lot of practice. But the benefits of learning this skill are huge. Consider mindfulness as a highly beneficial exercise of the brain.

Research on mindfulness suggests that regular practice enables us to sustain our attention, and inhibit over thinking (Bishop et al., 2004 cited in Sheppes et al., 2008). Ten sessions of intensive mindfulness training resulted in participants showing significantly enhanced working memory capacity, suggesting that mindfulness practice may increase working memory capacity. (Chambers, Lo, and Allen, 2008) Mindfulness may be a more effective remedy for coping with dysphoric mood and to redirect thoughts away from stressful ruminations. (Sheppes et al., 2008) These enhanced capabilities may indicate enhanced self-regulation of thoughts and emotions. Mindfulness seems to improve the ability to focus and redirect our attention to control reactions to stress.  Mindfulness has been shown to correlate with decreased levels of self-reported rumination, particularly reflection. Mindfulness may help decrease depressive symptoms and anxiety, and increased positive affect.

Mindfulness may prove to be a helpful part of treatment for Major Depressive Disorder, Attention Deficit Hyperactivity Disorder, Borderline Personality Disorder, Post-traumatic Stress Disorder, and even Schizophrenia.  (Chambers, Lo, and Allen, 2008)


Mindfulness skills help to reduce worry and regret. By refocusing from intrusive negative thinking or feelings about the past or future, we decrease confusion about our self and our world and decrease emotional upset. By focusing on this moment and monitoring thoughts, feelings and events, we acquire an amazing peace of mind. Worries and regrets become unimportant. The past becomes only relevant to those events we can learn from. The future may require planning, but that too is done in the present.  With less negative thinking, there is less pressure on our sense of self. We can see the results of our work without judgments and recognize the inherent competence and develop the self-confidence that we are capable of dealing with whatever comes.

Daily we practice observing, describing, and participating in experiences in a nonjudgmental, effective way, focusing attention on one thing at a time. We discover the futility, anxiety, waste and errors of multitasking. The focus here is both on observing, describing, and participating in one’s own experience and on being able to observe and describe the actions, feelings, and so on, of significant others in a nonjudgmental way contributing to the mindfulness of others.

A mindful state is characterized by full attention to, and awareness of, the internal and external experience of the present moment.  This awareness is employed without judgment, elaboration, or reaction. Mindfulness involves attention-regulation and an open, accepting orientation to experience. Mindfulness practice does not require a particular technique, rather it relies on a particular quality of attention, focus, and mindful awareness.

Worry is self-reinforcing in that it seems to walk us through multiple scenarios of threat and responses to those threats. We end up thinking we need to worry. But new approaches are seldom found. And, worst of all, new information may be missed due to distraction, which makes us less prepared. All we really get is a vague anxious reassurance that we’ve spent more time and effort preparing. Stopping worry is an option for everyone. Here is one author’s suggestion:

1. Catching the worry early. 2. Relax. 3. Challenge the irrational worrisome thoughts. (Greenberg and Pascual-Leone (2006):PG 616-617)

And I add:

4. Relax while planning actions that will answer the concerns expressed in the worry, one day at a time.Mindfulness concentrative exercises emphasize focus on a target object, such as a body sensation, visual image, phrase, or concept. We sit in a relaxed and upright and direct our full attention to the sensations of breathing. When we notice that attention has wandered, we gently return our attention back to those sensations. Getting off track at first is frequent, and feels frustrating. We can up-regulate concentration to ensure that we stay more on-task and regulate our emotions to overcome the frustration at failing to do so. When used repeatedly over many practice sessions we strengthen both our ability to focus and redirect negative emotions constructively to the task at hand. Research has shown that those engaging in regular committed mindfulness training demonstrate significant improvements in mindfulness, depressive symptoms, rumination, working memory and sustained attention. This has been shown relative to a comparison group who did not undergo any meditation training.

Our meditation analyses revealed that whereas there was a direct benefit of greater practice time on positive emotions. Improvements in working memory corresponded with reductions in negative but not positive affect.  (Jha et al, 2010)

Mindfulness practice, an exercise of the mind, leads to a healthy sense of well being, a productive focus on the moment and tasks that need to be done, and a patient stepwise process.  We retrieve all the time and energy spent regretting past events we can’t change, and anxiously worrying about future events.


Chambers, R., Lo, B. C. Y., & Allen, N. B. (2008). The Impact of Intensive Mindfulness Training on Attentional Control, Cognitive Style, and Affect Cognitive Therapy and Research, 32 (3), 303-322 DOI: 10.1007/s10608-007-9119-0

Greenberg, L. S., & Pascual-Leone, A. (2006). Emotion in Psychotherapy: A Practice-Friendly Research Review. JOURNAL OF CLINICAL PSYCHOLOGY, Greenberg and Pascual-Leone (2006), 62(5), 611-630.

Jha, A. P., Stanley, E. A., Kiyonaga, A., Wong, L., & Gelfand, L. (2010). Examining the protective effects of mindfulness training on working memory capacity and affective experience. Emotion, 10 (1), 54-64 DOI: 10.1037/a0018438

Linehan, M. M. (1993). Cognitive Behavioral Treatment of Borderline Personality Disorder. New York: Guilford Press.

Sheppes, G., Meiran, N., Gilboa-Schechtman, E., & Shahar, G. (2008). Cognitive mechanisms underlying implicit negative self concept in dysphoria. Emotion, 8(3), 386-394. doi:10.1037/1528-3542.8.3.386

Wallin, D. J. (2007). Attachment in Psychotherapy. New York: The Guildford Press.

David Earl Johnson, LICSW

7 minute read

Why Do Men Have Such Trouble With Intimacy? (Full article at the link in alternet.org) Real intimacy, unlike sex or hanging out, requires a vulnerability the ‘man code’ Cropped screenshot of John Wayne and Angie Dickinson from the trailer for the film Rio Bravo (Photo credit: Wikipedia) prohibits…. The answer is that most men are taught from an early age to be competitive, that feelings are a sign of weakness, and to avoid vulnerability and dependency at all costs.

David Earl Johnson, LICSW

2 minute read

This is an updated post from another a year ago. Here a highly intellectually focused researcher who surprises herself and begins a process of transformation from valuing strength in stoicism to embracing vulnerability as the core of strength. The first video was recorded in 2010. The second was released early this month. From Ted.com: Shame is an unspoken epidemic, the secret behind many forms of broken behavior. Brené Brown, whose earlier talk on vulnerability became a viral hit, explores what can happen when people confront their shame head-on.