Walking the Middle Path is a dialectical behavior therapy (DBT) skill developed especially for teens and their parents. This skill helps to bridge communication between parents and teens to maintain a relationship during this challenging time. Learn what this skill is, how to apply it in your home, and how Sunrise Residential Treatment Center can help your family master it.


WHAT DOES “DIALECTIC” MEAN?


VALIDATION


CHANGE BEHAVIORS

Imagine you’re on a hike with your family in rugged mountain terrain. It’s a hard hike. You stop for a break and look around. How far have you traveled, and how long do you have until it’s over? You look back at your family. Somehow, your teenage daughter is on the other side of the canyon. How did this happen?

Sunrise’s location in southern Utah is surrounded by the beautiful canyons of Zion National Park. Canyons are developed after years and years of water flow erode the rock and eventually leave a huge space between one rock and another. The same concept is found in families going through a struggle — including the struggle of having or being a teenage girl. In time, difficult emotions and behaviors such as mental health concerns, drug use, eating disorders, depression, and self-harm can erode your family’s relationships. Before you’re even aware of exactly what’s happening, you find that your daughter is out of reach. There’s a canyon between you. Your communication gets lost or garbled in the deep, vast canyon, and you don’t know how to get to your daughter.

Walking the Middle Path skills can help you and your daughter build a bridge to one another; or, if you’re in a preventative stage, can even stop a canyon from forming. Walking the Middle Path will help you and your daughter see each other’s perspective and ease the divide to come together and work through difficult situations.

What Does “Dialectic” Mean?

Many parents touring Sunrise RTC ask us what the “dialectic” in “dialectical behavior therapy”  means. Dialectic means that two opposing views can be true at the same time. This idea is essential in the DBT middle path skills.

For example, you can have a viewpoint that is true for you, and your daughter who has her own story and perspective may have a different viewpoint. You can come together and these two opposing views can be true at the same time. Ultimately, the goal is to find a middle ground of effective behavior to solve the problem.

Acceptance Versus Change

An example of a dialectic that we focus on in our DBT program is acceptance versus change. We want to communicate to our students, and we want parents to communicate to their daughters, that we accept them the way they are. We want to communicate that she is good enough, we love her, and we understand where she is coming from. At the same time, we want to help her change, become better, and learn behaviors that are healthy and helpful. It can be a difficult balance.

An experiential activity recently helped one Sunrise family find the challenging balance of “I accept you the way you are, and I want you to improve”.

Sunrise Example

When we teach middle path skills to families, we enjoy taking them to the nearby canyons. At a recent family weekend, we took a student and her parents into the canyons to rappel down the rock face and discuss Walking the Middle Path skills. We asked the student and her mom to stand opposite of a large canyon rock face and talk through their relationship — what brought them together and what tore them apart. The mother talked about how she wanted her daughter to be independent since she would be 18 soon. This was a topic she and her daughter agreed on, and without thinking, they moved physically closer to one another. The mother then brought up one of her daughter’s unhealthy friends from home — a topic they strongly disagreed on. Her daughter physically took a step away from her mother. We laughed as we pointed out that she had physically moved away.

This became an important moment for the mom. Everyone, including the daughter, knew that this friendship was a therapeutic topic that needed to be addressed. Yet the way the mom was trying to bring up the friend physically drove her daughter away from her. What the daughter heard from her mother was “you don’t trust me and I’m not good enough for you”. During this middle path activity, we talked about how they can come together as a family and how the mom can communicate that she accepts her daughter as she is.

We did eventually work out this friendship and focus on building relationships with healthy individuals. But this only came as her mom realized that in addition to encouraging her daughter to make better choices, she also needed to convey acceptance.

Middle path skills are used to balance this dialectic of acceptance versus change. The validation skill teaches acceptance of others and yourself. The skills for positive change teach how to help modify behavior. And the balance of these two qualities is the key of Walking the Middle Path.

Validation

Validation is an essential part of communicating acceptance in your important relationships. It helps your daughter and others to know that you understand her emotions, thoughts, and where she’s coming from.

Self-validation

Many of the teens we work with at Sunrise have spent years invalidating themselves. She’s told herself that she’s stupid for feeling an emotion, that she’s weird to be upset, that she’s weak because she cried, and that she shouldn’t feel the emotions that she does. These thoughts lead her to feelings of shame and self-hatred.

Using the middle path skills to teach her how to validate herself and her emotions helps to reverse those destructive feelings. You can teach your daughter self-validation by helping her understand that it’s okay to feel upset and be hurting, and she can still make good decisions in the midst of these painful emotions. In time, she’ll be able to do this on her own.

Sunrise Example

Self-validation was a changing experience for a Sunrise student who did her best to present as a “tough girl”. Instead of expressing her true emotions, she would lash out at the people she cared about; she yelled and fought and pushed people away. She rarely cried, and when she did cry or feel an emotion, you could see the discomfort and shame in her face, and then she would shut down.

As she worked with her individual therapist and community on self-validation, she repeated to herself, “It’s okay that I’m sad right now. It’s okay that I’m crying based on what happened. Anyone in my position would feel this way.” As she started to accept that it is okay to feel emotions, she changed internally and behaviorally. She was able to see other people’s perspectives, be more accepting of herself and others, and work through hard situations without damaging her relationships.

Validating your child

It’s obviously difficult to validate your child when she is making unwise and unhealthy choices. At the same time, you can still validate the things that are, in fact, valid: her emotions, her thoughts, and who she is as a person. When you do this, you are accepting her, even if you disagree with her choices.

When Brene Brown discusses empathy, she uses the analogy that a struggling person is alone in a deep, dark pit. When you express validation and empathy for that person, you’re going down into the pit to be with that person. As you empathize that it’s dark and scary down in the pit, you’ll be able to better understand where your daughter is coming from and validate that what she’s feeling makes sense. This can help you become a more approachable person when your daughter is struggling, and to help to avoid arguments that stem from the misunderstanding.

Validate only the valid

Valid: a person’s emotions, thoughts, and who they are
Invalid: certain behaviors

We teach the parents at Sunrise the essential, yet challenging, skill of communicating “we accept you the way you are” without accidentally adding “and therefore we condone all of your choices and behaviors”. You can accept your daughter without accepting unhealthy or irresponsible behaviors.

One of our families recently exemplified this with their daughter. She had chosen not to study for a test and, as a result, she failed the exam. She was sad and frustrated that she didn’t get a better grade. Her parents did not validate her poor study habits, but validated the emotion by saying, “I understand that you’re sad about your grade. That’s really hard. I hope you’ll prepare for your next test.” Her parents effectively communicated to their daughter that they understood her emotions without validating the behavior, and simultaneously encouraged her to improve.

How do you incorporate validation at home?

1. Communicate understanding.

When talking to your child, communicate that you understand where she’s coming from in an authentic way.

Authentic: “It makes sense why you’re hurting and feeling angry. This must be a frustrating situation.”

Inauthentic: “I understand where you’re coming from, but this is why you’re wrong.”
If you can’t validate your daughter’s behavior, look for her emotion, since emotions are always valid. Although she might make poor decisions when she’s angry, anger is still an okay emotion for her to feel.

2. Recognize your own emotions.

It’s difficult to validate your daughter in an authentic way when you’re experiencing strong emotions yourself. Practice self-care and awareness of your own emotions. Walking the Middle Path involves both parties stepping out of their own emotion to see another person’s perspective. When you’re aware of the emotions that you’re experiencing in the moment, you’re able to consciously step out to see your daughter’s perspective.

3. Use past experiences.

When you’re validating your daughter, especially when you’re struggling to understand where she’s coming from, think about what your daughter has been through and how those experiences might be affecting her emotions. Maybe it makes sense that she’s reacting this way because she was bullied in the past or experienced a trauma when she was younger. Once you’ve communicated that you understand what she’s feeling, you can move forward and help her look at a different way of doing things.

Changing and improving behavior.

If you’re like most parents, trying to change your child’s behaviors results in nagging, yelling, criticizing, and punishing. The response you get from a lecture is likely “Yeah, I know, Mom,” accompanied by an eyeroll. (A response you probably remember from your own teenage years and might have prompted you to call your own parents to apologize the first time you were on the receiving end.)

This pattern can take a heavy toll on your relationship with your daughter, and you’ll rarely get the result you want. DBT middle path skills teach effective ways to change behaviors, whether you’re trying to increase positive behaviors or decrease negative behaviors. (Or both!)

Increasing Positive Behaviors

Sometimes, the simplest option is a great option. “Catch” your daughter doing something good and praise her for a behavior you want to encourage. Since she’s no longer a child, you’re probably not impressed anymore when she meets basic exceptions like putting her plate in the dishwasher, hanging her towel after a shower, and putting her straightener away. As parents of teens, it’s easy to focus instead on the behaviors she needs to correct. Make an effort to praise your daughter for the things she does right, even if they seem basic. When you let her know you notice and appreciate a certain behavior, she’ll be more inclined to repeat that behavior in the future.

Another option to encourage positive behavior is offering a reward (a positive consequence) as immediately as possible. Maybe she gets an additional 15 minutes of screen time that evening or is relieved of her evening chore. Even quality time with you can be a positive reward. You can offer to take her on a drive, get your nails done together, or play a game. This will motivate her to do more positive behaviors in the future.

Some teens might prefer praise and recognition over a reward, while the reverse will be true for others. One of these tactics will likely motivate your daughter to continue engaging in positive behaviors during this phase when intrinsic motivation tends to be low.

Decreasing Unhealthy Behaviors

Trying to change or stop your child’s unhealthy behaviors can be one of the trickiest parts of parenthood. You want your child to stop screaming, using drugs, self-harming, or coming home after curfew. For most parents, the initial reaction is to increase punishment by grounding your daughter, taking her phone, or confiscating the car keys. This communicates to your daughter that she’s done something wrong, but doesn’t often help to change the behavior. At Sunrise, we focus on two types of consequences: natural consequences and values-based consequences.

Natural Consequences

A natural consequence is something that occurs organically as a result of a behavior. For example, when you touch a hot stove, you get burned; when you don’t attend class, you fail; when you drive recklessly, you crash. Allowing your daughter to experience natural consequences will give her the opportunity to learn the effects of her behavior on her own. If your daughter isn’t doing her school work, consider letting her fail the class. As painful as that can be to watch, it might be the most effective way for her to learn that poor academic behaviors aren’t helpful for her.

Values-Based Consequences

Sometimes, sitting back and letting your daughter experience the natural consequences of her actions is not a viable option. In the cases of self-harm behavior, substance abuse, and eating disorders (to name a few), the natural consequence could be death. When you have to intervene in your daughter’s behavior, we generally recommend doing so with a values-based consequence.

Whether you’ve defined them or not, all individuals and families have values. Common family values might be kindness, respect, cleanliness, safety, communication, and love. If your daughter is engaging in self-harming behaviors, you would intervene with the value of safety. To keep her safe, her values-based consequence might be hospitalization or residential treatment. Of course, values-based consequences don’t need to be reserved for extreme circumstances. An everyday example is that your daughter teases her younger brother until he cries. She’s not living by the family value of kindness. As a consequence, you might ask her to do one kind act of service for her brother every day for the next week. Do your best to make consequences immediate, values-based, creative, and directly related to the behavior you’re trying to correct.


Ride Out the Extinction Burst

Imagine that your toddler learns, as they all somehow do, that throwing a tantrum in a public place is the most effective way to get you to say yes. And what happens when, one day, you continue to say no? She ramps up the tantrum. Surely, you just missed the first one. It must not have been loud enough because a public tantrum always works. As you hold your ground, the tantrum grows larger, louder, snottier. From a psychological place, she knows this is the most reliable method to get that cinnamon candy she doesn’t like but she most definitely needs. So she’ll keep trying until you give in or she gives up. And the latter option could take a while. This is an extinction burst. It’s a temporary increase in the behavior you’re trying to eliminate in an attempt to get the desired result that she used to get from the behavior. Keep in mind that your daughter isn’t necessarily escalating intentionally.

Unfortunately, these bursts don’t end with toddlerhood. As you’re trying to change your teen daughter’s behavior, you can expect her to increase the behavior before she gives it up. You’ll likely have to endure a lot of painful experiences that could last longer than you expect. It’s so much easier to give in to the behavior after you’ve been worn down, but doing so will only reinforce that the problem behavior still works. So when you’re resolved to help your daughter change a behavior, prepare and commit to ride out the extinction burst. You know what’s happening, and you have a stronger staying power than your teen — even if she’s the most stubborn of them all. Don’t be hesitant to increase your self-care and brush up on distress tolerance skills to get through this challenging time.

Your Daughter Can Change Her Own Behavior

At Sunrise, we also help our clients to do this for themselves. By identifying a behavior they want to change and giving themselves reward, they’re able to increase or decrease the behavior. We recently had a client who struggled to seek support. She chose to increase this behavior by granting herself 30 minutes to read a book (her favorite activity) each time she reached out for support and talked to someone she needed to. As she repeated this pattern, seeking support became more comfortable, and eventually natural, which increased her ability to work through hard experiences.

How do you use the middle path to change teen behavior at home?

1. Recognize your own emotional state.

When you’re emotional, the punishment or consequence you choose is often extreme and ineffective. You’re also more likely to give in when your daughter is nagging, pushing your buttons, or in an extinction burst.

2. Sit down with your partner and get on the same page about rules and consequences.

Include your daughter in this conversation when she’s in an emotionally appropriate place. Remember that rules and consequences are most effective when they’re directly tied in with a value you’re trying to teach.

3. Start small.

Pick a positive behavior that you want to increase and think of ways to reward it. If you want your daughter to wash the dishes more often, begin reinforcing by thanking her for doing the dishes or giving her a reward. Use this positive reinforcement even if you had to ask her several times to do the dishes before it actually happened. Real behavior change takes time.

The DBT middle path skills can help you and your daughter get back on the same side of the canyon. As you learn to respect one another’s perspectives and validate the valid, a change in behaviors will come more willingly. We hope that by practicing these skills at home, your interpersonal relationships will improve and the teenage years will be more enjoyable for both parties.

Sometimes, a teen’s behaviors become so extreme that they can no longer be managed in the home. If you feel that your daughter’s behaviors are more severe than the average teen or that the canyon between you is too deep to repair on your own, take the next step in helping your daughter heal. Call us today at 435-900-7753 to learn more about how Sunrise RTC can help your family.

WE ARE COMMITTED TO THE SUCCESS OF YOUR DAUGHTER, AND YOUR ENTIRE FAMILY

Sunrise uses more comprehensive outcomes than any other fully integrated DBT treatment program. By integrating DBT into every aspect of our program, your daughter will live the skills, not just learn them. We focus on the family to create a healthy system in which your daughter will thrive after returning home. Through therapy, activities, academics, and support, your daughter will become a healthy young woman with a passion for life.