“Attention is the rarest and purest form of generosity.”

— Simone Weil

I began learning and training in Dialectical Behavior Therapy (DBT) in the late 90s, at what was once known as the Portland DBT Program, and now is the Portland DBT Institute. This was an especially auspicious time for me as a baby therapist fresh from graduate school who was just encountering patients who were in the throes of excruciating emotional suffering. Those diagnosed with Borderline Personality Disorder (BPD), others bearing the invisible scars of trauma, and others bearing quite visible scars indelibly etched into their flesh, acts of distraction, soothing, even countering bouts of dissociation, as I would come to learn.

From my initiation into DBT practice and to this very day, I learned and am learning, the power of presence, and the absence of presence in relationships. With mindfulness, I discovered how pervasively my mind was distracted for most of my life, how fractured my thoughts had been over the course of my life. It would take another ten plus years, a divorce and a personal crisis or two for me to deepen my appreciation for mindfulness and intentional living as radically important practices. My education, training and my own existential need provoked a more serious desire and devotion for cultivating mindfulness in my daily personal life, and this naturally tracked with my practice of mindfulness within my clinical practice where I encounter so many human beings in need of the full presence of another person, and where I teach mindfulness as the core of the DBT skills array, journeying with others engaged in building a life worth living.

The fruits of my increased practice of mindfulness include decreased reactivity toward clients and self, increased compassion for my clients and my self, increased psychological flexibility when it comes to responsiveness and problem-solving. And the benefits of mindfulness for the clients are truly manifold and myriad. They find new spaces for hearing their emotions without rejecting them, as they were taught by their invalidating environments. They experience a newfound trust in their emotions, which are giving them vital information needed not only for basic survival but for how they are doing with social connection and safety, where they stand in reference to others.

With their new listening skills, DBT clients come to befriend their emotions, understanding better how these former “enemies” actually work in their service by motivating effective action in daily life. Even in areas of work and school, romance and family. Feeling less reactive, DBT clients discover new space, a broader internal expanse, rather than an abyss, within their Wise Mind in which they experience broader awareness of a widening array of actions. They learn that they do have wisdom and they know how to live a wise life especially when they are paying attention. And perhaps more importantly, the invalidation in their early years, which sabotaged their ability to self-regulate, leaving them adrift in a sea of untamed emotions, DBT clients begin to experience increased internal coherence emerging from mindful self-validation. As of this writing, we find ourselves in an age illumined by Interpersonal Neurobiology (thank you, Dan Siegel, et. al.) in which we have a deeper understanding of how social events and transactions affect human physiology, and vice-versa. We know more about the bio of the biosocial theory in DBT that helps professionals frame their clients’ emotional suffering in a meaningful and compassionate fashion, which inculcates the DBT practitioner against the infections of reactive and clinically empty judgments.

Concerning the therapy relationship, presence invites safety. A mindful therapist recollected fully within the counseling venue demonstrates care and generosity in seeing the client as they are, free of preconceived notions or biases. Even where these notions remain their numbers are greatly reduced, de-cluttering the encounter between therapist and client. Presence invites connection with those who have been starved by invalidation. Presence turns one human being fully toward the other, like calling to like, presence then invites its counterpart. Presence invites rich existential encounters, where the other experiences being seen, heard and most importantly felt (as expressed by Daniel Siegel). I dare say presence invites existential authentication by the way of whole-person validation, Within these wise and tender spaces DBT clients experience themselves as real, they learn that their therapists take them seriously even if they are occasionally misunderstood. Because where human beings are present to one another, there is a willingness to learn the dance and language of each person sitting together, allowing for the natural emergence of the nuanced dance and language that can only occur there and only between-these-two. Rare and pure generosity become a given, a rich dialectic indeed. And what a struggle and honor to a participant.