When Fear Becomes Reality: DBT Skills for working with clients with "Immigration Status Fear"

Overview: Learn to adapt the DBT skills COPE AHEAD and PLEASE specifically for undocumented clients experiencing chronic fear of ICE detention (these skills will also help you as providers too). This training combines evidence-based DBT techniques with culturally responsive approaches, addressing the unique mental health needs of clients whose immigration status creates ongoing traumatic stress. This training will also offer you skills for yourself as you navigate these difficult conversations and scenarios with the people you serve.

Learning objectives:

• Cultural considerations when working with undocumented communities
• Discussion around Enhancing Evidence Based Practice with a Decolonizing lens
• Modifications to standard COPE AHEAD protocols for immigration-related fears
• Practical self-soothing skills
• Addressing intersectional trauma
• Dialectics of joy and fear as a tool to navigate these turbulent times

GUEST: Sofia Mendoza LCSW author of "Healing From Racism Stress Book"

Handouts:

COPE ahead in Spanish & English

 

Podcast Editors: https://www.sonivia.com/about

 

 

Transcript:

 

CSCSWSofiaFullEpisode

[00:00:00] Hello, you're listening to the California Society of Clinical Social Work Podcast. This podcast offers educational content by providing clinical, social work, training, and information that builds professional practice competency for our members. Hello, my name is Dr. Veronica gon and I want to give you a brief introduction to Dialectical Behavior Therapy.

Before we begin the interview and training for today, I wanna begin by providing a basic psychological definition of what dialectical means. It refers to a way of thinking that acknowledges the existence of opposing or contradictory ideas and seeks to find a balance or synthesis between them. It recognizes that two seemingly opposite ideas can both be true simultaneously.

DBT was developed by psychologist Marsha Linnehan in the 1980s. It began as an effort to treat a highly suicidal individuals using traditional behavior therapies. But the [00:01:00] process wasn't straightforward. It was shaped by trial error and deep clinical insight. Early on, Han and her team realized that standard behavior therapy with its heavy focus on problem solving and change, often felt invalidating to clients dealing with intense emotional pain.

Some clients would lash out, others would drop out altogether, and the challenge was that people didn't just need tools for change. They also needed to feel accepted, radically accepted, just as they were. This sparked a shift from a focus on change to a balance of change and acceptance. DBTs core strength lies in this dialectic.

The idea that two seemingly opposite truths can coexist. You can accept yourself as you are and still work toward change. You can feel pain and survive it. Drawing from behaviorism, Zen [00:02:00]Buddhism and contemplated practices, DBT introduced mindfulness and distress tolerance. Now, core components of therapy, Linehan and her team worked to to translate spiritual concepts like radical acceptance into concrete, teachable skills that didn't rely on religious or spiritual belief to make it all work.

DBT was structured as a comprehensive treatment including individual therapy, group skills training, phone coaching, and therapist consultation teams all built around a clear hierarchy of treatment targets. Eventually, the federal grant requirements push Linehan to focus research on a diagnosable disorder.

That led to the first clinical trials targeting individuals with borderline personality disorder. These studies were groundbreaking and they showed that DBT worked over time. DBT has been adapted for many other populations, including those [00:03:00] with substance use disorders, eating disorders, and adolescents.

Researchers and clinicians continue to refine DBT testing new skills and standalone interventions, but the heart of the treatment remains the same, helping people build a life worth living. This is why DBT can be applied to work with undocumented immigrants and the people who love and support them.

Sophia Mendoza is a bilingual, licensed clinical social worker working in Los Angeles since 2007. She's trained in EMDR, dialectical behavior therapy, trauma-focused CBT, and cognitive processing therapy. She is also currently co-authoring a soon to be published book on healing from racism stress. Her clinical offering for today provides our clinicians with training on intersectional DBT skills for working with immigration status sphere.

I, for one, am [00:04:00] grateful, deeply grateful for her ability to meet the moment by weaving theory lived experience and professional practice experience to provide a timely. Important professional development experience for all of us because I was undocumented until I was 12 years old and most of my family were undocumented too.

I love this community and I will always support them in living healthy and purposeful and happy lives. So it is my honor to host an episode today titled, when Fear Becomes Reality, intersectional DBT for Immigration Status Fear Provided by Sophia Mendoza, LCSW.

Good morning, Sophia. Thank you for joining us today. A lot of our clinicians would like to know a little bit about yourself. Some questions that we get are what, what shaped you into the person that you are today, and tell us a little bit about your expertise and [00:05:00] career trajectory. Yeah. Thank you so much for having me.

I'm excited to be here. A little bit about what shaped me and into who I answered. That's such a big question. But um, yeah. Sophia Mendoza. I am a licensed clinical therapist here in Long Beach, California. I'm a Bruin. That's important to say. What shaped me into who I am today. So when thinking about why I became a social worker, I always think back to being young.

I think maybe, maybe eight or nine or something, and going with my mom to the county building in a Department of Public Social Services because we were receiving, um, you know, cash Aid tanex is what they called it back then. Medi-Cal. And I remember her being interviewed by the caseworker there. And as a kid I was always interested in people.

And so I would people watch. And in the lobby I remember seeing all these people with [00:06:00] their kids and just really. Realizing like, wow, all these people have stories and how lucky are these caseworkers? They get to hear all these stories and help these people. Right? I mean, it's really funny because many, many years I actually interfaced with a lot of DPSS social workers and you know, a lot of them love what they do, but some of them do not consider themselves lucky, right.

Because they're working, uh, they're helping with, with so much need and sometimes it's beyond what they can do. Mm-hmm. But at the time I just thought like, wow, they get to help all these people. Wow. They, they get to help us. And so I think that was one of the first experiences that I can remember of like, not only needing help, but wanting to help too.

And as with most. First gen children. Right. First generation. You know, my mom's an immigrant and so [00:07:00] I was also translating for her. I was like a cultural broker for her. Right. And translating documents and reading and stuff for her. So for me, when I think about like, what shaped me into being a helper, it's really those early experiences of being, I saw a child of enigma friend in a single parent household and going to agencies to receive help.

I, I really empathize with that experience that you have and that you had as a cultural broker. Mm-hmm. Translating and, and being present and, and the re the response, holding that responsibility of helping your parents. Yeah. So when you went to UCLA, how did you get into social work after that? Well, actually I went to UCLA for my master's, but I went to uc, Irvine from undergrad.

But it's an interesting story because I actually, well, I'm also a community college baby, so I was a community college, really [00:08:00] straddling the line between I wanna be a writer or I don't know, you know? And so, mm-hmm. I remember taking all the pre-reqs and I was taking a lot of anthropology, sociology. I took some psychology, I took some creative writing classes and I was very discouraged in the creative writing classes there.

There weren't Latinos there. I think I might have been the only one. It was, it was really hard. It was, it was. It was a weird space to be in for me, and I got really scared. Really, really scared. And so at that point. Like they were talking about like finding a literary agent. And I was like, I don't know what any of that means.

Right? And I was kind of paralyzed with the writing. And so I said, okay, well maybe I'm not meant to be a writer or a novelist. I was still interested in like journalism and current affairs and things like that. So then I was like deciding between sociology and psychology. [00:09:00] And so I found a really great program at uc, Irvine, which is Psychology and Social Behavior.

And in the School of Social Ecology, they also had criminology, which was taught mainly by sociologists. And a lot of those classes were cross-listed with the Chicano Latino studies classes. And so that's kind of where my interests were married. And so I did the psychology, social behavior, and then the criminology double majors where I learned about how society influences us.

And then the psychology, like how it becomes individual and personal. And so I think that was such a great foundation for me because a lot of the classes were also about to Latino experience. And so I really, it really felt at home and knowing the influence and the impact of all our intersectionalities.[00:10:00]

Right. I went to undergrad at UCLA, so I'm a Bruin too. Mm-hmm. And my major was, uh, Chicano studies and psychology. Mm-hmm. And I didn't know about, I didn't know about social work until I graduated. I met this, this really powerful woman at the time, her name was Yolanda Redder. She was a, a, a queer activist in the community.

And, uh, she met with me and she, after hearing all about my. My goals, my dreams. She's like, oh, you don't wanna be a psychologist, you wanna be a social worker because you have this Chicano studies, a social justice major and psychology, psychology plus a, a social justice equals social work. And so she took, I was like, oh, that sounds great.

Where do I go do that? And she said, well, you can do it at UCLA or you can go to USC. So I went to to USC because I wanted a different campus experience. Mm-hmm. Yeah. Um, yeah, you know, I, I also was [00:11:00] gonna go the psychology route because I did a summer research program at the University of Wisconsin Madison right before I graduated, the year before I graduated.

And they were like, Hey, there's a home grade here if you wanna get your doctorate, wouldn't, seems really far away from me. And I didn't know how that would be for me, like personally being so far away from home and not having a support system out there. And so I was like, okay, maybe. But I actually took a job right after graduating.

I took a job as a research assistant at a, that's a private evaluation firm, but they did the evaluations for nonprofits in, in, in la. Mm-hmm. And so I was a research assistant who would go and help them collect the data, input the data. I would do some of the interviews in Spanish because a lot of them were with the SAMHSA grants.

And so then I was interfacing with a lot of social workers. And so I was like. [00:12:00] I like what they're doing. Right. I would interview participants at substance abuse inpatient centers in both languages. And so I actually was really interested in more like my evaluation piece and I thought I'm, I'm also gonna do macro social work.

That's why you went to UCLA? Yeah. Well I, well, I went to UJA because it was a lot cheaper. Yeah. So I said, well, we'll see if I, you know, they only took a small number of students. I think the cohort's like 90 or something. And so I was like, I'm just gonna give it a shot. You know, I'm gonna be really upset at myself if I don't at least try.

And so, you know, I got a deal I couldn't refuse with UCLA and so I went in, but my first, you know, your first year internships, they don't, you don't get to pick it. They pick it for you. And because I was gonna be a macro student doing research, they put me with LA County Department of Mental Health. [00:13:00] For my first year In Watts or in, yeah, Linwood.

Right next to the Martin Luther King Junior Center. It was the directly operated clinic. August Hawkin doing therapy. And I fell in love with therapy and I've been a therapist ever since, still with the Department of Mental Health. And that is, uh, a great, when we are able to find, find our path or our way.

And now we have you here sharing some of the, some of this knowledge with our, our clinician. Yeah. And this leads me to the question about why is this topic of immigration status fear so important to you? It is so important to me. Um, one, I am a child of immigrant, so I know that here, my mom, um, migrated to the US right around 76 when the civil war in El Salvador was like about to start.

She grew up in El Salvador. [00:14:00] Deep poverty. You know, El Salvador has been underdeveloped country for a long time, who went through a lot of civil war genocide. They just, they've been through so much that, that country, and so she came as, as an immigrant and my family too. And so, one, it's deeply personal, but also, you know, as a Spanish speaking, bilingual bicultural Latina in LA and the working for, you know, the county or department of mental health, my caseload has always been primarily Spanish speaking with immigrant families.

And so it's been my life's work. I've watched immigrant families navigate the system and I know it's, it's not easy for them. You know, and also working with the county, I work with other disenfranchised populations as well. And so like underneath it all [00:15:00] is reactions to stress and trauma caused by racism, unfair and unjust policies.

Mm-hmm. Right? Discriminations, microaggressions, violence. Yes. A lot of inequity. And so unfortunately, you know, it's been my life's work and what I'm passionate about is helping folks work toward healing. And we are very fortunate that you've been able to, you've been able to take this, this lived experience and translate it into some trainings for our clinicians because I, I think that a lot of us share this lived experience, uh, with you.

I myself was undocumented until I was 12 years old and I became a citizen with a immigration reform and control act of 1986. I didn't, I got my first green card as when I was [00:16:00] 14, I became a citizen at 21. My parents were undocumented, my cousins were undocumented, my uncles and aunts, and everybody was undocumented and at, at that time.

So every time I see an attack or persecution against my community right now, it just hurts my heart because I am them. They, they are mean. Oh, lucky. And I hear this from many clinicians who are out there who want to help. Mm-hmm. Who, who want to support. And it's important that they do because this community is experiencing a high level of trauma right now.

Absolutely. We have evidence from the post bill rates in Iowa in 2000. State that these long, the long-term consequences of this persecution is going to be seen in, in, in, in low birth weight. Mm-hmm. In mental health, mental health, uh, uh, negative mental health [00:17:00] consequences, socioeconomic consequences. This, this town in Iowa was completely devastated by the violent detainment of 400 undocumented immigrants.

Yeah. 15 years later, they're still seeing, seeing the consequences of that violent attack. So I'm wondering now I, I know that we are going to see the same here in, in Los Angeles. Yeah. How do we attend to this population right now so that we can prevent, uh, help prevent a public health crisis in the future?

And this is why I reached out to you, Sophia, because you have the, the knowledge and, and the skills to be able to teach this to, to our clinicians. Still, I just wanna thank you for that. Oh, thank you. I wanna thank, thank you. Thank you. Yeah. It's, you know, it's, I think for social workers, we're there, we're, we're, we're boots on the ground.

We're doing the work and without it, it just, for the sake of doing it [00:18:00] and not doing it for big payoff or the acknowledgement. A lot of our work is confidential because of Hitler, whatnot. And we still, so I think for me, I'm like just chucking along. Yeah. Doing the work. So, but thank you for, for validating.

We, well, the work that I'm doing. You're welcome. We, we, we need you. And on that note, why don't we transition into a lecture on this topic. So let, let's do that now

I wanna start with an acknowledgement and validation. This is hard. What we're going through right now is very, very hard, and I want you to notice where this is living in your body right now. When I say this is hard, where do you feel it for me right now, [00:19:00] it's in my heart. I want you to take a second and do a scan and notice where this, this is hard, where it's living in your body, and I want you to notice it without judging it, without trying to fix it or move away from it.

Just notice it because this is your humanity, this is your empathy, and simply breathe through it. This is gonna be really important for you as you've noticed that the people, maybe you've been talking with your clients, fellow staff, they're bringing some of these really tough topics to you and, and you might notice it in your body and it's okay to notice it.

It's okay to notice it and sit with it. All [00:20:00] right. So I like to start this talk with talking about decolonizing and enhancing EBPs. I've been trained in evidence-based practice for the last 17, 18 years. And what I have to say about it as a, uh, Latina person of color is that there is so much about evidence practice that is great and that I absolutely love and align with.

And at the same time, the dialectic, it's not everything right. And so there are ways that we can decolonize and we, we can, and we always have. I've been a clinician for 17 to 18 years now, and we've always modified. I've always adapted. I actually am now using the phrase I've enhanced because I feel that I have added so much to evidence-based practice.

When I include my clients, when I include their cultures or beautiful traditions [00:21:00] and other ways of healing, we will continue to, I say that we're we. We keep what works and we toss what doesn't and then challenge the rest. I wanted to share a few bipoc centered therapy books that are talking a lot about this work.

The first one, it's gonna be Post-Traumatic Slave Syndrome by Georgia Roy. She does, she is actually one of the first books I read when I was getting ready to give a talk on dialectical behavior therapy, kind of like a training. And so I came across work because I really felt like there was something else missing in terms of the invalidating environment, or there was something missing in terms of the experience for Bipoc.

And so I came upon Joy de Roy's work, um, which talks about a lot about epigenetics and research done. Going back to the times of slavery and what that trauma looks like and how it's been passed [00:22:00]down, not just at the cellular level, but also in the way we respond to stress. Decolonizing therapy by Dr.

Jennifer Mulan is also a really great text that talks a lot about how we do this work. Natalie Gutierrez, the pain we carry. She looks in healing from, uh, an IFS internal Family systems perspective. Highly recommend her book. And then there's Dr. Jennifer Shepherd Payne. Who wrote out of the fire, and this is an acceptance and commitment therapy text.

Uh, for, I believe it's for, it says Navigating Black Trauma and the next one, and, and Act and DBT. They, they kind of, a lot of people, they, they use both because they're very aligned. And so the next one, DBT is actually being co-written right now by yours, truly. We're still working on, we still have a working title, but it's really focused on healing [00:23:00] from race-based stress and trauma from this DBT lens, this DBT perspective using some of the interventions or a lot of the interventions from DBT.

And so, you know, when all this stuff was happening. I knew that for my energetic capacity, I, I was like, I, I think I wanna just train clinicians to, I, I wanna offer a webinar and give them some tools, not because it was easy. This was not easy. It's not easy. It's actually really hard emotional work. And I had go through so many creative blocks because of it, but it's because of the information is right here.

It's an instant download. Since I have been writing the book for the last few months, this is what I have to share with you all, and it's lean, a little bit of a sneak peek of what the book is going to offer. So let's talk a little bit more about enhancing EVPs for bipoc. These are the three pillars that I invite you to, to recognize.

So it's a combination of [00:24:00] allowing ancestral knowledge and community wisdom to be in the therapy room. I know you all know how to do this, but there's definitely a place and space for all of this. Um, we also wanna honor the lived experiences of those who have suffered and resisted oppression, especially, you know, for bipoc lineages, right?

There's been a lot of colonization, a lot of oppression, a lot of violence. And at the same time, we look at how these groups have still managed to thrive, survive, move forward together. Dr. Mulan says to acknowledge the colonial soul wound. And this, and I'm reading from my notes here, this is the impact of colonization on the psyche.

Spirit and soul of people and persons leading to disconnection, disembodiment and [00:25:00]fragmentation of the collective self, as well as over-reliance on western ways. And so this is more of a, when I think about the colonial soul wound and, and other, there's a native psychologist who also writes about this, um, I think his book is called The Soul Wound.

And they talk about how this is a phenomenon that's kind of like underneath it all at the root, right? And so it's really being able to name, name that grief, name that pain for a lot of our clients that they may not even be able to name it themselves, but they know that they feel it in their body in some way, shape, or form.

And so I strongly believe that we can add all these things in and, and, and use it to enhance evidence-based practice. I'm a, I'm a big believer in the Ramos, the, the, the alternate healing ways or the, the, the, the homemade recipes, right? That help. And it's gonna help for a lot of things. And at the same time, [00:26:00] there are some times where we're gonna need the antibiotic, right?

And so I see like true fidelity, uh, EBP as the antibiotic and how we can use both, we can use both the, the alternate healing and the antibiotic to help, um, when needed. And so in DBT, we always wanna start with validation. At the end of the day, it's for people who are suffering a lot. Um, but it was first research and founded under treating people with severe self-harm and suicidality.

And so, I mean, when we operationalize a little little bit more without a diagnosis or behaviors, it's people who are suffering a lot, right? And so validation is gonna be your first clinical intervention and anybody can do this. You don't have to be a clinician to know how to validate somebody. But it wasn't DBT that I really learned how to validate people.

And here [00:27:00] with what's happening, you know, a lot of people are at a loss for words. You can start with your pain and fear is valid. And sitting with that and holding that and being a witness to their pain or worry, being able to be a witness to someone's pain and worry is, is, is a big honor. And, and being able to do it in a way when you're not trying to fix them or change it.

Is even more powerful. And so with validation, we're validating the valid and, and we're sitting with that. Uh, I came across this quote, I'm like, oh, this one always makes me wanna cry. It's Dr. Gabor Mate. Do you guys know who that is? It's a really great psychiatrist for trauma, but also attachment type wounds.

And he says it's impossible to have your eyes open and not have your heart broken. And that's definitely how I've been feeling. I'm not, I'm not [00:28:00] sure if you guys have been feeling the same way, but for me it really speaks to what we're experiencing right now. And so I feel like, you know, these two go hand in hand.

It makes sense because it's impossible to have to not have your heart broken during these times. One of my favorite authors and sociologist Bell Hooks. In her book, healing Rage, she talks about, she doesn't talk about justified rage, but DBT we, we talk a lot about justified emotions. And so I wanna talk about justified rage a bit.

Um, and she says the rage of the oppressed is never the same as the rage of the privilege. And when, when I read that, I, I felt it at the pit of my stomach because, because I think it, it exemplifies what a lot of people are going through. And I think allies are definitely such an important part of this process.

And at the same time, it's okay to see that, that, that the rage is not the same. And so it's unfair [00:29:00] when people with different privileges tell the others, tell the oppressed like, oh, but you know, it's not like that, or, that's not what we meant. Right. Um, and so I, I ask you to really think about what justified emotions and helping your clients.

See what emotions they're having and, and where they're justified, right? I talk about, uh, justified rage, justified anger all the time. And actually we need it. We need it right now, right? To help with the, the movement. Dr. Mulan from Decolonizing Therapy, she does a lot of work. She, she calls it sacred rage, sacred anger.

So I really encourage, encourage you all to, to read her, um, her information. She also, on her website has, um, very reasonably priced training and, and workshops kind of like for everybody, but really talking about this and, um, giving people ways and tools on how to, how to honor that rage. [00:30:00]All right, so this is my, the only, well, maybe, maybe one of the only bio lessons here, short bio lesson, and I'm not, I.

A scientist by all means. But I wanna talk a little bit about science in our body. Um, this is the slide I actually took from our support group at our clinic. We do a support group for people experiencing immigration related fears. Wednesdays at one. Um, I can send you that information if y'all are interested.

It's a free group and so, so that's why it's bilingual. I also wanted to keep it bilingual. For those of you who are seeing Spanish speaking clients and want the words, I know it's like two different languages when we're talking about therapy in Spanish. So I wanna talk a little bit about epigenetics science and what our body is telling us, what science tells us, and then what our bodies tell us, right?

The pain and fear you're feeling is a normal survival response to something abnormal, unjust, and terrorizing. That is validation. Those are facts. That's what's [00:31:00] happening. Normal response, because our bodies and brains are wired to survive. They're wired to react when something abnormal, unjust, and terrorizing is happening.

So it makes sense, right? For many of us, for for many people with lineages in oppression, violence, this fear response has been encoded in our DNA, this is epigenetics genetics. Many of our ancestors have had these same fears of persecution, of oppression, violence. And I'm not sure if you've had this experience, but I know I have.

Like, I don't even know why I am feeling so scared, like I'm a citizen, I have my papers, but I am still feeling really restless in my body, or like, I am not okay. Right? And so the education, I give this education because then I, I let them know that you might not know what you're feeling scared, but it [00:32:00] might also be because on a cellular level.

Your DNA re remembers. So I am gonna read some notes I have here on that. So epigenetics refers to the, uh, to changes in gene expression that don't alter the DNA sequence itself, but it can be passed down through generations. Think of your DNA as a piano. The keys, which are your jeans, they remain the same.

But epigenetic changes like trauma, um, environmental stressors are like adjusting which keys get played louder or softer, or sometimes not at all. These modifications occur through te chemical tags that attach to genes, essentially turning them on or off in response to these environmental factors. But when it comes to stress and trauma, research shows that extreme experiences like slavery, like violence, like oppression, can literally change how, how our genes function.

And we saw [00:33:00] this a lot in studies of Holocaust survivors and their descendants revealed that trauma exposure alters genes involved with stress and hormone regulation, particularly around cortisol production and hypothalmic pituitary adrenal access. That sounds really important. Okay. And so these epigenetic changes can make individuals more sensitive to stress.

More prone to anxiety and depression and affect immune function and metabolism. And so if a parent who experienced severe trauma or a grandparent right may pass down this altered gene expression through their sperm or egg cells, meaning their children inherit not just genetic material like the nose that you, the family knows, like in my family, we call it the salve nose, right?

But also this biological memory of trauma. So this helps us explain why children of and grandchildren of [00:34:00] trauma survivors often display heightened sense of res responses, anxiety or other mental health challenges. Essentially, the body stays, hypervigilant, prepares for dangers, even though they may not come right?

Because in previous generations they've learned that these responses were necessary to survival. It was important to stay awake at night if you were on the lookout. And so generations later, maybe you have this kid that has a hard time falling asleep and staying asleep. Right? That's why it's important to ask about lineage, ask about ancestors, ask about family histories, right?

Of trauma and also oppression. Okay? And, and this is what, when people talk about intergenerational transmission of trauma, this is what we're talking about. This is what Dr. Georgia Gru's work is also based on. And so with that, this is where I ask people [00:35:00] to lock in. And this is where I channel my A OC, right?

And this is actually the, the second chapter in the book where we talk about it, it, it, it's titled, racism is Making us Sick because Bipoc are more vulnerable to illnesses such as high blood pressure, diabetes, and autoimmune illness. Guess what? Stress contributes hugely to all of these. My specialty is in treating trauma, and so a big majority of my caseload always has someone with autoimmune illness.

Maybe like pre-diabetes, diabetes, high blood, blood pressure. I, I will say though, autoimmune illness is probably the one that I see the most frequently, that that's a comorbid, but also breathing joy and accessing wise mind or your intuition, these all are gonna help to ground us so we can engage in the pros and cons of what to do next.

So [00:36:00] these three things can really help us ground and how we wanna move forward. What we need to do for ourselves, how we might need to take care of our bodies. I also wanna share that, um, this is another dialectic that while systemic issues, we wanna tell our clients and, and believe systemic issues are not our fault, and yet we are responsible for taking care of ourselves and each other.

And so this is, so the, the each other is how we implement community back into evidence-based practice. Because typically it's like how you can take care of yourself, you know, center your peace, you know, put your oxygen mask first. And that's all true. I'm not saying it's not, but how we're gonna enhance it is we're gonna say and how we take care of each other as well, because that is, that is really important to us.

Our values. And so we can't ignore that. We [00:37:00] can't bypass that. We can't ask our clients who come from collectivistic communities to only think about themselves. And in fact, I'm gonna say that they probably might have more buy-in when you remind them that, you know, an act of caring for themselves is caring for others because they're gonna be able to show up, you know, feeling better to, uh, and, and, you know, with, with clarity and openness when they're showing up for their families or their communities.

Everyone's gonna get a copy of this too. This was, oh my gosh, I think it was in 2019. Um, I know it was right before the pandemic when they were thinking of taking DACA away. And so I was asked to participate in a support group for folks with DACA status. And I did the same thing. I, I went ahead and I took some skills on the side here and then how it looks.

It's really tiny right now, but you, you'll get the, the full PDF looks a little bit [00:38:00] bigger and, and a lot of different skills that you can use. And I really focused on the body thoughts, but not thoughts in how we typically think about it in CBT where it's like, oh, evidence for evidence against that gives off some gaslighting vibes.

Right? And so not through traditional cognitive restructuring, but rather self-compassion and for clients with histories of oppression and their lineage, even if you are gonna do cognitive restructuring, how it is, I'm gonna ask that, please, please do validation first. Validate the valid validate how maybe I.

They were programmed to have this hypervigilant response or think that, is it because of my race, right? Even if it's not the case, does it make sense that their brain would go there? Especially what we know now about epigenetics and [00:39:00] maybe what they've witnessed, maybe what they've seen on the media may, you know, so it makes sense to me that your brain would go there first and, and then you can do the cognitive restructuring work.

But more than anything, I actually rely more on self-compassion because it's gonna be really hard to change your thoughts into something more balanced when you're hating yourself or judging yourself or feeling shamed or feeling like you don't belong. So self-compassion first. I also shared the Copa ahead plan, and then a hope box, which we'll talk about Copa ahead.

The hope box is essentially a little kit that you create. The hope box was meant actually for teens who were experiencing suicidality. And so the hope box was like this, this little box where they had memories and, and, um, emergency type of grounding skills and tools that can help them pass the moment.

And so I use it in this, in this way to [00:40:00] remind them of how they belong, remind them of their self-compassion. Um, remind them of their worthiness as a human being. You can also, I also use the, the hope box, like in miniature, I don't have one here, but like a little satchel that people carry with them. Um, with grounding tools like chapstick or gum.

Anything that you can use your five senses with that can help you come back into your body, come back into the present moment. They take it to them, with them to work, it fits in their bag. A big part of this work too, um, is also body basics. So teaching them how to breathe so they can ground, so they can release carbon dioxide and slow down that heart rate to get to the wisest part of their body.

So yes, to calm down, but when we say that, it sounds like we're blaming the person for being dysregulated, right? No, we, we want it to slow down so they can get to the wisest part of their body so they can get to [00:41:00] their intuition so that they can remember their safety plan or their Copa ahead plan so they can remember to stay silent and don't, they don't have to answer any questions without a judge's signed warrant so they can remember their rights, so they can remember their loved one's phone numbers or like what to do next.

So practicing. Even if you spent the whole session just practicing breathing and remembering like, I'm gonna stay silent. I'm gonna ask for a lawyer. That is gonna be really valuable. These are some other body exercises in somatics, any rhythmic movement. One of my favorites is swaying. And actually you might see this a lot, you might see this a lot, especially for, for kids who might be on the spectrum or trying to regulate, their body is literally wanting to do this and is asking 'em to do it, to [00:42:00]regulate, and it's actually a strength of theirs when you see them doing this or tapping.

We're gonna do an exercise with tapping later, or this is emotional freedom technique. Pretending to chew gum. Chew gum is kind of a fun one. If you wanna try to do it now. So when we pretended you come, we're kind of short circuiting our digestive system and it's our brain telling our digest or our digestive systems like, wait, we we're, we're getting saliva.

That means like, it's cool to eat. Oh, okay. Well, whenever we're in danger and running, we don't eat. So that's a, that, that means that we're safer. It's a little bit safer to eat. Right. So this is, this is a good one too, just reminding folks to do it. And it, it can, it can help, like on the back end, the, um, the, the cortisol kind of come down and the brain kind of catch up and say like, we're a little bit safer in this moment.

We're not in danger right now. [00:43:00] Jumping jacks or intense exercise is another one if we want to change our emotion quickly, but also breathing. So box breathing. Physiological breath. We're gonna do physiological breath in a bit. The butterfly hug that I'll also be sharing. And then self havening. Self havening is more of, um, very slowly engaging the touch sense, but it's also very soothing to the nervous system.

Remember as social animals, um, we've relied on our social bonds, and I'm sure you've all heard like babies, they need so much touch, right? But it's not just babies. Humans in general need so much touch. And so all these skills are really gonna help that amygdala relax. Our amygdala is like a little almond shaped structure in our brain in charge of, has a big role in, uh, flight and fight.

[00:44:00] I call it the little warrior. A little inner warrior, but it helps relax that little warrior down. Or actually, sometimes I say the chihuahua. The chihuahua, that's like, rah, you know? Um, it's gonna help soothe that am amygdala. And I ask my clients like, how are we gonna calm the chihuahua down? Right? Um, and so these are some ways, but also your clients know too, I promise you.

They know they do have ways that they're, they're using. And so a lot of it is gonna be also exploring that and seeing what they're using and what they can continue to use. I promised you the physiological sigh. So this is a great one, and I actually just learned it recently. They did a random control trial on this one and box breathing and one other one.

I, I think it was belly breathing, but, and this one actually beat the rest out in terms of it's the fastest at slow slowing the heart rate. It tells your brain to slow down the heart rate, and it helps you feel more centered to [00:45:00] make those tough, tough decisions in wise mind. So what you're gonna do is, um, you can watch me do it.

You're gonna, well, I'm gonna tell you first, and then I'll wa you'll watch me do it. You are gonna breathe in through your nose and pause and then take a short second. Inhale again, pause. And then finally breathe out long and slow through your mouth. I do the, uh, the breathing out. I do do a count of 10.

And so they sit like, do it three times in a row and you'll start to notice the effect. So feel free to do it with me now. I'm gonna take inhale through your nose, another one and let out 1, 2, 7, 8, 9, 10. The slower the better. It's going to release all that carbon dioxide out. [00:46:00] I've been trying this one on all my clients.

I learned it I think three weeks ago. Everyone's gotten it, so I encourage you to share that with them. And now for the Copa ahead plan. So the Copa ahead plan is a DBT skill, like I said, created by, um, Marsha Linnehan. And it's a combination of mild exposure by visualizing and rehearsing being in the feared situation and coping effectively.

Studies show that we can learn new skills by simply imagining and practicing new skillful behavior in our minds. Essentially, you're creating a story that's helping you process the reality of the fear. And it is like, it, it's really hard though, like this is one of the skills that I use all the time with clients, and it's hard, and I'm like, oh, do you wanna do a Copa ahead plan for the my clients who have been with me?

They're like, not really, right? Because they're like, hell no. I'm telling you that I'm afraid of this happening, and like, can you tell me that it's not gonna [00:47:00] happen? I'm like, I'm not gonna tell you that it's not gonna happen because I don't have that power. So I say to them, so here's the thing, you're gonna be worried about it regardless.

And, but you're here, you're, you're like at the worry. The what if, the what if the what if the Copa head plan allows you to break that wall and actually Ima, well, let's think about it. What if it does happen? But together we can come up with ways of how you would manage it, how you would get through it, how you wanna be, how you, what skills you want to use, or if it does happen, what do you wanna do about it?

Or, you know, and so, but, but it is, it's really hard and it's really painful, especially with this situation, right? I mean, I did a million of these during COVID times because at some point we all knew that everyone was likely gonna get COVID, right? We, we couldn't avoid it anymore. And in fact, those who were constantly avoiding it, and I'm gonna put [00:48:00] myself in there too, we're suffering.

Trying to avoid it so much, and it got to the point where we had to assess like, how is it impacting your mental health to avoid it so much, right? So it's hard, and I really wanna honor that because we're asking our clients to imagine being detained or imagine being deported, right? But here's the thing, like planning for difficult possibilities doesn't mean that we're giving up on better outcomes.

And so you can let them know that it's just, it's just one skill that we have, right? Uh, but, but we're not giving up hope. And so, keeping in mind the rates and entertainment, we wanna practice grounding and breathing first. Like spend some a, a good amount of time practicing grounding, practicing breathing, come, trying all of them and seeing which one works for them best.

Like, there's so many, right? Like with kids, I use bubbles to help them take deep breaths and that [00:49:00] really helps. Or there's like the hand one. There's so many, so, so many. Um, so I have hand breathing, box breathing, belly breathing, physiological sigh. All of these will help them slow down their heart rate, allow the carbon dioxide to leave their body so they can focus.

While this is not gonna solve the problem, I know this, I know it will help them with their decision making and memory recall. It will help them with their agency. Right. Um, it will help them decide how they wanna move forward. And so this is what it is. And you'll, you will all get handouts in English and in Spanish Exactly.

With this and also with a handout where they write in. Okay? So don't, you don't have to take too many notes. I have eight, eight worksheets for you guys. Okay. Um, it was only supposed to be one, and then, you know, you know, so this is the Copa ahead plan. First, we're imagining the worst thing happening. So in this case, it's gonna be being [00:50:00] detained.

And then you're gonna picture yourself getting through it, breathing, stating my rights, remaining silent, letting them know who my attorney is or who to contact. Maybe they're asking someone to film or record, right? Have them do it and visualize themselves doing it. And then maybe the next fear they're being, they're at a detention center.

Okay, let's imagine sitting in the detention center and coping through it. What are you doing? Who are you talking to? What connections are you making? Are you praying? Are you breathing? Which one are you grounding? You know, are you, are you counting tiles? Like, what are you doing? Right? Any of this can help.

Are you memorizing officer names and badges? I don't know. [00:51:00] Then imagine yourself problem solving and making the best out of this catastrophe. Not in a toxic, positivity way. Not like that. Not like that at all, but in a way where you're imagining that the safety plan you created with your family has been carried out exactly as planned.

Knowing that maybe your kids are safe with their tia because you put that safety plan in motion knowing you did the right thing and signing guardianship rights with the notary, imagining the helpers in your life coming through for you, that your attorney is being called, or the pro bono that that, that you asked for the pro bono attorney, that your family knows who to call so they can track you down.

That you created that binder with all that information and everyone knows where to get it. Okay. [00:52:00] Imagining this, visualizing it is gonna help their nervous system. I mean, they're not gonna be like all calm and cool if it happens, right? But at least they'll know that there was a plan in place. A client of mine, um, she's the eldest daughter and her Bo, both her parents are undocumented.

And so as of, actually as of January anticipating some of this, the house is under her name now, she's on all the bank accounts so that if anything happens, she can, you know, get in there. Dad also reached out to his family in their hometown, in their country and they, they set up an Uber account for him so that if he gets there, he can start driving and making money right away.

Hard, devastating, but that brought them a lot of peace. And then the last part of this, it is not in the original Copa head plan that Lenahan [00:53:00] created. This is how I've enhanced it. Um, self-compassion. Again, it's hard to do any of this when you're hating yourself, when you're shaming yourself, right, when you feel like you don't belong.

So imagine yourself being compassionate and tender with yourself. This is not your fault. You did not cause this. A part of self-compassion is also connecting with your humanity and with others who are also going through this struggle. So connect with everyone who is going through this. Be loving with yourself because it's so hard right now.

And on the worksheets, I have about 12 self-compassion statements focused on the immigration issue in English and in Spanish. And then I have some, I have about 12 for loved ones. I. Helpers too. Like, because they might be feeling a lot of guilt. They might be like, you know, there, there's two different types of fears, so I have that prepared for you.

And [00:54:00] then where they can write in some of their, their own or they can, you know, if they like any of them, they can use them. Okay. This is another thing that you can do with the Copa ahead plan. They can practice using and saying their rights from the red cards or rights cards. These are the cards that I got from Chila.

And so you can get them there. But essentially it's the, like, I have rise, I I, I'm going to exercise my rights of staying silent. So have them practice breathing and saying, you can practice, they can practice saying these and breathing and saying these to you over and over so that it starts to create a memory and then it, when we create that muscle memory, the, the body will know, like, breathe, I have rights, breathe.

That is not a warrant. Breathe, show me your warrant. Right? I actually did a Copa ahead plan for someone who was anticipating seeing a detainment happen or seeing something happen in person. And so we did a [00:55:00] Copa head plan of how she wants to respond, right? She's a citizen, but she's like, I know I will need to do something and I don't wanna freeze.

So we came up with two different scenarios. Okay, let's say your body freezes and then what should we do? Um, let's say your body doesn't freeze and what can we do? And she actually loved the, the one when her body does freeze because it was less chaotic for her. And so she actually gave herself a little permission to freeze so that she can breathe, do the least, which is the, she was just gonna take her phone out and start recording that was gonna allow her and give her some time to take some deep breaths and remember her script of what she was gonna say.

So now we go on to dialectics, and this is where two opposing things can be true at the same time. This is such a great way to treat black and white thinking in our, for our purposes here, though, we use it as we, where fear and joy, which are [00:56:00] typically opposing things, can exist in the same time in space.

Jaya John says, we can suffer and sing at the same time. In fact, we must, we can experience tragedy and feel connected with those who are going through this with us. Uh, this is one of the self-compassion statements on the handout. I can hold hope and fear at the same time. Planning for difficult possibilities doesn't mean I'm giving up on a better outcome.

This is what I, what I put for the Copa head plan, right? But also going through this in community with people who get it will be crucial to managing the distress together. And here's the thing, people are feeling isolated. People are going back to feeling like they're in the shadows. Right. They're isolating.

That makes sense. I get it. And where is there room to bring community in? Right. Right now we're going back to using Zoom [00:57:00] for a lot of things, getting connected that way. And so like you see these two little owls. I love this image. It's two little owls with the big, there's a, there's rain and then there right under the, the leaf.

This is what it means to be connected during times of distress. This is how I imagine some people being connected at detention centers. We saw this a few years ago during the immigration, the, the caravan, immigration. There, there were some camps here in la um, with a bunch of children who, you know, were, were picked up at the border.

And, and this was a lot of it, it was allowing them to feel connected, experiencing joy, even in this tough situation. And, and then I, so I saw this video on Instagram. It was posted by, uh, undocu professionals. I think Issa Hernandez was the original, uh, postie. But it, it really exemplifies how we cannot heal in isolation.

We, we really need each other. It's gonna be really important for people to ask for help, especially as [00:58:00] they're building these safety plans, these Copa ahead plans. Okay. For those that is really hard to ask for help. Okay. Raise your hand or put in the chat if that's you. I'm gonna say me. It's hard to ask for help.

So a way to like step into it is receive it, then receive it when someone's offering it to you. Okay. And also when it comes to help as a helper, you know, this help at your capacity. I think for a lot of our community members, they really feel. Like they can't contribute right now. And so underlying themes help at your capacity, whatever that means for you.

Okay. But I do wanna play this clip because it's really powerful and it really shows how joy is a part of resistance. Thumbs.

You hear it?[00:59:00]

Yes. Hear it.

Notice how there's blame.[01:00:00]

Okay. Did you guys get chills? I got chills. I always get chills. So this is the second time I'm doing this webinar. The first time everybody in the chat was like, oh my god, I'm crying. It was also very fresh, right. Um, members of Las Gafe. Yeah. It was so beautiful. So, so beautiful. And. It also reminds me playing this clip for you all reminds me to slow down because I'm, I, I get the urge of like, okay, that's enough.

Let's keep going. But I'm like, no, fully allow myself to listen, be in the joy of it. You know, there's also that feeling of, of pain, of like the reason why they're doing it right. But really it, it helped, it makes me wanna sway it. Um, yeah, it's, it's really great. It's really great. And I'm like so committed to letting the whole thing play out.

And she came up with, you know, just like a butterfly, the, the [01:01:00] butterfly hug and now everyone uses butterfly hug. And so it's important to also give credit where credit's due to our creatives, creators, you know, scholars of color. Alright, so for those of you that are not familiar with the Butterfly hug, you are gonna bring your hands like this and then you're going to cross them.

You're gonna hook your thumbs. See now you have a butterfly and you're gonna put it, put, put them like on your chest with your, your fingers, um, by your clavicles. That's a good place for them. If you feel like that's too tight, you can let go of the thumbs and, and bring it here, or even put it in your, um, on your arms here, whatever feels comfortable for you.

And I'm gonna ask you to just start slowly tapping with alternating hands very [01:02:00] gently, very slowly. Feel free to incorporate breathe breath. This is a really nice self-soothing skill. You really wanna go slow though. 'cause fast opens up, it opens up the brain to process. So we just wanna go slow because we're just really using it for comfort.

We're using it for touch, right. Keep doing that, and I'm going to share. As you're tapping, I'm going to share four affirmations. These are dichos, they're sayings, Spanish sayings from my community. I'll say them in Spanish and in English because you're focused on just being in, in this moment and, and also the impermanence of things and how um, nothing in this life is permanent.

Okay? So keep tapping and you can feel free [01:03:00] to, you know, have come up with your clients' own affirmations. For the sake of this training, we'll use these, okay?

After the storm, calm always comes.

The only lost battle is the one you don't fight.

There's no misfortune that lasts a hundred years. This was from someone in our support group when we talked them about breathing.

They can't take my breathing away in the last one. I don't have it here, but I'll say it. It's one of my favorite songs by Shakira.[01:04:00]

When you least expect it, the sun comes out. Alright. All right. Take a few deep breaths as you come out of, come out of um, this butterfly hug exercise, others that come to mind that you wanna share. This is a collective. This is a collective wisdom here. You guys also have so many. Ideas. And with your permission, if you add some, I would love to include them in the slides for later viewing.

But I'm gonna bring up this slide again because I'm gonna ask y'all to lock in again, and I feel like it's important to, uh, this is such an important reminder, we're gonna lock in again. It's so important for us to focus on that stress reduction and making movement toward taking care of our bodies, because bipoc are more vulnerable to illnesses such as blood pressure, diabetes, and autoimmune illnesses.

Like I said, stress contributes hugely to all of these, [01:05:00] but breathing, joy, accessing wise mind, they all help to gr they all help us ground so we can engage in the pros and cons of what to do next so that we can remember those vital steps. And our safety plans and systemic issues are not our fault, and yet we're responsible.

For taking care of ourselves and each other. And yes, it's unfair and messed up and Right. We don't have a choice. And so this is another skill is I, I added this for this webinar. So this is another DBT skill, um, that we use a lot. The, it's, it's mainly used for emotion regulation, but because it really gets at the beginning of a crisis or the beginning of chaos, um, we call them vulnerabilities.

What, what made you vulnerable that week? Like I know times when I've exploded on someone or [01:06:00] maybe didn't take care of myself the way I wanted to, it was always because of a vulnerability. Like I was really tired, I was having my own autoimmune flare up, right? I was sick, things like that. And so this DBT plea skill is focused on treating your body first and taking care of those vulnerabilities.

Not to not be vulnerable, but take care of yourself when you are. And so the P and the L, it stands for treating physical illnesses. So this means take care of your body, see a doctor if you need to take medications, vitamins, supplements, monitor your blood pressure, blood sugar levels. Because remember, remember right, bipo are more vulnerable to these illnesses.

The E stands for eating. And here I just, I ask people like, what nourishes you? Not where it is in the, in the nutrition spectrum, but like what lands well in your stomach, [01:07:00] right? Because even healthy things can be really hard on some people. Like, I wish I could have oatmeal out. Oatmeal tastes great. It's so good for you.

I don't know why it gives me heartburn. I cannot eat oatmeal because I will be in discomfort. It does not land well in my stomach. Right? So this is another decolonized approach that we can take, um, instead of the whole calorie thing. And how good is it for you? It's like, does it help your stomach or does it hurt it?

Right? The A is for a mo avoid mood altering substances. And here I wanna urge you, I'm more of a harm reduction clinician technique user, and always assess the function of it, right? So if people are, you know, using cannabis to sleep at night because I haven't been sleeping, I'm gonna say, does it work for you?

Right? Is it helping you or is it hurting you? Right? I. If the ca Oh, but if the [01:08:00] cannabis is maybe making them have some hallucination, as we know it does for some people because of those epi, you know, the, the genes, right? Some get turned on, some don't. For somebody who might be vulnerable to that, we're gonna be like, Ooh, well hallucinations, come on.

Is it helping you or hurting you? Maybe you're more prone to being, you know, not aligned with your values when it comes to that. So assess it, but harm reduction's gonna be best, but also other real substances like caffeine. I purposely did not have caffeine this morning because then I was gonna be talking way too fast, right?

I'm asking my, my older clients who can't sleep at night, I'm asking them at what time do they stop drinking caffeine? And some of them are having, you know, diet Cokes or caffeine, 5:00 PM and I'm gonna ask them to scale back a bit. So that their nervous sys, they, they don't go into sleep with their nervous system heightened because that's what caffeine [01:09:00] does.

Sleep is gonna be really important. REM sleep is where we process the day to day and our emotions. That's why for those of us with interrupted sleep, we wake up like a truck hit us because we didn't get sleep. We're gonna be grouchy because we didn't get to process those emotions in REM sleep. And just the fun fact REM sleep, um, EMDR with a bilateral, it mimics REM sleep, which is why it's so helpful for processing traumas and things like that.

So REM sleep is very important. Exercise and intense movement. So this is important because it helps the body complete the stress cycle and get that cortisol and I do this, get that cortisol out of your body. The Naski sisters talked about this in their book burnout and how we really have to help get that cortisol out of our body through sweat, through movement, through creativity.

Here we're talking about exercise [01:10:00] though, but it can be anything. It can, it can be walking around your couch. It can be finding a safe space in your backyard. If it is safe there. It can be grabbing a book and, and going like this, you know, pretending they're weights or the masa or milk jugs or water jugs, anything.

It could be putting Zumba on the tv. I. On YouTube for our folks who are physically limited, maybe they, their mobility is limi limited. Visualization helps too. So in the burnout book, the Naski sisters talk about a client who was like, no, I'm not gonna work out. I don't care. I'm not that person. And they're like, okay, what can you visualize then?

Um, and imagine like taking all of your strength, taking it all out. And so this woman visualized beating, this is the quote, beating the crap out of the patriarchy. And that helped, you know, our visualization is so powerful, so, so [01:11:00] powerful. So maybe that's the cop ahead plan too. Imagining that they're working out, imagining that they're beating the crap outta the patriarchy, imagining beating the crap out of racism.

Find what works for them. I saw this billboard, I think it's a, I have to go buy it again. It's off the seven 10. I don't know if it's a blue shield, blue, blue cross, but it says, wellness starts with we. And I love that because it really exemplified how we heal in community and how we use it to decolonize evidence-based practice that focuses on the self wellness.

Starts with we, and you know, we're, we are, and let me know whose quote this is. I can't think of it right now, but, um, if one of us, what is it? If one, none of us are free. If one of us is not free, none of us are free, or something like that. It reminds me of that. And so this is where I say I'm not gonna talk about self-care.

'cause self-care, you know, for therapists, for providers [01:12:00] we know we have the, we get the talks all the time. It gets to talk to us all the time. I also feel like. It can be a little like victim blaming when we talk about burnout. Like, but how are you taking care of yourself? So I like to say the revolution starts at home.

And so what does this mean to you? Does it mean how are you caring for yourself and for each other, for your body? And so let's get some collective wisdom going. A pinata patriarchy. Oh my God, that's such a great idea. So I'm gonna ask you, this is my self, my my, my checkout, my self-care checkout that I do in my team meetings.

I run a team meeting and at the end of the meeting we do a self-care checkout, which is, uh, a self-care intention like. What's something you wanna do for yourself, either right after this meeting or for the week? What's, what's gonna be something that brings you joy? Or what does your body need? Right? When I was on a DBT team, we used to end [01:13:00] with like, which DBT skill are you gonna use?

And everyone knew if they just said, I'm gonna do the please skill, and just like hydrate in my team meetings, people are like, oh my gosh, my water's still full. I'm gonna, I'm gonna drink it before the day ends, or I'm gonna go and walk around, I'm gonna go do stairs, whatever it is. So I'm gonna ask you, what does it mean when I say the revolution starts at home?

And what is it gonna mean for you today?