Episode 18 Transcript: What Is Borderline Personality Disorder? DBT Therapist Sara Weand Breaks Down Symptoms, Causes, and Effective Treatment

There’s a Lesson in Here Somewhere Podcast
Episode 18 Transcript
Guest: Sara Weand, Dialectical Behavior Therapist

There’s a Lesson in Here Somewhere is a podcast hosted by Jamie Serino and Peter Carucci that features exceptional people that have compelling stories to tell. Whether it’s a unique perspective, an act of kindness, an inspirational achievement, a hardship overcome, or bearing witness to a captivating event, these are stories that must be heard, and from which we can draw important lessons. 

What Is Borderline Personality Disorder? DBT Therapist Sara Weand Breaks Down Symptoms, Causes, and Effective Treatment

Want to learn more about Borderline Personality Disorder (BPD)? Then check out this conversation with Sara Weand, licensed professional counselor and Dialectical Behavioral Therapist (DBT). Sara unpacks what Borderline Personality Disorder looks and feels like, from the intensity of how emotions are felt, to the misreading of social cues, to the struggle with impulse control. We then discuss the details of how DBT provides the validation, structure and compassion to help people manage all of this and thrive.

Sara breaks down BPD, discussing core patterns of dysregulation, how BPD shows up in relationships, and why it’s so often misdiagnosed as bipolar disorder or misread as manipulation. Using examples, Sara explains how some of us are born more emotionally sensitive, and when that sensitivity meets an invalidating environment at home, school, or in a relationship, people learn to fear emotions and chase short-term relief. That relief can be a range of actions that could include substance use, cutting, overspending, or rage texting. It works for a moment but then results in damage and shame. Understanding the root function of this behavior is the first step to changing it.

The discussion then turns to Dialectical Behavior Therapy, which can be used to help people with BPD. Sara walks through how it works and why it works. A key concept is dialectics. Things aren’t always either/or and there can be two truths at once. That shows up in language and narratives. For example, using “and” instead of “but” to frame situations, which can help.  acceptance and change to move together. Another key concept is structure and Sara discusses  skills modules that people move through in therapy, and she offers concrete examples of how they stop crisis spirals, repair relationships, and keep the world from tiptoeing around you.

Sara’s energy and straight talk make complex ideas simple and useful, whether you’re seeking help, supporting someone you love, or just curious about BPD and DBT.

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Transcript

Intro

Welcome to there's a Lesson in here Somewhere conversations with interesting people with fascinating stories to tell and from which we can draw important lessons. Here are your hosts, Jamie Serino and Peter Carucci.

JAMIE SERINO

Hello and welcome to There's a Lesson in Here Somewhere. I'm Jamie Serino.

PETER CARUCCI

And I'm Peter Carucci.

JAMIE SERINO

And we're here today with Sara Weand, a licensed professional counselor and a dialectical behavior therapist at DBT. So we're going to speak with Sara today about DBT and about borderline personality disorder, BPD. The psychology field has a thousand acronyms. So these are two topics that we could speak about for hours. So we're happy to explore those with Sara today. Sara, welcome.

SARA WEAND: 0:51

Thank you.

JAMIE SERINO: 0:53

Sarah, why don't you start off telling us a little bit more about yourself and about your practice?

SARA WEAND: 0:58

Yeah, sure. So, like you said, like I'm Sara Weand. I have my master's degree in clinical counseling. And then I went further and I got my license in um psychological counseling. Uh and um I went further than that and became um a dialectical behavior therapist or DBT therapist. So um I have been doing mental health work for 25 plus years. So this is very much my wheelhouse. Um I specialize in borderline personality disorder, BPD. Um, it's something I'm very, very passionate about. I um started my career uh way back right out of college doing a lot of different community work. I've done some group homework, um, group homework, and um also worked in some um outpatient um facilities and some inpatient things. And eventually I ended up doing my own uh private practice just based on I wanted to work the way I wanted to work. I wanted to see the clients I wanted to see. I wanted to focus on the things that I felt were important and that my schedule that I want and basically be in charge of the way I work because if I'm happier, if I'm effectively working, then I'm more effective working with my my clients, right? So um many years in the making, and then here I am um starting, uh I opened my doors, I believe, in 2018, um, doing um my private practice. So I've been doing that um my whole uh my whole practice is virtual. So as long as someone is in the state of Pennsylvania, that's where I am licensed, their feet need to be physically somewhere in Pennsylvania and I can work with them. Um so the the the virtual uh the virtual practice has allowed me to has allowed all kinds of people from across the state access me because borderline personality disorder is a very complex disorder. Not many people like working with BPD, and there aren't that many clinicians that work with BPD or are trained specifically in the gold standard, which is dialectical behavior therapy. So it it allows people to access me and me with them. And it it has worked beautifully, I think. It started working, I started doing that even before COVID. So it it's very much what my comfort level is. I enjoy doing it.

JAMIE SERINO: 3:29

Great. Um, why don't you just tell us a little bit more about borderline personality disorder? Because I feel like, you know, we've been hearing a lot about it over the years. And I think some people understand what it is, some people may not. And so why don't you just start there? What is borderline personality disorder?

SARA WEAND: 3:48

Yeah, absolutely. And it it's it is a very complex disorder, and there's so many uh there, it's a complex disorder, right? So um, so when we talk about BPD, it's it's a mental health disorder that impacts how someone experiences emotions, relationships, identity, how someone thinks and behaves. Clinically, we talk about five patterns, right? We talk about um five patterns of dysregulation. So we talk about emotion dysregulation, we talk about impulsive and self-destructive behavior, we talk about unstable and chaotic relationships, black and white thinking, and also a shaky and constantly shifting sense of self, right? Let's be honest, though, that like that's not how we capture like the raw of it to actually live with it. Okay. So what happens is living people with have BPD living with it often feels like their emotions are constantly hijacking their life. Okay. So the emotions feel intense, they hit hard and fast. It's like out of nowhere when experiencing negative emotions, right? It literally is painful for them. So one of the quotes I often explain to people, um, Marsha Lanahan, and we can talk more about her later, she's the founder of dialectical behavior therapy. She has said, which I think just hits the nail on the head. She has said something along the lines of borderline individuals are the psychological equivalent of a third-degree burn patient, right? They they simply have no emotional skin. So what happens is because the emotional pain is so intense, they'll literally do anything to make that pain stop when they're feeling a negative emotion, right? So, in some ways, people with BPD often become what I would call emotion phobic. Like they'll do anything to not have to feel that devastating emotional pain, right? So this is where um the impulsivity comes out. This is where like the life-threatening stuff, like the cutting, this, the suicidal threats, the excessive substance use, like the damaging, destructive relationship shit, like the behavior, like clinging, excessive texting, raging, texting, all this stuff. So on the outside, yeah, it looks like crazy shit. Okay. Their nervous system is literally on overdrive, right? So they're constantly on the lookout for being rejected or abandoned. So trust me, they don't want to act crazy. Okay. They are just so desperate to not feel just to make that pain stop. So yeah.

JAMIE SERINO: 6:17

Well Yeah. So you you you said a you said a few things there that um, you know, uh, I have some follow-up questions.

PETER CARUCCI: 6:24

Absolutely.

JAMIE SERINO: 6:26

I I'm really glad that you said that about, you know, it's their behavior, you know, ends up being a reaction to how they feel emotions or how they're processing information that's coming to them. Um and you know, it's not necessarily, I guess, uh to excuse bad behavior in society, right? Oh yeah. But you you can have a at least a reason for it, and that helps you then, well, let's work on this, right? So how how would so how did you become involved with wanting to work with people borderline personality disorder?

SARA WEAND: 7:04

Well, initially I thought, no, I'm not doing this initially. Okay. And um I was working um for the state hospital system in Pennsylvania, and um an opportunity presented itself, and I thought, ooh, I love to learn. I will be part of this DBT consulting. We can get to what that means and what that looks like later. But the the idea was um I was privileged enough to to go to this intensive training that was paid for. Okay. Um and and and that is the piece that really helped set the stage, right? And I I I've I've it's not a once and done learning process, right? It's like a constantly you can't just go once and it just sinks in, right? Like this is something like I I practice in my life. Like I I view the world, like we were talking off camera earlier. Like, I view the world, like I do believe that DVT is a lifestyle and get to that. How do I get to working with people with BPD? So um there's kind of this people often ask, like, how do why am I like this? How does this happen? Like, why is this why am I like this? Okay. And um, I'm I'm gonna answer your question. I'm gonna kind of go around and get to it if that makes sense. Um so for people that have a BPD, right? What happens typically, okay, is is I look at what's considered like a biosocial theory, okay, and what the biosocial theory states is that there is a biological component, okay, to emotion vulnerability. Okay. And what that means is this like we all are born with a certain biological predisposition. Okay. So there are people that are simply more sensitive emotionally. Okay. So I am okay. I know my mom is, I know my daughter is. Okay. So it's it there's a biological piece, and what does that what does that mean? Okay. What does it mean to be highly emotionally sensitive? Okay. So what that means, okay, is that like I was the kid who cried very easily. Okay. Someone would look at me or I would get hurt feelings like nobody's business. Okay. I still do, right? I just have the skills now to kind of help my brain not process it that way.

PETER CARUCCI: 9:36

Yeah.

SARA WEAND: 9:36

So there's people that are highly sensitive emotionally, okay, they're just more sensitive to emotional stimuli. So I often explain to people that it's very similar to what pop culturally, perhaps like an empath, like if if if you know what that means, right? So um, yeah. Um for people that have BPD, okay. They and for people who are highly emotionally sensitive, right? Like there's like an intense emotion, right? It kind of comes out of nowhere and it can be long-lasting. Now, what can happen, right? And this is why I can identify I enjoy working with people because I, you know, I've been called like the whisperer of this because I think I get it. And I and I'd like to say one of the reasons is because I'm also highly sensitive. Now the other part of this BPD soup, how it happens, right? This I didn't experience this, right? So there's this biological piece, and then there's also the environmental impact. Okay. So I was fortunate enough to grow up in a family and have an environment that supported this high sensitivity, right? Like I was very much like it was embraced, you know, here are these are, you know, I I I I was musical, um, I'm I'm artistic, I still am. Like if someone is raised in an environment where there's this high emotional sensitivity, right? And the family or whoever the environment is, they don't have if they're not highly sensitive, they're not gonna get it, right? And and and I'm not saying like families are purposely trying to mess up their kids. What I'm saying is they don't get it, right? So they're trying to help navigate these, you know, intense, like, why is why is this kid crying all the time? What is happening? Like, gosh, this is no big deal. So what happens is the environment, right, is uh it becomes an invalidating environment for people. Okay. So yeah, yeah. So it what what that environment does, right, is it communicates to the people that are highly sensitive. There's something wrong with you, you're you're weird, you're bad because you can't control the emotions, right? So it ignores the reactions and does nothing to help that person, right? So it's the message like, what's wrong with you? Can't you be like more like your sister? She doesn't act like a crazy person, or like, my God, this is not a big deal. Okay, now again, like we're not like no, they're not most families are not trying to do this. They just don't know how to do it, they just want their child to stop crying, or they just want to it's like parents don't get some manual, right?

JAMIE SERINO: 12:27

Right. And and so that this is where like a a therapist working with a child, a lot of times it helps work with the parents too, because you know, your child, this is how your child is, and this is how you should parent that child. But without that, parents are thinking like, oh, that kid's not listening to me, they're disrespecting me, or they're this or that, or this child's fine, that child's not, and everything you're saying, right, that that tends to happen. So, so with the biological component, you have an environmental component that could, like you said, invalidate their their experience and their feeling. Um, so what do you think about sort of like recent-ish time, the recent-ish time period that has led to an increase in diagnosing BPD and what were happening with people with this sort of, you know, um this experience, what were they diagnosed with previously, or were they just not being helped? And could you talk a little bit about that, about that that shift, that arc?

SARA WEAND: 13:31

Yeah, it it's still being misdiagnosed, right? So there's some very similar a lot of times this the symptoms or the um behaviors, different diagnoses, like the the there's a lot of similarities, so I can see how it'd be easily misdiagnosed. I can, you know. Um your first question had been about um why is it more is it more often seen or or talked about now?

JAMIE SERINO: 13:58

And I think maybe like diagnosed a little bit more now lately, but but I think also to your point talked about more. I feel like it's talked about more, you know, in in in the mainstream, I think, and even in culture, you might hear it in a in a show or a movie or something like that. And I just feel like the level of awareness of it is is raised. Um, and I'm wondering like about that arc and and you know, uh I imagine that's been helpful, but what what has caused that additional focus on that, you know, and and what what what has been the effect of that?

SARA WEAND: 14:35

Well, I think it's twofold, right? I think that a lot of times people will often like I think clinicians do this, and and and I don't blame them because they it it's just how people are taught, right? Any kind of um difficult behavior is often seen as being manipulative or borderline, okay? So like just because someone's being difficult, okay, or it's a difficult situation doesn't make someone borderline, right? So like that's that's huge, okay. Um when I talk about the the behavior patterns, like initially when I was like, okay, so there's a couple things at play here. A lot of times people will believe or say if there's any kind of self-harm at all, it's okay, that's borderline behavior. Not necessarily.

SARA WEAND: 15:25

Um, because life-threatening behavior can occur with all different kinds of of um diagnoses, right? Um, one of the reasons I also work with people with trauma is because trauma or having PTSD, those symptoms play together. Okay. And it's it's it's there's nuance to did the trauma cause all this, or is there something more, or is there something else going on, right? So that's why I do a very, very thorough assessment, right? Because I can I can tell the difference. Um a lot of times people with BPD are often misdiagnosed as bipolar, okay? And and what bipolar is, and I'm not an expert in bipolar, um, what I am aware of it is is that um there is a pattern of highs and lows. Okay. The highs are like what people think of as like manic. Um, there's a lot of excess energy, there's um like days on day, you know, days and days and days of not sleeping. And then on the other hand, there's like this the bottom, right, is this depressive stuff where people become suicidal. Okay, and then in between, there's like a period of like a little bit of stability. Okay. I can see why someone who has rapidly shifting moods would be diagnosed with with bipolar disorder. The the key difference is this. Someone with borderline personality disorder, their moods are not going to be shifting like that days upon days upon days. Their moods are gonna be shifting over dinner. And most of the time it's in response to some sort of perceived or not per it could be a real legit like of of of rejection or abandonment or some sort of relationship issue. Okay. Um I often, and I wish I could take credit for this. I can't, I don't remember where it came from, but what I what I explained to people is be like BPD isn't an is not an island. And what I mean by that is you could put somebody with schizophrenia, with depression, with bipolar disorder, all different kinds of diagnoses, even anxiety. You can put them on a deserted island, just observe them, and their diagnoses and their disorder would still be present. You could see it happening, okay. Um, with depression, you could see someone they they they probably sleep all day, right? You might see them crying. You might, you know, for someone that is has schizophrenia, it might be they're responding to something that's not there, unseen stimuli, whatever it is. With BPD, you only see the dysfunction in the context of relationships. That's where that's dysfunction comes out because you would not see it any other way. Yeah.

PETER CARUCCI: 18:13

Wow.

SARA WEAND: 18:13

Yeah. And uh, so I really try to teach people this, right? Because a lot of times someone could just have someone could be moody, okay, and there could be a whole other shit problems going on. And it's not necessarily, you know, it could be part of BPD, it might not, right? So it's a complex thing, and I see why clinicians misdiagnose it. I get it.

PETER CARUCCI: 18:34

You have to look at what causes it per individual, like uh the trauma or the PTSD, or is it something generic? Like I'm very fascinated with causality here. Like what creates someone how does bipolar and I'm sorry, borderline personality disorder uh gain a footing in someone kind of story.

SARA WEAND: 18:59

Yeah, no, and I love that question. Like, so when I talked about like the biosocial stuff, right? Yeah, like there's that biopiece, right? The high sensitivity, right? And then also there's that crop, it's a chronic invalidating environment. So like let's say um uh, you know, let's say there's um it might not even be within the family, it might be in the school system, right? It might be with the you know, or it could happen maybe perhaps later in life and someone's with an abusive partner, and think about how an abusive partner could create that situation of invalidation, right? So um you take that, you take somebody that has, you know, the the BPD soup, I like to call it, right? It's like the the the invalidating environment, the high sensitivity, right? And what happens is, okay, the social environment actually ends up reinforcing that crazy behavior that no one likes. Because what happens is that person's like, They're feeling a thing. Okay. Let's say, um oh hell, I don't know. Um, let's say there's um a couple and they're dating, okay, and like the the the they're planning on going out to dinner, the girl comes home, her boyfriend's asleep on the couch, right? Okay, they had plans. She might be disappointed, okay? Realistically so. Like, okay, maybe, you know, like they're there, why isn't he ready? Does he not love me? Whatever. Like, there's Ms. You know, so she's believing that this that her boyfriend's like blowing her off. Of course you're gonna be upset, right? The problem is, is when the person, the environment says, What the hell's wrong with you? I was just taking a nap. Why are you so dramatic? So it just increases the the the the behavior, not consistently reinforcing. I'm just giving a random example, but like it's not just that once and over, it's this reinforced pattern. They're being reinforced for their out-of-control behavior. Right. Does that make sense? Does that answer?

JAMIE SERINO: 21:04

Yeah, yeah, that I think that is a good example, you know, the or the the the misreading of something, and and um, you know, and and and so I guess at times like if it is a relationship, they say opposites attract, and maybe sometimes that's good, but maybe that's not good in this case. Uh but um what what would you say to to someone who maybe thinks, you know, I think my partner has BPD, or I think my child might have it, or my boss has it, or something. Like what would you say to them, you know, just in terms of like, you know, uh dealing with that, or or if it is a person that's close with them where they could maybe recommend, you know, why don't you see someone? And you know, what would you say in terms, you know, I I guess this is also finding the line between they're stressed out or they're this or that, or they've got BPD.

SARA WEAND: 22:00

Another great question, and I hear this all the time, legitimately, okay. Um It also depends who you're talking about, right? If it's a family I I hear it for about family members or close friends a lot. Um, they'll say, Oh, I know this person, I don't even know. Doesn't matter what I say to her, and I'm gonna say her because most of the time it is, unfortunately, you know, default here. Um you know, it doesn't matter what I say, she just flies off the handle, or she just constantly misreads all these things. The biggest advice that I give to people is this even if it sounds like the most crazy, absurd, preposterous thing that the other person is saying, you look for the kernel of truth.

PETER CARUCCI: 22:46

You might have to really look hard to be fair. Yeah, okay.

SARA WEAND: 22:50

Um because people that have BPD or people that are suicidal, there are often very good reasons they're feeling that way. Okay, so you the the the the message here is validate, validate, validate. Only validate what's valid. Okay. So for instance, let's say someone is uh let's see.

PETER CARUCCI: 23:16

I like that a lot. Only validate what's valid.

SARA WEAND: 23:19

No, you don't smoke. No, no, no. Yeah.

JAMIE SERINO: 23:21

Well, the and I like the kernel of truth. I mean, you're saying some wonderful things here.

SARA WEAND: 23:27

There's always a kernel. Here's here's the thing.

PETER CARUCCI: 23:29

Okay. Let's say, you know.

SARA WEAND: 23:34

Um, I I watched um this, the I watched uh Marsha Lenhan, founder of DBT, do this role play from years and years ago, and I was like, this is gold. She was doing a role play with apparent, I'm gonna set the scene. It was a it was a it was a man who um apparently the backstory was that he it he and his wife got into an argument of whatever, and in the process of grabbing her, he broke her wrist. Okay. Now, he kept saying, Marsha, you don't understand. She said, This, I was so hurt, I didn't know what to do, and I just grabbed her. Now, she didn't say, Oh, I get why you grabbed her. No, no, no. She said, Your feelings were hurt and you broke her wrist. Do you see what I'm saying? There's no, oh, I get why you did that. It's like, well, no wonder you did. It's it's it's your feelings were hurt and you did this thing, right? Because people often think with validation, it's like sugarcoating or it's making irreprov. That that's that's not what it is, right? What is that kernel of truth? It could simply be you believe this thing and I believe this. It does not mean, again, agreeing. So you only you only do want to validate it out. So when there's people that consistently say, you know, cre and I'm saying this a lot of me crazy sounding shit, okay. I might say something like oh wow, that sounds really hard. Because it's true, like I and I'm not blowing smoke up their ass, like I'm being serious. Like it sounds hard if you're dealing with this, of course, you know? Or um wow, other people in your sit in your shoes probably would feel the same way. Again, it's it's val.

JAMIE SERINO: 25:22

Yeah, because if if you validate their experience, you're sort of telling them like, you know, you're not crazy, right? It's it's valid what you experience. Now let's work on how you react to those experiences, right? I guess. Absolutely.

SARA WEAND: 25:38

And let's be fair here, we've all done crazy shit. Okay. Again, true, you know. Um, and you know, and again, like when you're like how not to react, I mean, I that's what DBT. It's a whole complex treatment, but we can get there whenever you're one of the.

PETER CARUCCI: 25:58

Well, I've I'm wondering, like, for a few things. I just gotta give give a minute some processing. So like I couldn't remember the difference between uh bipolar and borderline. So I have I have Madonna's son borderline in my head. Well, no, no, that's how I know we're talking about borderline personality disorder, right? V P D. And um and it essentially emanates from someone who's emotionally um in touch, right, biologically.

SARA WEAND: 26:36

They're very, very sensitive to emotional stimuli. So like they can pick up on other people's emotions pretty quickly.

PETER CARUCCI: 26:42

They won't you know but society or their local whether it's a family or it could be school or abuse, creates this invalidating environment for those emotions. Am I right?

SARA WEAND: 26:55

Yeah, they're they're they're being told like, hey, there's something wrong with you because you feel too much. That's that's the bottom line. Yeah.

PETER CARUCCI: 27:03

So I I just did a lot of armchair research for a song that I just finished, which um was about uh certain kind of relational um issues, like avoiding attachment style. And I wonder the difference between that, which is like uh, you know, people avoiding emotions and BPD. Like, for example, is the dissection the difference there that someone who just avoids that emotion or is taught to avoid emotion, maybe that person doesn't necessarily have the same kind of biological sensitivity that someone who has uh borderline borderline personality disorder. Is that right?

SARA WEAND: 27:51

When I say emotion avoidant, the reason that they do that is because they've bit it's been communicated to them that the way that they respond to emotions is wrong or what they're feeling is wrong. So yeah, it's it's and they've it's been communicated like peace at all costs. It's usually a lot of people come from households where it's like we must always have a smile on our face, right? We must always pretend like everything's fine, even if you know there's a lot of chaos going on. Um, because we have to have this happy family, right? That that's why I have a real problem with these sayings like good vibes only, or because that's us that that that's just reinforcing the shit, right? Like I under it, I understand like the the the I understand that why people want that, right? But sometimes shit is just shit. And if we're trying to say, oh, don't be upset about that, that's not a big deal, well, then you're teaching that person that maybe I'm not feeling the right thing. Maybe I need to just not feel you know what I'm saying? So when when someone feels hurt or scared, most of the Yeah, you don't know.

PETER CARUCCI: 29:07

Yeah. You know, I had a boss once ask me, um, or how do you handle conflict avoidance? And I said, How do I handle it? I don't avoid conflict. I have you have to deal with it. And you know, that's the right answer. And I was like, oh, okay. You know, and I so I wondered, is it kind of taught to them to avoid meaning by uh borderline personality disorder? Is it taught to them essentially like you need to avoid this behavior? Uh those emotions rather, you need to avoid that, and that invalidating non-stop is what I'm trying to put together as is harming themselves here. Is that is that right?

SARA WEAND: 29:52

Yeah, like here, okay, so a lot of times people are instructed not to feel a certain way without tolding without being told how to change their behavior or how they're feeling, right? Because we can change how we feel sometimes. We and we can change our behavior, but if someone's just instructing you, stop doing that, how are you gonna stop it if you're not taught how to stop it? Right? Or does that make sense?

PETER CARUCCI: 30:18

It does. I it uh it totally does. I I you know I'm just thinking of examples of people that I I know or have known that have like you know the cutting and things like that. And how does I I I can't process how it how that kind of avoidance of emotional and that you know, emotional avoidance and invalidation creates someone to arrive at that point where they're they're harving themselves.

SARA WEAND: 30:45

I've never been able to I can it totally answer this for you. So because I'm getting I get excited about it, yes.

PETER CARUCCI: 30:53

I've never understood this. Sorry.

SARA WEAND: 30:55

No, it's fine. So when people are under excruciating emotional pain, right? They will literally do anything to make it stop, right? Sometimes, sometimes it's going out and and and sleeping with the whole bar, right? It could be like they're spending money they don't have this is the impulsive behavior somewhere along the line there comes this desperation where they're like feeling so unbelievably horrible. And remember, like people with BPD, like it's like it hurts, like it physically hurts to feel emotional pain, right? So what happens is someone might um cut themselves, sometimes some people burn themselves, and and and what happens is I'll often ask people well, did it help? Like, no, no, no, I'm so bad. I cannot believe I did that. I'm so embarrassed. I'm like, think about right after. Because more often, like what has been found, right? And what people actually, it's like the light bulb moment is for a split second, there's relief. A split second of that like relief of not feeling that emotional pain because of whatever, you know, there's something that happens that when someone hurts themselves on purpose or goes and goes on a cocaine binge or goes on whatever, with the cutting in particular, there is a split second relief, and that is enough to be reinforcing that it might work. So they keep going back to the same thing over and over because it gives them that little doesn't last because after they do it, and that split seconds over, then comes the shame, then comes the embarrassment, then comes, you know, because not everyone who cuts, not everyone who does this does it in front of people. In fact, most people don't. Most people do it like they'll they'll they'll they'll cut the in like their inner thigh so that way no one will see or around their hip butt. Yeah.

JAMIE SERINO: 32:58

So it's and that takes away the argument that they're doing it for attention.

SARA WEAND: 33:03

Now, perhaps they perhaps they don't know how to ask for help, and that's their way of getting someone to help, because that can reinforce it too. Well, a lot of what I do is okay, what is reinforcing about this problem behavior, whatever the problem behavior is, whether it's cutting, whether it's overspending, whether it's reckless driving, right? Whether it's rage texting your boyfriend because he didn't get back to you right away. There's a whole spectrum, right? If it's a behavior that's problematic, that's what we're gonna look at. And what is making it stick around longer? What's keeping it? Because we only engage in behavior that's doing something for us. Like if it weren't doing something.

PETER CARUCCI: 33:45

Right.

SARA WEAND: 33:45

Yeah.

PETER CARUCCI: 33:46

I have a weird question too. I never actually thought about it till you mentioned it before that majority of cases are female. Um is that a is that perhaps axiomatic of like society clamping down on expressing yourself as a as a female, or is it uh a familial kind of um cultural, uh, you know, I I why or what what is the thinking behind why it's affecting so many more females than males?

SARA WEAND: 34:17

I think it's a lot of different reasons. I mean, I have worked with with men that have BPD, like and it I think it I think it presents differently in men and women's. There sometimes there's an overlap. I mean, there's truly, you know, um the and I don't necessarily like this term because it means different things to different people, but like the promiscuity, right? Like the one night like that's kind of across the board men and women, like they'll they'll do that. Um and that I think symptoms can be misread in different people, depending if they're if they're you know the guy or girl, right? And I think I think for men, a lot of times it'll come across as like antisocial personality disorder. So depending upon the overt behaviors that are seen, and I could be full of shit, like I don't know, I don't yeah, I this is I'm hypothesizing here, you know. Um but I think in general women are more relationship-based. Okay, I think I think there's been a cultural, like, you know, um uh way of telling people like a hysterical female, like we're not supposed to have like emotions because we are, we're like out of control.

PETER CARUCCI: 35:48

Um or I think there's a lot at play, right?

JAMIE SERINO: 35:54

But I think in gener women maybe like seek help more than men, and so that could be part part of it too.

SARA WEAND: 36:02

It's a lot of different stuff, you know, and I you know, and and and looking at the disorder, right? I I do believe it's on like a continuum, right? Because there are people that might have some traits and they're perfect, like they're perfectly fine, like in society, you know, things might not even come up where it's problematic, right? And then there's the people that you know, I worked with several people in the state hospital level that were like male borderline patients, right?

PETER CARUCCI: 36:26

Um it just typically it's women.

JAMIE SERINO: 36:34

So um tell us then a little bit more about DBT. And you know, so we talked, you know, about okay, so you're validating maybe how it feels, and okay, you know, it's understandable that you feel this way because this happened. But now, how can I address that? How can I react differently? How can I feel differently? How can I interact in society a little bit, you know, differently? So so what what is it about dbt that makes it such a good therapy for borderline personality disorder? Yeah.

PETER CARUCCI: 37:08

And again, what does it stand for again? Dialectical behavior therapy.

SARA WEAND: 37:15

Yeah, so DBT, it's just, you know, it's kind of a mouthful. So um, so let me just kind of give you a really what is DBT? Okay, so there's several main pieces. So it it it's it's definitely an effective treatment for people who have difficulty controlling their emotions and behaviors. That that's the aim, okay. So it also aims to replace problem behaviors with skillful behaviors. Remember, I was talking about like um whatever the problem behavior is, a lot of times people don't have the skills or were ever taught how to be skillful. So that's a big piece, too, okay. Um there's a DBT skills part, which helps people experience a range of emotions without necessarily acting on the emotions. So a big part is okay, we are gonna is learning how to experience not just positive ones, not just the negative, shitty ones, but everything and learning that you don't necessarily need to act on those, even though you're experiencing it. Okay. It it also helps people navigate relationships in the confines of their environment. So what that means is I'm not expecting the environment to tiptoe around somebody because that's not real life. Okay. This helps clients learn how to navigate the relationships out in the real world. Okay. So the the the overall foundation, the overall like um part of DBT is the goal is to help people create this life that's worth living because no one wants this is not a suicide prevention program, because a lot of times that's what people think, because it's it's we're gonna target life-threatening stuff. The idea is who wants to be free of life-threatening behaviors and still miserable? Like, no, no, no. This is helping people create a life that that they want to be a part of.

JAMIE SERINO: 39:15

Could you tell us a little bit more about so this is a behavior or behavioral therapy? Um, and a lot of people tend to know about CBT, cognitive behavior therapy, nation of cognitive therapy and behavior therapy. And people know about talk therapy. They're gonna go and talk to a therapist that's like a person-centered approach, perhaps, and a bunch of different theories there. So, what makes DBT so different from CBT and what makes behavior therapy in general? You know, I think it would be good to explore that behavior therapy so different from other types of therapy.

SARA WEAND: 39:53

Yeah, absolutely. So let me kind of give you what does dialectical mean? Because people don't know what that means. Like a lot of times. It's it's you know. So one of the first people, one of the first things I I share with people, like my client, you know, is what does that actually mean? Okay. It what it the bottom line, real basic Cliff Notes version, right, is that there are two dialectical means that two opposite ideas can be true at the same time and when considered together can create a whole new truth and a way of viewing a situation. So, in other words, there's always more than one way to think about a situation, right? So remember when I was saying about validation, right? And the guy, the the example about the man who broke her wrist, right? Yeah, like there was not you're hurt, you're, you know, you broke, you know, but you broke her wrist. It's the word and, right? The word one of the first tweaks that I tell people they teach them is replace the word but with and. So I'll give you an example with my daughter, right? And and she knows I give examples of her all the time. And you know, we all kind of giggle about it. Here's an example. I'll say, kiddo, I love you so much and you are really pissing me off. See the difference if I were to say, I love you so much, you're really pissed. That but almost negates the first part, right? And with people with BPD, they're they look at things all or nothing. That person's mad at me, therefore they must hate me.

PETER CARUCCI: 41:24

So you asked about um behavioral therapy in general.

SARA WEAND: 41:33

Uh yeah.

PETER CARUCCI: 41:34

So um by the way, so dialectical is the word dialectical?

SARA WEAND: 41:39

Dialectical or a dialectic.

PETER CARUCCI: 41:42

Both things can be two true at the same time. Got it. I I love that.

SARA WEAND: 41:46

I'm so glad. I love it too.

SPEAKER_01: 41:49

Well no, I'm I'm I'm understanding a lot more of um well, everything.

SARA WEAND: 41:54

I'm so glad. I geek out on this shit. You have no idea. Like, I totally geek out on it. It's not even funny.

PETER CARUCCI: 42:01

Well, that's a great conversation because I'm learning so much. Now, Jamie, your question was behavioral therapy versus talk therapy?

JAMIE SERINO: 42:08

Or yeah, I mean, I guess that that explanation there was was wonderful. Um, you know, and so I think we start to see how it gets separated. Uh how how would you further separate it from cognitive behavior therapy?

SARA WEAND: 42:23

No, I love it because it is a lot of people know about there's parts of it. Yeah, and it is hard because people, you know, so there are several main pieces that create DBT, okay? So the um DBT is supportive, like I said, it's not a suicide prevention program, right? It's a life-worth-living program. It's not like do these things and still be miserable, okay? It is behavioral, excuse me, in that what that means is we we analyze behavior, we analyze problem behavior patterns, and we learn to replace problem behavior with skillful behavior. Okay. You know, and and I'm just really giving I'm summarizing, you know, the cognitive piece is this, right? My clients and anyone in DBT will learn to change beliefs, expectations, and assumptions that were once helpful and no longer effective, right? So that that's the change. There is a part where we will be learning how to change the way we're thinking. Okay. That that's part of that's part of it. Okay. Skill-oriented means that we are people are going to learn, they're going to be taught new skills and enhance the capabilities that they already have. There's a separate skills training component to DBT. Okay. There's also um this piece, and this is the dialectic, the overarching dialectic in and of itself, right? There dbt balances acceptance and change.

SARA WEAND: 44:05

So DBT therapist will accept where you're at, will accept you, and at the same time, will also help you make changes in your life. Okay. So what that means is okay, the it's the the humanistic part, the person centered part. I'm accepting. There's like this acceptance be I'm accepting of everything you have and everything that you're bringing to the table right now. And at the same time, your life is in the toilet and you're not happy. How do we help you change so you can be in this life that you love, that you want? Okay. So it's not all about everything you do, it's not necessarily Rogerian, right? There are parts because I validate, validate, validate. And I'm gonna also say, are you are you hearing yourself right now?

JAMIE SERINO: 44:55

Yeah. So I'm I'm glad you said it's not necessarily Rogerian.

PETER CARUCCI: 45:01

Um that's important. Yeah.

PETER CARUCCI: 45:04

Rogerian, of course, means um Good question. Uh wait, I don't know, else you're making joke, but I don't know what it means. Rogerian?

SARA WEAND: 45:15

He's uh Jamie, you're in grad school right now.

JAMIE SERINO: 45:19

Yeah, so Carl Carl Carl Rogers. Carl Rogers. Yeah, like is you know, so like the humanistic approach or the or the person-centered approach. And it's it's really like um helping a person realize themselves what the issue is and realize the path they need to take. And stuff, it's not it's it's yeah, it's it's it's not necessarily CBT, but a lot of people I I was actually getting into this discussion in in graduate school that it's almost as if every theory can incorporate person-centered and humanistic. And, you know, it's basically saying, like, you know, the best way to teach someone something is to help them learn it themselves and it's more powerful, right? Instead of me, you know, saying, here's this and here's that, it's lead the student or lead the you know, the client, the patient to the answer themselves. And the Carl Rogers approach is the talk therapy and very much like bouncing it back to the client. And after a while, the client realizes, like, oh my God, like that's the problem. Oh, that's how I find my way out of this. But it seems like, but when you get to behavior therapy, you're really like, you know, almost prescribing in a way, and I don't want to like describe this the wrong way, but when you get to behavior therapy, you're sort of saying, here's the behavior, here's how to fix it. And and that's an oversimplification. No, it's fine. You're very much working with this person saying, yes, we're validating how you feel. It's okay, you're not crazy. Everyone's telling you you're crazy, you're not validating how you feel, but the way you're behaving in society is not really working out for you, right? You said you like in the toilet, right? So how can you speak these inputs which you're very sensitive to, and how can you turn them into better behaviors out in society? Yeah, sounds like yeah, which is not revering.

SARA WEAND: 47:17

You know, here's so here's the thing. Okay, so we explain it to be often people like people often say, Well, my, you know, DBT is different, all this stuff. People often come to me with one or two, like one of two complaints that they've experienced, okay? And most of the time, this is they're not their first bout of therapy. Okay. So they might have been with a therapist, they might come and say, Hey, I had this therapist, I really, really enjoyed them. They got me, they understood me. And then I said to them, Well, when are you gonna help me now? When are you gonna solve help me solve my problems? Right. Then on the other hand, you might get people that are like, okay, um, I was told I just need to think more positively or change the way I'm thinking. Okay. That's those are the two complaints. And it's like, where's the compassion? Right. So DBT is accepting and changing, right? So it's it's both, right? So the the another key component, the last part that I really want to emphasize here with like um why or what it is, okay, it it's it's also based on a collaborative relationship. What does that mean? It means that both me and my client, we are both responsible. I often tell my clients when we first start working together, I'm like, listen, my job is to consistently come into therapy in a manner in which you want to work with me. Your job is to consistently come into therapy and continue to behave in ways I want to work with you. Okay. So you understand it's like practicing relationships in real life. So there is a metaphor. Again, I wish I could have created this gym. It's like, imagine you're in a rowboat, your therapist, the client. We're in a rowboat. See the client's goals are on the far end of the lake. My job is to not direct the client how fast to row, which rower, which way, all this stuff. Nor is it, you know, nor is it when my back is turned that the client is drilling a hole in the boat. Do you see what I'm saying? We're both responsible for this. So DB ter DBT therapy, we're a different breed because we often will bring in how we're using skills in real life. I will often explain, you know, we I'm not sharing completely dirty laundry, obviously, you know, I'm sharing how I'm skillful because that's huge.

PETER CARUCCI: 49:45

It sounds to me also, I mean, in my layman's terms, that it's transitioning coping coping mechanisms into skills that one can rely on to engage emotions and thought so that the behavior is not harmful or negative. Does that make sense?

PETER CARUCCI: 50:11

Oh, yeah, I think that makes sense. Yeah. Like I'm getting through the day, I'm trudging, and I'm not cutting myself anymore, but I'm just barely getting by, or whatever that, or I'm not impulsive anymore, I'm not Michael Slee dry, whatever the behavior is that's harmful. It's like taking, it's transiting, it's trying trend uh transforming really that that um uh into a positive skill. Is that right?

SARA WEAND: 50:37

That's part because a big part of it also is learning how to tolerate the painful stuff and not necessarily acting on it, because there's a piece where um you can learn to cope with things and you can change things, and sometimes it's literally the only thing you can do is to tolerate it.

PETER CARUCCI: 51:02

Truly, you know what I mean?

SARA WEAND: 51:04

Because people with BPD, one of the like when I talked about skills training, okay, that's a whole separate component. So there's an individual therapy piece where I meet with my clients once a week. There's also a skills training piece, which has to be a completely separate session in addition to that therapy, right? It's not a cheap treatment, okay, because it's intensive. So the skills training piece, there are modules, there are four modules that target all the quote crazy stuff that no one wants to deal with, okay, in the clients, because it can be crazy making. So there's there's a whole module, weeks of learning how to tolerate stuff, tolerating stuff so you don't make things worse or destroy relationships, learning how to accept reality, even if it's not the reality we want. There's a whole mindfulness thing, uh core um uh module where that is the the core piece, learning how to just be aware. Because you need to be aware of the present moment. Otherwise, you're not going to be able to incorporate the other skills. There's also a piece on um emotion regulation, and that's where people can learn to change emotions if you can. You know, that's about learning a like learning how to check the facts on things instead of just making, you know, well, we feel this way, therefore it must be. That we I'll be like, all right, let's check the facts for a second. And I'm really simplifying this for the podcast, but there's a way to learn how to change things. And the last piece is interpersonal effectiveness, because a huge part of it is people don't know how to behave and interact effectively in relationships. So there's there's four pieces. I mean, it takes about it takes at least a good six months to get through one cycle of this.

JAMIE SERINO: 52:56

So that that's an interesting piece of it too, is that um and and earlier when we were talking about something being Rogerian, it it's just one I want to be very, very clear, it wasn't to make Rogerian sound negative at all. You know, it was a massive sort of breakthrough for therapy, what Carl Rogers did. But um, you know, just trying to separate different types of therapy so people might understand like why they're in therapy, why they go and what they're supposed to get out of it, and maybe what they should seek out, you know, and and they're they're maybe on a website and this therapist does this and this therapist does that, and what does all that mean? And I think Sarah, you've been wonderful with clearly laying this out. So a clear difference here also is that it also seems like there's like a beginning and an end. And I think a lot of people think of therapy of like, I'm gonna be like a like Woody Allen, I'm gonna be the therapy and have a breakthrough like 20 years from now. Um it's it's like I didn't realize that there were those like four modules. I didn't realize you would go more than once a week. And and so there does there there are these clear, very clear goals. And therapy does set clear goals, but this seems to be very like, you know, you're gonna have this for this amount of time, and then we're gonna move on to this and this. And and uh I I didn't realize that it was so clear in that way.

SARA WEAND: 54:19

Yeah, it really is, and and and there's a lot of work, you know. So people often find DBT as like a last ditch effort because they've tried everything else and it's just not it it's not helping or working for them, right? So um, you know, so I mentioned there's two, there's four pieces to DBT to make it DBT, right? So there's the skills training, there's the individual therapy, okay, each or once a week. And then there is um phone coaching, right? So that means um, like for instance, um it's one thing for my client and I to be practicing skills and talking about things in the therapy room. It's a whole other ball game. Putting those skills and implementing them when shit's hitting the fan out in the real world. Okay. So that's and and that's what stands apart from a lot of DBT programs that say that they're DBT and they're not because they don't offer that. Well, you know, I'm glad that they're offering it. It's just not the adherent piece, right? So I will often say, I want people I'm very clear though, too. I'm like, if I'm not available, I'm not available. Like we have a plan, it it we have a whole plan, all right? The idea here is you contact me or call me before you do the thing, whatever the thing is, right? Because don't call me after you've cut yourself, because that defeats the purpose. Call me before you get to that point, and then I can coach you through it. Because and it's literally like coaching, like um like if you were to think of like a coach on a basketball court or a soccer game, it's brief. It is like literally like did you try this? Okay, go try now. Go come back, you know, call me, you know. Um, it's it's brief. It's not therapy, it's like that's a really cool analogy, actually.

PETER CARUCCI: 56:15

I never even thought about it in that way. It's basically like coach. No, that's really, really cool. Can I ask you, uh, I mean have you have you had amazing are you willing to share maybe uh not obviously, I mean, you must have had amazing successes uh with DBT. Have you ever faced an a situ well I'm are you willing to share maybe a situation where you've done everything and it still doesn't work? I mean, is it not take? Or do you just keep working with that person or you restart the cycle? Or I'm fascinated to know what that looks like.

SARA WEAND: 56:56

Oh I love that question because we can't like first of all, it's not a foolproof thing. It's the gold standard. That doesn't mean that it's flawless, right? And oftentimes when I start working with clients, one of the first things I do is I do a consult. They're free for people because we need to make sure it's a good fit. Like, can I help you? Can you, you know, are are you willing to do these things? Like it's a very um there needs to be a good fit. I might not be the best fit for that person, and we might only find that out later, and that's okay. Right. Like we are very schooled on, you know, we can fail at this, like therapists, because it might not be done the the way it was intended. It might not be, you know, it and that's okay. Right. It just means that it might not be the best fit or that type of treatment for that person. Okay. People that are in dbt, right? A lot of times and here's here's the reinforcement. This is like the the leverage, right? A lot of time, like we will only cape clients or continue to work with them if there is progress. You see, that's oftentimes dbt is often called blackmail therapy because it's like you need to be doing this thing, otherwise, I if you're not making any progress, I can't work with you. Right. So that's very opposite than traditional talk therapy, where that means we just meet longer or whatever. You know, now again, most of my clients that I work with, like average it's about two to three years of weekly stuff. So that this is not like a quick thing, which is why insurance companies don't want to pay for it. Okay. They want very, you know, if it's a if it's a very um CBT is very much like paid for by um insurance companies because it's it's prescribed in a it's it's a quick treatment, right? Um for I don't I and I don't want to speak out of turn here, but for less complex cases. Okay. You know, and and and for the reason that DBT is so complex and people with BPD are difficult sometimes, okay. All DBT therapists, one of the reasons I can consider myself a DBT therapist is I have a consult team. I have someone I meet with regularly who also does what I do, and that's where we can, you know. It's great. Yeah, it's therapy for the therapist sometimes, or what am I missing?

JAMIE SERINO: 59:33

What's almost like supervision or something? Yeah. Um, you know, and you provide that for other people and you kind of go back and forth, but that that's great. Um, and and you kind of mentioned earlier like the positive vibes thing, and you know, uh it probably didn't make you very popular at Jimmy Buffett concerts, but um I think but but I think there there I think there is something to be said there about. Positive psychology going too far. And I've seen some articles and I've heard some people on podcasts talking about that. Positive psychology, I think, has been wonderful. And I think it it is helpful. But when it goes too far, kind of thing. And this is what it is. And go ahead. Anything that might maybe could be difficult for a person with BPD to be dealing with.

SARA WEAND: 1:00:57

I mean, I think I think, okay, so I think agree I agree that positive psychology can be great. The problem is when you're trying to sell that to someone that has borderline personality disorder and their whole life they've been told just think positively and you'll feel better. Because obviously they're not, right?

PETER CARUCCI: 1:01:15

Like so I think it's important that we just need to be mindful of people's experiences.

SARA WEAND: 1:01:31

So if someone's saying, like, hey, this is really hard for me to experience, you know, like I've been really sad about this thing. Like instead of saying, Oh, don't be sad, right? Because that's what most people will say. Like, of course, I would want to say that too, because who wants to see someone that's sad? Sometimes just the most powerful thing you can do is sitting with that person, sharing that space. One of the most difficult things for people in graduate school was their their experience was sitting with someone that was having a painful emotion and not trying to fix it. Yeah. Because most, you know, most people that go to school for psychology in grad school, they're helpers. We're helpers. We want to make people feel better. Like that's part of being a human being or a parent or it's really hard. So what I suggest with people, like sometimes the most powerful thing you can do is just sharing space and not fixing. Sometimes people want to problem solve and help to fix, right? But I think in general, you know, even if someone passes or dies, right? Most people they'll be like, oh well, that person lived till they were 90, you know, and they're trying to make the other person feel better. And the reality is so sad.

JAMIE SERINO: 1:02:50

Yeah. Yeah.

SARA WEAND: 1:02:52

You know.

JAMIE SERINO: 1:02:53

Like you said earlier, like accepting the reality.

PETER CARUCCI: 1:02:55

Yeah.

JAMIE SERINO: 1:02:56

The sadness.

PETER CARUCCI: 1:02:57

Yeah.

JAMIE SERINO: 1:02:59

So as we look to wrap up, I I I wanted to to bring up um so I saw on your you know social media feeds that Sarah, you're a weightlifter and you get involved in these, you're picking up giant tires, and you know, like you're running through mud and you know, do sorts of crazy stuff out there. Yeah, so how'd you how'd you get into all that? It just that the the photos, everything looks really cool. So how'd you get into that?

SARA WEAND: 1:03:30

Um so I've always been an athlete, like high school. Like as long as I can remember, I've always been an athlete. Now, when I went to college, that kind of went out the window, and then after I had my daughter, I was like, I need something. And um, CrossFit has become one of my happy places, and um, I'm I'm competitive in nature. So the reason a lot of times people love CrossFit is because there's a competitive piece to it, not necessarily with other people, but kind of within ourselves as well. Um, I there is something magical about being able to flip tires. There is something magical about being able to like climb up ropes and like you know, pick up certain weights. It's it's it's um it's magical. Okay. Um I kind of love it. I love and and there is something that scientifically, bio like biologically, intense exercise. There's a reason why people say they have runners high or they do these things because it it it can that's one of the fastest ways to um kick start your um parasympathetic nervous system, like it creates this calmness or whatever. That and I also just love the community of people and their its group atmosphere, and I kind of love it.

JAMIE SERINO: 1:04:54

Yeah, you can see that in the photo and everything.

SARA WEAND: 1:04:58

I like to do badass. Yeah, no, it's very fun.

JAMIE SERINO: 1:05:01

Yeah, awesome. And and so Pete has developed this habit of wearing a hat now in each of our episodes.

PETER CARUCCI: 1:05:08

Yeah. Well, this is this is kind of not really related at all.

JAMIE SERINO: 1:05:13

No, no, it ends up choosing unrelated. There was one time when it was. Um, that was weird. But uh, yeah, that was interesting. But so so what's the story with this hat?

PETER CARUCCI: 1:05:24

This I won at a gig I had. That's that's simple. And I was like, no way. Hats are fun. I love this hat.

SARA WEAND: 1:05:32

Yeah, yeah, yeah. In fact, I have a Yeti mug that I've been using. This is like one of my favorite. I I volunte I was chosen, like I applied two years ago, and I was chosen to help with um the CrossFit games. I was like a volunteer, we got off his fun merch. So yeah, no.

PETER CARUCCI: 1:05:46

So this strangely related to this CrossFit let's see, and yeah.

JAMIE SERINO: 1:05:53

And that and that happened last time too, Peter. You had the same mug as someone, right? Now you have the same brand hat, mug. Good connection. So Sarah, um, thank you very much. Uh this is this has been so helpful. I I learned so much. I cleared up a lot of confusion I had, and you were so Rogerian, Jamie.

PETER CARUCCI: 1:06:16

Without even understanding you were so Rogerian, you know. Like, what is he talking about?

JAMIE SERINO: 1:06:21

Yeah, right. We we learned a lot of terms, a lot of acronyms, but you really were very clear in in explaining all this to us, and I appreciate that. So um, how does someone find you? So you operate in Pennsylvania. How does someone find you?

SARA WEAND: 1:06:39

My website is a is the biggest source where people find me, and it's it's just my name. It's Sarah Weand, L P C.

JAMIE SERINO: 1:06:47

Okay. Um and I'll I'll include it. I'll I'll put it in the show notes and stuff. Um, but Sarah Weand, it's W-E-A-N-D Um L P C.

SARA WEAND: 1:07:00

Yeah.

JAMIE SERINO: 1:07:00

Okay.

SARA WEAND: 1:07:00

Or Sarah Weand D B T therap.

JAMIE SERINO: 1:07:03

You know, I'm yeah, just Google it. I I was actually Googling and you did come up. Um so good. So people can seek you out in Pennsylvania. Um again, thank you so much. This was great. And uh I feel like if you're open to coming back, we didn't even get into the nervous system stuff. Sure. And you know that that's fascinating to me. But um, there's more to explore here, but you definitely helped clarify a lot. So thank you, Sarah.

SARA WEAND: 1:07:32

Thank you. I thank you.

JAMIE SERINO: 1:07:34

All right, and thanks everybody for watching or listening, and we will see you next time.