DBT From a Patient’s Perspective

I recently finished an 8-week program for Dialectal Behavior Therapy, and this is what they taught us in group in a nutshell.

DBT from a Patient’s Perspective

  1. Distress Tolerance
  2. Mindfulness
  3. Interpersonal Effectiveness
  4. Emotion Regulation

Distress Tolerance:

Sometimes we find ourselves in a crisis. A panic attack, a bout of depression, a spell of mania are all examples of a crisis. Really a crisis is any time we feel real bad in one way or another. Extreme pain, moods of OCD cleaning. A crisis is a shot-term extreme reaction to stimuli. A crisis looks different for different people. There are 6 ways that Dialectal Behavior therapy suggests getting out of these extreme moods.

  1. The STOP Skill
    1. Stop, Take a deep breath. Take stock of the situation before you act. Take a deep breath. Go into Observer mode. Observe what is happening in your surroundings and how you feel. Observe your thoughts as thoughts, not facts. If you can, describe your feelings to yourself and validate why you feel them. Proceed mindfully with the situation out of Wise-Mind (Covered later-on). Remember to Act rather than Re-Act old programming.
    1. Find something else to do with the energy.
  2. The Pros and Cons List
    1. If the crisis is about having to make a decision, or having an urge, step back and make a pro cons list. This is a way to Logically work with the emotion mind and find a solution that works for all aspects of yourself and those around you in a compromise. This is best done after a crisis and before you have another one. In group we made a pro cons list on acting on the urge to self-harm. (SELF HARM = overeating, overdrinking, undereating, cutting, suicidal thoughts, smoking, ect.) We found that the long-term benefits of not acting on it outweighed the short-term benefit of relieving the urge.
  3. TIP your body Chemistry
    1. Temperature, Intense exercise, Paired Muscle Relaxation, and paced breathing are all ways to reduce the physical symptoms of a crisis. Cold water on the face, a cold shower, or dipping in a cool body of water are all ways to invoke the divers response. The divers response is when the blood goes into the essential organs, it created a bridge between the brain and the heart, linking emotional and reasonable mind to get one back into wise-mind immediately. Caution:::: Cold water showers and baths give me flashbacks occasionally and may do the same for others with extreme trauma.
    1. Intense exercise is a way to spend your body’s extra energy so you no longer are worked-up enough to be in crisis. Examples of intense exercise are running, body weight workouts, dancing, swimming, jumping, ect.
    1. Paired Muscle relaxation is one-by-one tensing every muscle in the body, and then one-by-one mindfully relaxing each muscle. It is a similar practice to body-scan mediation. It reminds you that yes, you are tense, but you have the power to physically relax your body with mindfulness.
    1. Paced Breathing is doing deep breaths. Breath all the way down into your toes, expanding your stomach and then your chest, hold it, and then slowly release for longer than you were breathing in.
  4. Distracting is reducing contact with the distressing stimuli when it is too overwhelming. This should be done after the situation has been Radically Accepted (covered later).
    1. You can distract with activities, such as reading a book, going for a walk, or watching TV.
    1. You can distract with contributing by calling a friend, volunteering, or donating things to Salvation Army.
    1.  You can distract with comparisons by comparing how you feel now with how you have felt in the past. This helps to change your perspective.
    1.  You can distract with Emotions by listening to emotional music, reading an emotional story, joke books, or by reading old letters or texts.
    1. You can distract by Pushing Away by leaving the situation mentally, denying the problem for the moment, or by building a wall between you and the problem.  
    1. Distracting by thoughts is one of my favorites, you can count, repeat a mantra (I like Ho’Oponopono), or by daydreaming.
    1. Distracting with sensations involves things like eating a candy, holding ice in your hand, taking a shower, or listening to loud music.
  5. Self-Soothing is using the 5 senses to soothe one’s self. The goal here is to reduce any feelings of deprivation.
    1. Sight: Look at beautiful art, the stars, a neat Tumblr or photo blog, nature in your window, the plants in your house. Find something beautiful to look at.
    1. Hearing: Turn on a meditation, binural beats, a great playlist, or work on making a great playlist for yourself.
    1. Smell: Burn some incense, a candle (also good for sight), use perfume, or take a shower or bath with all of your favorite smells.
    1. Taste: Eat a yummy snack or candy, drink some yummy tea.
    1. Touch: Practice self-massage, take a bath, hug someone, pet a pet, put clean sheets on the bed, or put on your favorite comfy clothes.
  6. Improve the Moment is exactly that.
    1. Can be done through imagining anything pleasant.
    1. Improving the Moment can also be done through finding Meaning in the situation. Focus on the silver lining. Move into Gratitude for the lessons that life has to offer.
    1. Praying can help by giving the situation over to a higher power (including your own wise-mind) that is loving whom you can trust.
    1. Improve the moment by taking a mini vacay. Go sit on the beach, a park, or walk around the neighborhood for a few minutes by truly stepping away from responsibilities for a short time.
    1. Lastly, you can improve the moment by self-encouragement or rethinking the situation. Cheering yourself on like the best coach or mentor you ever had is a great way to find the strength to get through a situation. Saying things like “I can make the best of this” and “I can Stand to Endure this”
  7. Distress Tolerance Bonus section, Radical Acceptance. Radical Acceptance is split into 5 sections, The acceptance itself, turning the mind, willingness, half-smiling and willing hands, and allowing the mind mindfulness of current thoughts.
    1. Radical Acceptance is accepting a moment just as it is. There is no need to change the situation or person, just observe. Observe if you are fighting reality by having “should” statements. Remind yourself that it be how it is. Remind yourself the causes or the reasons why things are the way they are. Validate reality. Practice accepting the situation in your thoughts, your emotions, and in your spirit. All is as it should be and that is well. Life is worth living even with the painful events. Rejecting reality keeps you stuck in that reality. You cannot change your reality until you observe and accept it the way that it is. Acceptance may cause an unpleasant emotion in the moment, but that will be replaced with a deep sense of calm shortly if you don’t ruminate. (If you’re ruminating you haven’t accepted it).
    1. Pain + Suffering = Misery.            Pain + Misery = -suffering
      1. Accepting Misery as a part of life reduces suffering.
    1. Turning the mind involves making the conscious choice to accept reality as it is. Fist you Observe that you aren’t accepting reality as it is. (you’re throwing a tantrum or burying your head in the sand. Saying things like Why Me?) Go within and make an inner commitment to accept that if it’s meant to be it is. Do it again over and over until it sticks. Develop a plan for later when you are drifting out of acceptance again.
    1. Willingness is the opposite of stubbornness. It is the acceptance that divine will can operate through you, you are willing to do what is necessary. This is the opposite of being Willful. Being willful is being so full of your own will that the correct, non-ego based will from the wise-mind cannot enter.
    1. Half-Smiling and willing hands is putting a little smile on your face even if things aren’t how you would like them, because you know that everything is as it should be. Willing hands is a posture of upturned hands, a show that you are willing.
    1. Mindfulness of current thoughts is knowing that you are not your thoughts. The Self is the observer of thoughts, actions, and emotions. To be mindful of your thoughts start by observing your thoughts, and not giving them attention. Just letting them pass through your conscious mind. Be curious about your thoughts, wonder, what am I thinking? Don’t block or repress a thought because you disagree with it or find it distasteful, let it pass in its entirety, and then let it go. Try meeting your thoughts with love, acceptance, and validation.

Mindfulness:

There are three goals of mindfulness practice, these are to increase happiness and reduce suffering, to increase control of the mind, and to experience reality as it is.

  1. Reducing suffering mean that mindfulness practice is clinically shown to reduce pain, tension, and stress, as well as increase physical health, healthy relationships, and increase happiness. Mindfulness increases your control over your mind, so it fights racing or unpleasant thoughts, as well as built more positive thought frames. Experiencing reality as it is means embracing the reality of situations and living moment to moment.
  2. What is Mindfulness? Mindfulness is being aware of the present moment, without judgement, rejection, or attachment.  This means that we experience each moment as that, a moment, that will pass in time.
  3. What are Mindfulness skills? Mindfulness skills include meditation, prayer, and movement such as thai chi, mindful walking, yoga, spiritual dancing, hiking, singing, ect.
  4. WISE MIND. Wise mind is something that I refer to as the higher-self or the soul. Wise mind is the part of each person who knows and observes the whole truth. Wise mind holds wisdom, sees reason and emotion, and knows the middle/correct path. Stillness invites connection to the wise-mind.
  5. Reasonable mind is cool, rational, and task focused. Reasonable mind can easily be spun into overdrive or underdrive and operates on self-satisfaction. When in reasonable mind one is ruled by facts, reason, logic, and pragmatics. Values and feelings are not considered.
  6. Emotional mind is hot, mood-dependent, and emotion-focused. Emotion mind is powerful, aware, strong, and it operates on memory. When in emotional mind you are ruled by your moods, feelings, and urges. Facts, logic, and reason are unimportant and not considered.
  7. There are many meditations to get in touch with wise mind. I will list a few names of meditations and leave it up to the reader to explore this topic on YouTube. Stone flake on the lake, walking down spiral stairs, asking wise mind a question, asking wise mind if this is wise mind, pulling attention to center, expanding attention to entire room, ect.
  8. Taking hold of the mind: Skills.
    1. OBSERVE. Notice something for each of your senses. Pay attention to what the current moment, the current reflection of yourself, the current environment is like. Control what you give attention to, thoughts, emotions, the environment. What you pay attention to will attract more of that into your life. Practice wordless watching, simply observe the environment and the thoughts and feelings without naming or describing them. The key here is not to stick to any one observation, let things pass through your consciousness.
    1. DESCRIBE. Start naming the things that you observe gently. Acknowledge and validate them. Labels thoughts, feelings, and actions as such. Do not interpret what you are observing, simply notice and let go.
    1. PARTICIPATE. Become one with whatever you are doing. Operating out of wise-mind, find a flow and flow with the moment. Be one with the moment. Respond appropriately and with spontaneity. Be aware that you are a strand that makes up the beautiful tapestry of each moment.
    1. NONJUDGEMENTALLY. See the moment, but do not label it as good or bad or this or that or the other. See your emotions, thoughts, feelings, and environment and acknowledge them. Validate them. Do not label them. And move on. If you notice yourself judging, than don’t judge that fact that you are judging, simply let it pass.
    1. ONE-MINDFULLY. Merge with you current activity, and rivet yourself to each moment. Do one thing at a time, multitasking is unhealthy and inefficient! Let go of what is distracting you. Don’t check your phone while a friend is talking to you. Don’t get so caught up in the traffic noise that you can’t focus on sleeping. Be aware of what you want to be aware of in each moment. Concentrate and find focus on what you intend to do/are doing.
    1. EFFECTIVELY. Be mindful of what your goals are in each moment and do what is necessary to achieve them through wise-mind. Focus on what works and let go of the things, people, or places that don’t. Read the room and play by the common rules or social expectations. Act skillfully, do what is appropriate for the current situation, exactly as it is. Not how you think it should be. Let go of being stubborn or non-participation. Again, know what your objective is going into a moment and do what is deemed necessary by the wise-mind to accomplish that goal.
  9. Practice Loving Kindness to increase love and compassion. Loving kindness is a mindfulness practice designed to increase love and compassion for ourselves and all beings. Loving kindness can reduce feelings of ill-will, judgmentalness, and hostility. To practice loving kindness, choose a person to send love and compassion to someone, preferably someone you already love and care about or yourself. In a meditative stance, bring the person gently to mind. Then, radiate loving kindness by thinking or saying positive things to the person. This can be “May I be Happy” “May I feel Love” “May things go well for me” “May I be safe and at peace” Continue until you feel yourself immersed in loving kindness. After you are immersed in the feeling, move onto other people and beings to whom you would like to send loving kindness. If you are feeling confident, it would help you to also send loving kindness to those whom you dislike. Gradually work through all the people in your life, and them move into radiating loving kindness into the world or universe. Practice each day for as long as it takes you to do the meditation. Start with yourself and them move onto others.
  10. WHEN IN WISE MIND one lets go of having to achieve goals while still working very much to achieve the said goals. In wise mind, doing and being are balanced.
  11. There are many mindfulness mediations to start practicing on YouTube, meditation is like working a muscle. When you start it is usually difficult to remain focused and your thoughts just wander. Consistently bringing yourself back to the breath and the theme of the meditation is how to get better at it and receive the benefits.

Interpersonal Effectiveness

  1. Why aren’t you being effective?
    1. You Don’t have the interpersonal skill you need
    1. You don’t know what you want, going into a conversation there should be a goal in mind
    1. Your emotions are keeping you from acting the way you want to.
    1. You forget the long-term goals for short-term goals. Urges come first and long-term goals are left to the wayside.
    1. Other People are getting in your way because they are more powerful, jealous, or humiliating.
    1. Your thoughts and beliefs are getting in the way. Beliefs such as you don’t deserve what you want, there might be negative consequences if you say no or ask for what you want, or beliefs that others don’t deserve what they want. Change the harmful myths you have surrounding interpersonal activities to be more effective.
  2. DEAR MAN GIVE FAST (skills)
    1. D- Describe the situation to the person
    1. E – express your feelings or thoughts on the matter
    1. A – Assert what you want or say no assertively
    1. R- Reinforce, reward, the person when they do what you want. If they do not do it then explain what they get out of it. Sometimes you must be a broken record on this one.
    1. M – Mindfulness in conversations. Listen and be present with the person. Keep your goal in mind and do not revert to emotion or rational mind.
    1. A – Appear Confident. Expect to get what you want and know that you can do what you want to do.
    1. N – Negotiate – Discuss compromise and negotiate a solution that is beneficial to both parties.
    1. G -Gentle – Be respectful of the other person. Don’t yell or appear upset. Don’t be manipulative or make threats. Respect boundaries. Exit the conversation gracefully if you must.
    1. I – Interested- Listen and appear interested in the other person. Remember what they say. Imagine that each person you meet is the most important person in the world.
    1. V- Validate – Show that you understand where the other person is coming from. Let them know that their thoughts and feelings make sense.
    1. E – Easy Manner – Smile, use humor, sweet talk. Do a soft-sell rather than a hard sell. Leave attitude at the door and appear at ease.
    1. F – Be fair with the other person and yourself. Validate your own feelings and wishes as well as the other person’s.
    1.  A – Apologies, apologize when you have done something that offends the other person, but don’t over apologize.
    1. S- Stick to your values, Don’t sell out your values or integrity for reasons that aren’t extremely important. Be clear on your sense of morality and stick to your guns.
    1. T- Truthful. Don’t act helpless when you are not and don’t act tough when you are not. No exaggeration or excuses, be upfront with who you are speaking to.
  3. Validation:
    1. Validation means finding truth in what another person is saying. It’s acknowledging a person’s thoughts, behaviors, and emotions have causes and are therefore reasonable. You do not have to validate things that are untrue. Validation doesn’t necessarily mean that you agree with the other person.
    1. Why Validate? Because it improves our relationships by decreasing pressure to determine who’s right, negative reactivity, and anger. We also validate because it hurts to be invalidated.
    1. Important things to validate: What is true, the facts of a situation, a person’s experiences, thoughts, beliefs, feelings, thoughts, suffering, difficulties, opinions. Do not however, validate the non-valid. That means if someone is stating a fact that is not true, do not validate it.
    1. When invalidated by someone else, it is important to practice self-validation. Self-validation means doing validation for yourself. Accept that your feelings are hurt, that you can make mistakes, and that you need to talk to yourself in a compassionate way. Check the facts and admit when you are wrong. Stand up for yourself if you check the facts and they remain true.
    1. Recovering from invalidation can be difficult. Invalidation is not helpful and should be changed when you are being ignored or ignoring others, if you are being misunderstood or misunderstanding others, and when important facts are denied or you are denying important facts. Invalidation is helpful when it is gentle constructive criticism. Constructive criticism is non-judgmental, helps change incorrect beliefs, and helps us grow. It may bring up feelings of guilt, in-confidence, embarrassment, shame, fear, anger, acceptance, or humility. How you react to constructive criticism is up to you.
    1. Pavlov yourself into doing things that increase your interpersonal effectiveness or to stop doing things that get in the way of interpersonal effectiveness. If you have done a social thing well, reward yourself. If you did or are doing something unwell, DO NOT punish yourself, it is ineffective. Instead, find a way to stop the behavior before it starts. Listen to your urges and find something better to replace them.
  4. Ending difficult relationships is a critical facet of interpersonal effectiveness. If you are questioning if you should end a relationship, make a pro cons list of how that person effects your life. Move into wise mind and decide if you really do want to end the relationship. Try problem-solving if the relation is uncomfortable, but non-destructive. If the relationship is destructive, decide to end it and cope ahead with the inevitable confrontation. Coping ahead is imagining the best- and worst-case scenarios and coming up with a plan for each of them. Coping ahead is also moving yourself into a stable and wise-mind space before the conversation. Use DEAR MAN GIVE FAST to explain why you are ending the relationship and approach the conversation with love.  
  5. Mindfulness of others. Being mindful of others is observing them, describing them, and participating in activities with them.
    1. Let go of focusing on the self (such as questions like how am I being perceived?). Observing others includes paying attention to their body language and what they are saying. Stay focused on the moment rather that what you are going to say next. Be open to new information about others. Notice judgmental thoughts and release them.
    1. Describe others using the facts, not judgements or opinions. Avoid assuming what someone thinks about you, and instead check the facts. Give others the benefit of the doubt and avoid questioning their motives. When we feel we are being manipulated, quiet the mind and ask the wise mind. Description of others is basically turning your observations into facts.
    1. Participation with others is fairly straight forward. It means being mindful and focusing on what you are doing with the other person. Do not multi-task and give them and the shared activity your full attention. Go with the flow of conversation, rather than trying to turn it one way or another. Become one with the group and the activity.
  6. Setting boundaries is a critical aspect of interpersonal effectiveness. Boundaries are most effective when based on your values. Everyone’s boundaries are different, because everyone has different values, and because many people never learn how to set effective boundaries. Effective boundaries are neither porous or rigid. To set a boundary, there are many things that are good to say, including no, I can’t do that for you, I don’t want to do that, and this is not acceptable. Do not say maybe when setting a boundary because it is interpreted as a yes. To effectively set a boundary, as well as saying what you mean, it is important to appear confident, be respectful, cope ahead if your boundary is likely to be ill-received, and compromise when it is with reason to do so.
  7. Values are like a compass from which we are guided through life. Clarifying what your values are will help to shape your beliefs in a more effective way, so that you can form the life that you truly desire. Common values are love, family, success honesty, spirituality, stability, wisdom, adventure, popularity, and freedom. There are lists of values on the internet, and it may be helpful to look at them to decide what your values truly are.

Emotional Regulation

  1. Goals of emotional regulation
    1. Identify and understand your emotions
    1. Decrease the frequency of unwanted emotions
    1. Decrease emotional vulnerability
    1. Decrease emotional suffering.
  2. Identifying your emotions:
    1. Emotions can be difficult to describe, but they often begin as a feeling within the body. This could be a feeling of lightness, heaviness, pain, peace, flow, or un-flow. There are many words used to describe emotions that can be confusing. However, there is a logic to the flow of an emotion. That flow starts with a prompting event, the thing that makes you feel an emotion from the environment. Then your beliefs and interpretation of the event determines what the emotion is. There are biological changes, actions/behaviors, and then the naming of the emotion itself. There are even secondary emotions that follow after you have experienced an emotion. This seems confusing at first, but I will go through some common emotions as examples so that you can understand how it works.
    1. Love: Words to describe love include enchantment, love, adoration, fondness, affection, charming, sentimentality, warmth, tenderness, compassion, and passion. Prompting events for feeling love include being with someone you have fun with, someone doing things that you find admirable or valuable, spending a lot of time with a person, sharing a special experience with a person, being physically attracted to someone, or finding someone who adds significant value to your daily life. Beliefs and interpretations that lead to love are believing that someone wants, needs, or loves you, thinking that someone is physically attractive, judging a person as wonderful, pleasing, or fun, or believing that someone will always be there for you. Biological changes and experiences of love include feeling confident, happy, warm, trusting, relaxed, and giddy. It also includes wanting the best for a person, wanting to be intimate with someone, wanting to be emotionally close to someone, or wanting to give time, touch, or gifts, words of affirmation, or acts of service to someone. Expressions of love include eye contact, touching, expressing positive feelings towards someone, smiling, sharing time with someone, gift-giving, or doing what another person wants or needs. Side-effects or secondary emotions of love include only seeing the good in someone, daydreaming, being open and trustful, feeling more vitality, remembering positive events, joy, and believing in yourself.
    1. Anger is an emotion that many people have issues with. Anger words include frustration, irritation, fury, grouchiness, hostility, agitation, rage, and wrath. Prompting events for anger, or reasons to feel angry, are having an important goal blocked, being attacked or threatened, losing power, status, or respect, as well as physical or emotional pain. Beliefs or interpretations that propagate anger are; a rigid attachment to being right, blaming, believing things should be different, judgement that something is wrong, ruminating about what made you angry, or believing that you have been treated unfairly. The body’s response to anger can be tension of muscles, jaw clenching, getting flushed or hot, uncontrollable tears, wanting to hurt someone, and/or hitting inanimate objects. Expressions of anger are yelling, aggressive gestures and mannerisms, breaking things, throwing things, swearing, mean facial expressions, brooding or withdrawing from others, ranting, and/or criticizing/complaining. Aftereffects, or secondary emotions following anger include guilt, narrowing of attention, dissociation, or rumination of what has made you angry in the past.  
    1. Fear is an emotion that has plagued me personally for a long time. Fear words are anxiety, apprehension, dread, edginess, hysteria, nervousness, panic, overwhelmed, terror, shock, and worry. Reasons to feal fear are being in proximity to an angry person, flashbacks, being in situations where someone is being hurt, pursuing your dreams, being in an unfamiliar situation, being in crowds, being in the dark, and public speaking. Beliefs and interpretations that propagate fear are the belief that you could die or be hurt, someone might reject you, that you might embarrass yourself, you won’t get help, you could lose something, or that you are helpless. The body’s response to fear includes breathlessness, racing heart, lump in throat, tension of muscles, nausea, getting cold, wanting to run away, wanting to scream, wanting to fight, wanting to freeze. Expressions of fear include closed body language, becoming speechless, yelling, shaking, sweating, freezing, gastrointestinal issues, darting eyes, frozen stare, exedra. The secondary reactions to fear include narrowing of attention, being hypervigilant, losing ability to focus, becoming hyper-focused on threats, imagining more failure, isolation, flashbacks, and rumination on past fearful events or situations.  
    1. And lastly, happiness. Words for happiness include joy, satisfaction, enjoyment, pleasure, giddiness, delight, contentment, triumph, optimism, gladness, exhilaration, and bliss. Reasons to be happy include receiving love and affection, being accepted by others, exceeding your expectations, getting something you have worked hard for, being successful, achieving goals, receiving praise or recognition, and doing things that are pleasurable. The interpretations of beliefs that propagate happiness are appreciation of a moment exactly how it is, and being grateful for the moments given to you. The body’s response to happiness includes feeling excited, physically energetic, feeling like laughing, urge to keep doing the happy thing, feeling at peace, feeling open or expansive, and/or feeling calm. Expressions of happiness include hugging/physical touch, laughing, smiling, being bubbly, communicating about what makes you happy, silliness, and/or having a bright, glowing face. Aftereffects of happiness include being friendly, having a positive outlook, having a high resilience to negative experiences, ruminating on the other events that have made you happy in the past, creating more opportunities to be happy, and expecting to feel joyful in the future.
  3. To decrease the frequency of unwanted emotion one needs to build resilience. Building resilience has many facets and is the basis for decreasing emotional vulnerability, decreasing negative emotions, and decreasing suffering. To do that according to DBT there are many strategies contained in the acronym ABC PLEASE.
    1. Accumulating positive experiences means scheduling time to do things you enjoy, as well as building a life worth living. Building a life worth living means having values, not sacrificing those values in the form of holding boundaries and being truly present for pleasant experiences.
      1.  Values are like a compass by which you make decisions. There are so many values that one could have, but it boils down to what you Value in life. My values include adventure, honesty, stability, success, laughter, spirituality, wisdom, safety, nature, love, and creativity. That means I make space in my life to experience these values. Do things that lead to goals based on your values.
    1. Building Mastery adds satisfaction and confidence to your life. Building mastery involves practicing an activity that you enjoy and becoming good at it. There are endless talents that you can propagate in yourself, but the ones that I do are dancing/working out, singing, poetry, playing the ukulele, reading, Vibrational Astrology, make-up skill, sewing, and knitting. Really any hobby that you put time into helps to build mastery. Planning a short amount of time each day to practice is essential. Planning for success helps you to stick with it, as well as not pushing yourself too hard. Don’t be afraid of failure or challenges. Failure helps you learn a lesson and challenges push you to do better.
    1. Coping ahead with emotional situations is knowing that you are going into a difficult situation and doing things that will mitigate its difficulty. Coping ahead is composed of description, deciding, imagining, rehearsing, and relaxing.
      1. Describe the probable situation with the facts, not your emotions or expectations. Name what is likely to happen.
      1. Decide what coping skills you would use in the situation. Coping skills include deep breathing, putting ice water on face, acting out of wise-mind, working out before or after, and meditating before of after.
      1. Imagine the best- and worst-case scenarios for the event. Imagine yourself IN the situation and play it out.
      1. Rehearse how you will cope effectively with the best- and worst-case scenario. Rehearse what you are going to say, do, and think so that it comes easily in the moment. When the event happens, be willing to change or alter your responses based on the situation.
  • PLEASE means treating Physical iLlness, Eating correctly, Avoiding substances, Sleeping correctly, and Exercising. These seemingly obvious resilience factors are often overlooked. Treating physical illness means going to the doctor when you need to, and/or using herbs and over the counter medicines as necessary. Eating correctly looks different for everyone, but you should avoid feeling extremely full or hungry. Avoiding substances includes not drinking alcohol, not doing coke or heroine or crack or meth or any of the other drugs that negatively affect us as humans. If it gets you high and then a low follows, it’s not good for you! Exercise makes our bodies and minds stronger. Exercising three times a week is what my doctor recommended, so sometimes I walk or run or do a bands-workout or a body weight exercise session or dance or hike. Some people like sports and going to the gym. Finding pleasure in whatever keeps your body moving is critical to keeping it up. If it feels like a chore, you won’t do it regularly.
  • Miscellaneous skills for regulating emotion include checking the facts, problem solving, and opposite action.
    • Checking the facts means using the logical mind to know what is actually happening. Taking a deep breath and moving into observer mode while in an emotional situation, and then describing the facts moves you out of emotion mind so that you can respond rather than react.
    • Problem solving is another skill that uses logic mind. Think about what the problem is, check the facts again and again to get to what is really the problem, identify the goal or what you want to happen, brainstorm lots of solutions, choose an idea that is likely to work, and then put that choice into action. After you take the action, evaluate how well it worked and brainstorm again if the problem isn’t resolved.
    • Opposite action is noticing an urge within yourself to do something that you know isn’t good for you and doing the opposite. For example, if we are sad and want to isolate, chronically, we should go out instead. If we want to cut ourselves, we should do massage or another form of self-care instead. If we are angry and want to yell, taking a deep breath and walking away is probably the better solution. We are not slaves to our urges, you have control over what your actions are, regardless of your emotions.

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