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Emotional Regulation Part 3


All posts in this series reference working through DBT® Skills Training Handouts and Worksheets, Second Edition, and all quotes come from that book unless otherwise specified.

Managing Really Difficult Emotions

The next subsection of the emotional regulation section of the workbook is about managing really difficult emotions. This is broken down into three parts: mindfulness of current emotions, managing extreme emotions, and troubleshooting and review.

Mindfulness of Current Emotions:

The book recommends thinking of your emotion as a wave that ebbs and flows and imagining surfing the wave of your emotions. I have aphantasia and autism, and imagery and metaphor don't really work for me. However, the book also says you should practice mindfulness of your current emotion, noticing it without trying to increase it or decrease it, get rid of it or hold onto it.

You should also pay attention to sensations in your body related to the emotion: where they're located and how long it takes the emotion to fade.

You should keep in mind that your emotion does not define you, and you do not have to act on it. "Remember times when you have felt different."

"Practice loving your emotion. Respect your emotion. Do not judge your emotion. Practice willingness. Radically accept your emotion."

Managing Extreme Emotions:

The first thing you should do when your emotions are extreme is identify whether you are at your skills breakdown point- that is whether your emotions are too high to use your skills. Check the facts.  If you are not at this point yet, you should try to use your skills. If you are at this point, you should you the observe and describe skills to state that you are at your skills breakdown point. You might note things like:
  • "Your distress is extreme.
  • You are overwhelmed.
  • You cannot focus your mind on anything but the emotion itself.
  • Your mind shuts down; your brain stops processing emotion.
  • You cannot solve problems or use complicated skills."
If you are at your skills breakdown point, and you have observed and described that you are at that point, the book recommends following these steps:
  1. Use crisis survival skills, which will not be taught until the section on distress tolerance, which I have not yet reached. However, these skills include "TIP your body chemistry", "DISTRACT yourself from emotional events", "SELF-SOOTHE through the five senses", and "IMPROVE the moment you are in."  
  2. "Return to mindfulness of current emotions"
  3. If needed, try other emotion regulation skills.

 Troubleshooting Emotion Regulation Skills:

  1. Check your biological vulnerabilities (PLEASE acronym). Are you ill? Have you eaten the right amount of healthy foods? Have you gotten a balanced amount of sleep? Have you taken your medications as prescribed? Have I used illicit drugs? Take care of these needs and then try emotion regulation again.
  2. Check your skills. Is the skill you used appropriate to the situation? Did you follow the skill instructions exactly? Do you need to review and try other skills or the same skill followed more closely? Do you need coaching? Check these things and try emotion regulation again.
  3. Check for things that are reinforcing your emotions. Do they communicate something to others or influence others to do things? Do they motivate you to do things you think are important? Do they validate your beliefs or identity? Do they feel good? These things are called reinforcers. If you find that there are reinforcers for your ineffective, very strong emotions, find alternatives for each reinforcer. If it communicates to or influences others, practice interpersonal communication skills. If it motivates you to do important things, look for different reinforcers to motivate you. If it validates your beliefs or identity, self-validate. If it feels good, do pros and cons for changing emotions. 
  4. Check your mood. Are you putting in the time and effort needed to change your emotions? "Do pros and cons for working hard on skills. Practice radical acceptance and willingness skills. Practice the mindfulness skills of participating and effectiveness."
  5. Check for emotional overload. Have you reached your skills breakdown point? If not, problem solve. If so, use the steps above in this blog. 
  6. Check for myths. Check the facts. Challenge any myths that are getting in the way.  

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