DBT Emotion Regulation Troubleshooting

When what you are doing in the way of skills simply isn’t working, where do you turn? In the final week of this 7-week module in my DBT Skills Group, this is what we investigated.

The need for Troubleshooting is something I am pretty familiar with myself. Sometimes it is only when I take a step back from what it is I am doing, that I realise there are some more specific areas I need to individually target before I can even attempt to regulate myself more fully.

If you find yourself in a situation like this, here are some things worth checking out before you move on:

  1. Check your BIOLOGICAL SENSITIVITY
    Ask yourself:
    Am I physically ill? Am I due my period? Have I recently engaged in unbalanced behaviours with food, alcohol, drugs? When was the last time I got any exercise? Did I get enough sleep last night? Have I taken my prescribed medications?
    Now what? 
    Take care of any physical illness and treat it. Take medications which have been prescribed. Work on your PLEASE skills – eat balanced, get some sleep, participate in exercise, take a shower.
    (These will have an accumulative effect, so if you don’t feel better immediately, don’t give up, continue using these skills regardless – they will certainly not make you feel any worse!)
  2. Check your SKILLS
    Ask yourself:
    Do I need to be focusing on Acceptance skills or Change skills right now? Are the skills I have tried using appropriate given the context? Are they likely to be effective? Have I followed the skill as instructed or have I cheated slightly? How willing am I to engage fully in skill use?
    Now what?
    Keep trying skills, and review and try alternative skills too. Get crisis/ skills coaching to receive guidance and support with skill use. Keep trying. Remember, as long as you are not ‘worsening the problem’, you are remaining effective.
  3. Check for REINFORCERS
    Ask yourself:
    Are my emotions communicating something important to me? Are they influencing people around me to act or feel a certain way? Are my emotions motivating me to take action regarding things that have meaning to me? Are my emotions validating my beliefs or my identity? Do my emotions feel good?
    What now?
    If yes: Practice Interpersonal Effectiveness skills to aid communication. Identify and work toward employing other reinforcers to motivate yourself. Practice self-validation. Do a pros-and-cons for changing the emotion you are feeling v.s. not changing the emotion you are feeling.
  4. Check your MOOD
    Ask yourself:
    What mood am I in? How motivated am I feeling? Rate your willingness levels on a scale from 1 – 10. Am I putting in the required time and effort needed in order to solve the problem at hand?
    What now?
    If no: Write a pros-and-cons list for engaging effectively with skills v.s. not engaging effectively with skills. Practice radical acceptance and willingness skills. Practice using the Mindfulness skills of Participating and Effectiveness.
  5. Check for EMOTIONAL OVERLOAD
    Ask yourself:
    Am I too distressed, overwhelmed or dysregulated to use complicated skills right now?
    What now?
    If yes, ask yourself if the problems you are currently experiencing can be solved within this moment? If yes, use problem-solving, including Checking The Facts, identifying your goals, and Opposite Action if appropriate. If no, practice Mindfulness – specifically Mindfulness of Current Emotion(s) – in order to ride the emotional wave, self-validate, and foster Acceptance over what is being experienced – without worsening the problem.
    If your emotions are too high to think straight, go straight to using TIPP Skills.
  6. Check for EMOTIONAL MYTHS getting in the way
    Ask yourself:
    What messages am I giving myself right now? What judgements are going around my head? Am I experiencing any beliefs or cognitive distortions regarding the situation? (e.g. “What I am feeling is stupid/ pathetic/ wrong”, “Why do I have to be so dramatic/ needy/ sensitive?”).
    What now?
    Check The Facts. Challenge the myths you are telling yourself – write down an alternative rationale. Practice thinking Non-Judgementally, being descriptive in your experiences.
    Remind yourself that your emotions do not dictate who you are as a person, and that “This too shall pass”.

P.s. The next of my DBT Skills Group sessions is a way away, on the 26th September, when we will start the Distress Tolerance module!

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