DBT Emotion Regulation - Understanding the Emotion

“I don't want to be at the mercy of my emotions. I want to use  them, to enjoy them, and to dominate them.”  ― Oscar Wilde, The Picture of Dorian Gray

Functions of Emotions: What Emotions Do For You

There is a reason why humans (and other mammals) have emotions. The purpose of regulating emotions is NOT to get rid of them. We Need Them!

Emotions Motivate and Organize Action:

• Emotions motivate our behaviour. Emotions prepare us for action. The action urge connected to specific emotions is often "hard-wired".
• Emotions save time in getting us to act in important situations. Emotions can be especially important when we don't have time to think things through.
• Strong emotions help us overcome obstacles - in our minds and environment.

Emotions Communicate to and Influence Others:

• Facial expressions are connected to emotions. Facial expressions communicate faster than words.
• Our posture, gestures, words and voice tone can also be hard-wired. Like it or not, they also communicate our emotions to others.
• When it is important to us to communicate to others, or send them a message, it can be very hard for us to change our emotions.
• Whether we intend it or not, the communication of emotions influences others.

Emotions Communicate to Ourselves:

• Emotional reactions can give us important information about a situation. Emotions can be signals or alarms that something is happening.
• Gut feelings can be like intuition; a response to something important about the situation.
• The can be helpful if our emotions get us to check out the facts.
• Sometimes we treat emotions as if they are facts about the world: The stronger the emotion, the stronger our belief that the emotion is based on absolute fact. "If I feel unsure, I am incompetent."
• If we assume that our emotions represent facts about the world, we may use them to validate our thoughts or our actions. This can be trouble if our emotions get us to ignore the facts.

EMOTIONS DO NOT VALIDATE OUR EXPERIENCE OF THINGS

Factors Reducing Emotion Regulation

• Biology - Biological factors may make emotion regulation harder
• Lack of Skill - You don't know what to do to regulate your emotions
• Reinforcement of Emotional Behaviour - Your environment reinforces you when you are highly emotional.
• Moodiness - Your current mood (apathy, irritation, boredom) not your skills controls what you do.
• The Emotional "Sea Of Dyscontrol" - With overwhelming emotions, you fall into the "sea of dyscontrol" where you feel like you are drowning under hurricane strength waves of emotions.
• Emotional Myths - Emotion myths get in the way of your ability to regulate emotions. Myths that emotions are bad or weak lead to avoiding emotions. Myths that extreme emotions are necessary or are part of who you are.

DBT Emotion Regulation Skills

"We cannot be happy if we expect to live all the time at the highest peak of intensity. Happiness is not a matter of intensity, but a balance and order and rhythm and harmony." - Thomas Merton

Emotion Dis-regulation

• The inability, even when one's best efforts are applied, to change or regulate emotional cues, experiences, actions, verbal responses and/or non-verbal expressions under normative conditions.

Overview of Emotion Regulation Skills

1.  UNDERSTAND and NAME THE EMOTIONS YOU EXPERIENCE

• What good are emotions?
• Model for Describing Emotions
• Ways to Decrease Emotions.  

2.  DECREASE EMOTIONAL SENSITIVITY; Reducing unwanted emotions

• Changing emotional responses to situations
• Reducing vulnerability to negative emotions (ABC PLEASE skill to be described later)

3.  DECREASE EMOTIONAL INTENSITY: Stop or reduce the intensity of unwanted emotions once they start

• Mindfulness of current emotions
• Managing extreme emotions

Rearing Its Ugly Head

My BPD is rearing its ugly head this evening. My daughter desperately need DBT but there is a very long waiting list for the funded program. I, myself, am in a private program but it is very expensive. I can only do it because of my husband's insurance. But after talking with my husband about the company's EAP, he said my daughter, because she is not living with me, is not covered under insurance. If she came back to live with me, she would be covered under insurance.

I'm feeling somewhat smug about that - mainly towards all those involved in her "well-being" - child services, my ex-husband, my daughter's therapist, etc. I want her to get the help that she needs but she is not going to be able to get it by living with her dad.

Let's see just how much they all are invested in her well-being and how much they are invested in being right and saving face.

Of course, now I feel kinda guilty because I'm feeling smug at my daughter's expense. I desperately want her to get the help that she needs but it doesn't look like that is going to happen any time soon if she stays where she is.

How To....Radical Acceptance

So the last post was about Radical Acceptance - what it is and what it is not.
But how do we do it? That is the million dollar question.

There are 4 skills to help you with radically accepting the situation, as it is, in the current moment.

OBSERVING YOUR BREATH
This is a practice intended to help you tolerate the current moment. It is a way of taking hold of your mind and centreing yourself and gaining access to solving the problem or improving the moment.

Observing you breath serves 2 important purposes.

1. Focusing on your breathing assists with physiological relaxing. When nervous, many people hold their breath or breathe shallowly, which creates additional tension and increases carbon dioxide in the blood (triggering adrenalin bursts). By observing your breath, you release the effort to control it. When you stop controlling your breath, your body takes over and your breathing naturally becomes deeper and fuller and more relaxed.
2. The breath is used as a point of focus because it is always available and provides a basic connection to the present moment. This activity occupies your mind and there is less room for worrisome thoughts.

HALF-SMILING

This is the practice of accepting and tolerating reality with your body. It is the adoption of acceptance with one area of the body: our facial muscles (lips).

Facial expressions communicate with the brain which in turn, influences our emotions. Since emotions influence our facial muscles unconsciously, by consciously controlling our facial muscles, we acn affect our emotions or how we feel. (Research Based!!)

To do it, you relax your face, neck and shoulder muscles and then slightly up-turn your lips. Half-smile is best achieved with a relaxed face.

NOTE: Many people struggle with this skill as they feel it invalidates their feelings. Many will say they wore a "happy face" for years and that half smiling triggers them to feel like they are FAKING IT...As if everything is OK when it is NOT.

However, the reason individuals practice half smiling exercises is to help them tolerate and accept reality and reduce their suffering. It is about self-care and control, not to prove their 'happiness' to other people.

Half-Smiling is done for oneself.

TURNING THE MIND

Turning the mind from the topic causing it distress is to 'turn toward acceptance'; and is a choice because you have to CHOOSE to turn your mind. However, acceptance any only last a moment or 2 so people have to continuously turn their mind, over and over and over again. When we 'turn the mind' in a certain direction or away from a specific situation, change occurs. The goal is to decrease the intensity of an emotion and increase the feeling of power in make the choice.

Example: Quitting Smoking - When a person who smokes decides to stops smoking, they DO NOT make this decision once. The individual needs to make the decision over and over again. This is due to the fact that although the individual decided to quit smoking, they will inevitably experience the urge to smoke again, which makes sense. In order to avoid giving in to these urges, the individual needs to 'turn their mind' to their choice to not smoke and needs to do this over and over again. It will becomes easier. The person must also accept that they will have these thought and urges AND know that they have a choice as to whether to act on them or not.

WILLINGNESS VS WILLFULNESS

In order to 'turn the mind', individual need to be WILLING.

WILLINGNESS is accepting 'what is' and then responding in an effective way. It is doing what works in the current moment or situation.

WILLFULNESS is imposing one's will on reality - trying to fix everything or refusing to do what is needed. Willfulness is asking 'why?' vs accepting 'it happened and it is what it is'. Willfulness is the opposite of doing what works to move forward.

Willingness and willfulness do not apply to specific things or situation. they reflect instead the underlying attitude one has toward life.

Example: Life is like hitting baseballs from a pitching machine. A person's job is just to do their best to hit each ball as it comes. Refusing to accept that a ball is coming does not make it stop coming. Willpower  defiance, crying or whimpering does not make the machine stop pitching the balls; they keep coming over and over again. So...a person can CHOOSE to stand in the way of the ball and get hit, stand there doing nothing and let the ball go by as a strike, OR swing at the ball.

DBT Skills - Distress Tolerance - Radical Acceptance

Distress tolerance skills constitute a natural progression from mindfulness skills. The skills increase your ability to accept, in a non-judgmental way both oneself and the current situation.
Essentially, distress tolerance is the ability to:

• "perceive the environment without putting demands on it to be different"
• "experience the emotional state without attempting to change it"
• "observe thoughts and actions without attempting to stop or control the outcomes".

The stance here is a non-judgmental (acceptance); which does NOT mean that it one of approval.

ACCEPTANCE OF REALITY DOES NOT EQUAL APPROVING OF REALITY

Believing that something is wrong with us generates a deep and persistent suffering. This suffering emerges in crippling self-judgments, conflict in our relationships, addictions, perfectionism, loneliness, isolation and overwork (to name a few). These patterns keep our lives constricted and unfulfilled.

Accepting reality helps individuals accept and tolerate themselves, others, the world and 'reality' as it is, 'just in this moment'.

Applying RADICAL ACCEPTANCE / accepting reality involves developing the capacity to tolerate pain skillfully in order to adopt and attitude of acceptance.

Radical is meant to imply that the acceptance has to come from deep within (when you are actually fighting it).

Radical Acceptance empowers genuine change: healing fear, shame and helping to build loving, authentic relationships.

Radical Acceptance is letting go of fighting reality.

Acceptance is a way to turn suffering into pain that can be tolerated. Pain is a part of living, whether it is physical or emotional. Refusing to accept pain creates suffering. Suffering comes when people resist reality as it is (at that moment, not forever). Refusal to 'accept reality' and the pain that goes along with it interferes with reducing pain. Through the practice of radical acceptance, we can shift suffering to 'just pain'. 

DBT Skills - Distress Tolerance Pros and Cons

Crisis Survival Skill #4

Pros and Cons

This is where we learn to identify the beneficial and harmful effects of choosing to tolerate the distress.

How To Use The PROS AND CONS Skill

When using the pros and cons skill, individuals are making 2 separate lists. One list is about the pros and cons of tolerating distress; the other list is about the pros and cons of NOT tolerating distress.
By not tolerating the distress means choosing avoiding, using alcohol or drugs, binge eating or engaging in some other impulsive self-defeating or self-destructive behaviour.

People use pros an cons all the time to help make decisions. For example, each day, you do a pros and cons list to get out of bed. We do not necessarily thing "the pros of getting up today are..." and the cons of getting up today are..." but we do this on a subconscious level.
The key is to strengthen this skill and practice it before a crisis happens so that we can consciously use pros and cons when we are feeling distressed.
The goal of practicing pros and cons is to help make decisions from a wise mind perspective.
This skill help us to look at a situation from every perspective and identify all possible outcomes. The eventual goal is to see that accepting reality and tolerating distress leads to a better future than fighting reality and refusing to tolerate distress.

WHEN COMPLETING PROS AND CONS LISTS...

• focus on both the short-term and long-term pros and cons
• thing of the positive consequences of tolerating the distress. Imagine how good you will feel when you can tolerate distress without 'making the situation worse' i.e. acting impulsively (which is an example of a pro)
• think of the negative consequences of not tolerating the distress. Remember past times when you may have acted impulsively to escape the moment and the situation is now the same or worse and you have no better coping methods.
• Fill our the chart completely and make it easily accessible
• in the midst of a crisis, focus on the pros of not giving into the urges. This will help get through the moment and make you feel stronger in the long run.

Note: if doing it once is not enough then re-do or reuse the list if the need arises even if it is 2 minutes later.

Note: Remember to practice self-soothing when not in distress to make it easier to use when in distress. If you start feeling and thinking you do not deserve to self-soothe, then observe those thoughts, put them aside and practice the skill again.

Venting

I know I'm scheduled to update my DBT distress tolerance skills but I had a meeting today with Child Protective Services and I feel the need to vent. I honestly don't get their purpose - or at least not in my particular situation.

It would take me forever to detail everything so I won't. A lot of things happened to get to this point but let's just say that my 15 year old daughter is living at her dad's house ever since she was released from a mental health unit in the hospital. Ever since she was released from hospital, she has gone downhill. My ex is an extremely bitter man and isn't happy unless he is miserable. He blames all his miserableness on me. Everything that has ever gone wrong in his life is my fault. And he has never been able to keep his mouth shut, even around the kids - especially around the kids. And now my daughter is with this cesspool of shit 24/7.  He even openly admits that mental illness is an excuse and doesn't really exist. He has no knowledge of her self-soothing skills and therefore can't help her with them.

So on to this meeting I had today. CPS keeps insisting that they are not considering removing the girl from her dad's house. So I delved into my DBT skills and used the radical acceptance one. I told the caseworker that even though I don't like the situation, I accept it as it is. I continue to ask my questions that I prepared. The answers weren't really what I wanted to hear but they were what I expected, more or less. What really has me confused or pissed or a combination of the 2, is that my ex can say anything that he wants to our daughter without repercussions but I'm not allowed to have any communication with her.  tells her out-right lies about me and there are ZERO consequences. When I clarify the "lies" to her, I get blamed for harassing her. And of course, he shares that with CPS. Caseworker suggests I write her a letter. I said that I had contemplated that but dismissed it for fear of getting shit on for it in one way or another. She says that the letter should be OK depending on what it says. So to get a letter to her, I have to bring it to the CPS office and get them to read it first to approve it. They said then that they will forward it to her.

I saw my daughter last week at another CPS meeting. She looked horrible - she was so pasty pale, almost gray. Her face was broke out the worst I've ever seen it. She has packed on about 50 pounds. She isn't singing anymore, she isn't playing guitar anymore, she didn't register for her music exam, she isn't performing, auditioning, acting, nothing. She isn't even going to school if she doesn't feel like it. And she never comes out of her room.

AND CPS thinks that she is doing just fine.

So enough venting for now. I feel better now. Thanks for listening.
Oh and if you have any suggestions on how to deal with this situation, please let me know. I'm thinking of writing regularly to my MLA and the minister of human services until something actually happens. I also have a lawyer working on this for me too. And I have a reporter waiting to receive my situation summary.

That's all for now...........