DBT Skills to Know - Emotional Regulation

Dialectical Behavior Therapy (DBT) teaches critical skills relative to Emotional Regulation, which is arguably relevant for people of all backgrounds, behavior types, and with or without mental health conditions. We can all benefit from greater emotional regulation. 

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While emotions are important and feelings are relative in our relationships and day to day life and processing (they help us communicate and understand our experiences), they can also create a great deal of emotional suffering if left unchecked. Many people pursuing DBT do so out of a desire to decrease emotional impulsivity and find relief from the intense highs and lows they experience every day. 

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The goal of the Emotional Regulation module in DBT is to help us learn to name and understand our emotions, decrease the frequency and severity of unpleasant feelings, and diminish the sense of vulnerability we may feel which can lead to stress, anxiety, depression, and other types of suffering. 

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Included below are a series of DBT skills that can help you in your quest for greater Emotional Regulation. 

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STOP

The STOP acronym is a succinct way of reminding ourselves to stop when we feel our emotions are out of control. Rather than reacting and increasing the intensity of our movement, actions, etc, the goal is to FREEZE (even physically, and especially muscles in our face and mouth). This freeze action keeps us from acting without thinking and helps us stay in control. 

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Begin with S (stop). Then, (T)ake a Step Back. In this part of the STOP skill, the goal is to take time to calm down, think, and detach momentarily from the situation that is causing your emotions to spiral. Take some deep breaths, regain control of your body and mind. Don’t be afraid to take time to respond or react to a situation! 

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Then, (O)bserve. In this stage, take some time to review what is happening around you, to you, within you. Think about who or what is involved, and review what others have done/are doing and saying. Avoid jumping into Automatic Negative Thoughts (ANTs) and instead, try not to jump to conclusions. Gather as much relevant information as you can before proceeding with any decision making or communication. 

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Finally, proceed (M)indfully. In this stage of STOP, you’ll want to ask yourself what you want as the best possible outcome, what your goals are for the situation, what choices may make things better or worse, and what decision can create the greatest impact in a positive way for your goals. Review the information you’ve gathered, and use your mindful ability to stay rooted in the present to maintain calm control. 

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OPPOSITE ACTION

This Emotional Regulation skill recognizes that every emotion we feel drives us to respond based on how we are biologically wired. Rather than react on programmed impulse, the OpposIte Action Skill suggests we look toward the OPPOSITE response from our biological programming. 

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For example, when fearful emotions rise, we may feel an urge to escape the situation causing us anxiety. When you feel sad, you may want to withdraw or become passive aggressive. Opposite Action suggest we work toward doing the opposite of what our negative emotions are driving us to do, for instance staying present in the moment even when anxiety rises, or communicating purposefully and directly when sad rather than resorting to passive aggressiveness. 

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ABC PLEASE 

This skill helps us reduce a sense of vulnerability by focusing on critical elements of self-care. Unless we take care of ourselves first, we can’t take care of anyone else and can become susceptible to illness and emotional impulsivity. 

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ABC PLEASE stands for: 

1. Accumulate positive emotions by doing pleasant things. 
2. Build mastery doing what you enjoy (cooking, riding your bike, building a puzzle, playing an instrument, etc.) 
3. Cope ahead of potential crisis by reviewing a plan in order to be prepared for any negative emotions or experiences. 

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Then, PLEASE: 

• Treat illness with medication as prescribed
• Balance your eating to avoid mood swings 
• Avoid mood-altering drugs
• Maintain healthy sleep patterns
• Get exercise to improve positive emotions

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BUILD MASTERY 

This Emotional Regulation skill suggests that doing the things you enjoy and are good at (such as cooking, riding your bike, building a puzzle, playing an instrument, etc as mentioned above) can create a sense of control, competency, and fulfillment. 

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Start by trying something new, such as a new recipe, a speed or distance goal for biking, a complex puzzle or game, etc. Take the time to understand everything involved, and anticipate mistakes. If you need help, seek it out! 

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Next, practice! Working through the practice required to master your skill can create a sense of accomplishment along the way, and can create unity with others as you build relationships around the skill you’re mastering. 

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Finally, give yourself credit as you build mastery. Be proud of everything you’ve done, and when you’ve mastered something, don’t be afraid to challenge yourself with a new goal. 

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COPE AHEAD 

This skill invites you to consider how to prepare appropriately for potentially stressful situations and circumstances. For instance, when preparing a presentation for school, you will have done your research, prepared notes, etc. in order to prepare to adequately execute that presentation. This is a practical way of coping ahead of time, because being unprepared in the moment of your presentation could potentially lead to negative emotions. 

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The best way to Cope Ahead is to rehearse a plan thoroughly. Here are a few ways to get started: 

1. Write down or consider the situation that could bring you anxiety or other uncomfortable feelings. Review the facts of the experience and be specific. Think about the exact emotions and choices that could interfere with your happiness or success. 
2. Consider which problem-solving tools might help you best in the situation, and write out specifically how you might react and review your options if your emotions surge. 
3. Take time to mindfully imagine the potential situation as vividly as you can. 
4. Then, rehearse how you’ll cope effectively in that situation. Rehearse what you might specifically say and do as you imagine this experience. 
5. Finally, take time to relax and reset after working through your Cope Ahead scenario. 

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These DBT Emotional Regulation skills, and others, can dramatically increase your ability to cope and control your feelings in the moment, and to experience greater peace in your everyday life. 

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