Wednesday, February 8, 2012

Reducing Emotional Vulnerability

It may seem like a no-brainer that people need to take care of themselves physically, emotionally and spiritually in order to have a life worth living.  Yet how often do we ignore our basic needs?  As a female who grew up in a patriarchal culture I was taught to feel shame around putting myself first when I needed to do so.  I thought I couldn't say "sorry, make your own dinner, I need to rest."  It just wasn't lady-like.  Instead, I was unconsciously expected others to take care of me in the way they saw fit.

Learning and teaching the DBT skills has given me permission to let go of this old conditioning that demanded that I ignore my needs and feelings.  I've learned that, as an adult, my first responsibility is to stop expecting that other people will magically be aware of and then take care of my needs, and instead, take charge of my own well-being.  In the DBT skills training module titled "Emotion Regulation" one skill that is discussed is reducing emotional vulnerability.  When we actively attend to our own needs on a daily basis we become more resilient to stress and we have more to offer the world because we aren't driving on an empty tank.

Linehan summarizes the skills used to reduce emotional vulnerability using the acronym PLEASE MASTER.  Needless to say, the acronym itself has generated lots of laughs in DBT groups I've facilitated.  Each letter represents a particular self-care skill that we must pay attention to if we want to be at our best.

When I notice that I am feeling "off" the first thing I do is check in with myself regarding the PLEASE MASTER skills.  Have I treated any physical illness (PL)?  Have I gotten enough exercise lately (E)?  Am I well-rested (S) and have I been eating right (E)?  Finally, have I been engaging in mastery activities (MASTER) that help me to feel competent or creative?

Invariably, when I'm having a tough day I can go back and look at these elements and realize that I've been slacking somewhere.  Last night I got home and realized that I'd only eaten a bowl of soup the entire day, and that I was running on four hours sleep.  Not a pretty picture.  So I stepped out and picked up a quesadilla, came home, got into bed, and ate it while watching my favorite TV program.  Then I promptly fell asleep.  This is certainly not a scenario that my mother would have approved of, but I felt really good about identifying my own needs, then taking care of them.  Kinda grown-up and responsible.








Monday, February 6, 2012

Opposite to Emotion Action

Do you ever have the urge to medicate away your feelings of stress or tension?  "Medication" can be any action or substance that serves to get rid of unwanted or uncomfortable emotions.  Drinking alcohol, using drugs, over-shopping, over-indulging in foods, starving yourself, self-harm....all are ways of dealing with painful emotions.  They are effective in the short-term and that's why some of us keep repeating unhealthy behaviors.  The problem, though, is that these responses make life worse in the long-term.  They can lead to consequences such as addiction, debt, health problems and even death.  There is a better way. We can learn to substitute skillful actions for these habitual and self-defeating reactions to stress and tension.

The other day I got home in the evening and noticed I was much more stressed than usual.  My cat had died; I had a very unpleasant meeting with my ex-husband; I'd been wearing uncomfortable shoes for seven hours!  I had urges to take some kind of action to make the feelings disappear.  It felt like being swept up in a tornado.  I had to do something NOW to start feeling normal again!  My mind went immediately to past medicines that had worked.  A drink...or four.  A huge dessert.  A trip to Macy's and a credit card.  But I stopped myself from going there, even though all of these things would have made me feel better in the short-term.  Why?  Because each and every one is an interference in my long-term goals of health, well-being, and financial stability.

How did I stop the madness that was threatening to ensue?  You know the answer:  using my DBT skills.  This time I pulled from the emotion regulation module and used "opposite to emotion action."  I knew I wanted to run out and do something unhealthy so that I could get instant relief from what I was experiencing.  Instead I planted my behind in a chair and just sat still.  I stopped myself from grabbing my keys and heading out the door and instead began identifying the emotions that were causing the stress and tension.  Primary emotions:  grief over the loss of my cat.  Fear around the power held by my ex-husband.  On top of these primary emotions, I had emotional reactions to the emotions themselves (called secondary emotions):  shame that I did not manage to save my cat from a terminal illness.  Shame related to the dissonance in my relationship to my ex-husband.

After identifying the emotions I felt a little less caught up in the whirlwind.  I didn't feel better, but I realized I had more control over how to respond to the feelings.  I decided to take action to make sure I didn't do something I would later regret.  I realized that I had urges to change my state of tension so I figured out how to make this change in a way that wouldn't compromise my long-term goals and values. Instead of gobbling chocolate, I exercised.  Hard.  And for a long time.  45 minute walk/run.  30 minutes of yoga and calisthenics.  Afterward, the tension was gone.  Yes! 

I'm not saying there's no place in life for indulgence.  No way!  Little indulgences are one of the things that make life worth living.  However, I want to be conscious about the times and places I grab that chocolate or credit card.  I don't want to need these things as a crutch to get me through.  Let my "crutches" be skillful, consciously chosen actions that are supportive of my well-being and personal development, and let the occasional indulgences be chosen rewards for a job well done.  Mastering the urges that come along with emotions gives such a sense of strength and serenity.


Wednesday, January 25, 2012

One-mindfully

Worry about the future....recriminations about the past.....how often do you find your mind somewhere other than where you find your body?  Synchronizing body and mind is so refreshing, bringing relief of stress and tension caused by focusing on any moment other than the present moment.  We can use the one-mindfully skill to take the reins of our mind and place our attention on what is going on right in front of us.

The first step is noticing when our mind has drifted into a dream of the past or future.  Set the intention when you arise in the morning to notice when the mind is wandering away from the present moment.  This intention alone will spark moments of "waking-up" to the discursive mind...the mind that plots, re-plays, fantasizes, worries, engages in self-criticism.  You get the picture.

Once you notice that mind and body are in two different places, bring your attention back to the present moment.    Feel the warm water as you wash the dishes.  The smoothness of the keyboard as you type.  The sound of your voice as you speak, or the sound of someone else's voice as you listen.  The senses only operate in the present moment.  They anchor us to the here and now.

It is normal for the mind to wander.  It's no problem that you will have to practice this skill again and again.  Each time we make the effort and have the discipline to return to the present moment we are strengthening our power of attention.  By choosing what we pay attention to we gain mastery over our lives.

Sunday, January 22, 2012

Emotion Mind

In DBT skills training we talk about three states of mind:  wise mind, emotion mind, and rational mind.  Emotion mind is at the helm when any particular emotion is dominating our thinking.  We can be in a balanced state of emotion mind (emotions are appropriate to the circumstances) or move on a continuum to an extreme state of emotion mind (feeling suicidal rather than sad or angry; feeling grandiose rather than happy or proud).

Today I noticed I was often caught up in emotion mind.  I was sad about the loss of a friend who has been in my life for about twenty-three years, and angry about the circumstances of that loss.  Just noticing and naming, "oh, emotion mind...sad," or "ok, emotion mind...angry,"  helped me to take a few steps back, identify and accept the feelings, and know that the feelings are something I am experiencing within my own mind, rather than something bigger or more powerful than me. Difficult emotions are no fun, but by remembering to notice when we are in emotion mind, then going on to name the dominant emotion/s, we are able to relate skillfully to those feelings as they take place in the present moment.  We don't have to "fix" them, change them, or do anything about them.  Just notice.  Try it and see what happens.

By the way, identifying emotion mind is a useful thing to do when we are experiencing more benign emotions, too.  Reminding ourselves, "oh, emotion mind...pleasure," (as we bite into something delicious), or "ok, emotion mind...happy" (as our loved one smiles and gives us a hug) can double the positives of the emotion in the moment, and generally enhance our emotional control over time.

Friday, January 13, 2012

DBT Skills Daily

Dialectical Behavioral Therapy skills are helpful in creating a life worth living.  Originally conceived for women struggling with borderline personality disorder, over twenty years of research has shown that they can have positive effects in the lives of most anyone, not just those diagnosed with a mental illness.  As a DBT skills trainer working in the Hudson Valley, NY, one of the agreements I made in taking the intensive training from Marsha Linehans' Behavioral Tech, LLC. was that I would practice these skills in my own daily life.  I have found this regular daily intention to be remarkably grounding.  In the morning I reflect on my goals for the day and choose a skill that I think might assist me.  I bring it to mind and practice it throughout the day.  For example, if I know I'll be dealing with a difficult family member I might choose one of the relationship effectiveness skills.  If it's going to be a regular workday, I usually pick one of the mindfulness skills.  There are four main sets of skills, and within these modules there are lots of skills to choose from.  In addition to intentionally picking a skill every morning, I almost always find myself spontaneously turning to particular skills I need to navigate unexpected situations that arise.  Give this process a try.  Make friends with the skills.  You can rely on them to help you to create the life you want.