DBT chat

We have moved the chat to Tuesday. Sorry for the confusion, but I will be consistent from here on. I'm late today because it was raining and my son needed a ride to school. I'm in the chat room now. I also need to post a summary from Saturday morning.

Ok, I've been promising summaries and getting bogged down with other stuff and not getting a round tuit.

We have continued to talk about emotions, and how complex they are, and how breaking it down into smaller pieces makes it more possible to understand emotions. And you have to understand them and accept them for what they are, before you can change them.

Marsha Linehan says, ""If you don't accept that your tire is flat, you're not going to be able to change it."

There are only about eight or so basic emotions (such as Love, Joy, Surprise, Anger, Sadness, Fear, Guilt/Shame), but there are many variations and combinations that go along with those. I have had people argue with me about anger being a basic, or primary emotion. They have learned that anger is always a secondary emotion. It is true that anger seems to be a reaction to feeling something else first, but in the sense that I'm talking about it is a primary emotion in that it is one that people recognize and understand around the world, and that babies can sense and display without having to learn it. Complex emotions are combinations of emotions, learned emotions, patterns of emotions, etc.

In this model, emotions can become prompting events for new emotions. Such as being mad after feeling afraid, or surprised that you felt happy, etc. To understand all of what you are feeling, you can go through the model of emotions with each separate emotion that you notice, and identify the prompting event for each one, your interpretation, what you can sense, how you express it, how you label the emotion, and the aftereffects.

I think I need to explain a little more about aftereffects. These can be whatever you are left with, or what changes for you as a result of the emotion you experienced. "Intense emotions have powerful aftereffects on memory, thoughts, and even the ability to think, physical function and behavior. In a sense, we can say 'emotions love themselves.' They organize the person in such a way as to continue (or keep firing) the very same emotion." (Linehan, p. 89: Skills Trainng Manual for Treating Borderline Personality Disorder) Emotions tend to keep us feeling them, and we can also go numb and attemt to stop feeling emotions. I'm not sure whether to consider going numb an aftereffect, or simply a behavior. What do you think it is?

I thought I had posted the model of emotions in this thread already, but I can't find it. We've been working with this model. I don't know if I can get it to show up here, or if you will need to click on the link to go and look at it:



http://www.dbtselfhelp.com/html/er_handout_3.html

Cool, it looks like that worked. The box that just says "prompting" should say "prompting event 2." Many times, the first emotion is the prompting event for another emotion. Also, the box that says "Brain Change" lists how emotions are experiences or sensed. Another way that is left out is "action urges." The box that starts with "Face and Body Language" is how we show or express emotions, and should also include actions. I like to point out that these two boxes interact with each other. You might express what you sense or expereince, but what you express also changes what you experience. For example, if you smile a lot, you will probably feel happier, or if you go around frowning, or acting mad, etc., you will feel sad or mad.

Today, we worked though this model for an example of Shame. This isn't on the DBTSelf Help website, but comes from the Skills Training Manual. There is a very long handout in the manual that goes through these details for several basic emotions.

Shame has several words, which have different characteristics, but are generally associated with this emotion. Shame words include:

shame, contrition, culpability, discomposure, embarassment, guilt, humiliation, insult, invalidation, mortification, regret, remorse

Some common Prompting Events for shame include:

• Doing (feeling or thinking) something you (or people you admire) believe is wrong or immoral.
• Being reminded of something wrong, immoral, or "shameful" you did in the past.
• Exposure of a very private aspect of your life.
• Having others find out that you have done something wrong.
• Being laughed at, made fun of.
• Being criticized in public, in front of someone else; remembering a public criticism.
• Others attacking your integrity.
• Being betrayed by a person you love.
• Being rejected by people you care about.
• Failing at something you feel you are (or should be) competent to do.
• Being rejected or criticized for something you expected praise for.
• Having emotions that have been invalidated.

Interpretations that Prompt Feelings of Shame could include:

• Believing your body (or body part) is too big, too small, or not the right size.
• Thinking that you are bad, immoral, or wrong.
• Thinking that you have not lived up to your expectations of yourself.
• Thinking that you have not lived up to others' expectations of you.
• Thinking that your behavior, thoughts, or feelings are silly or stupid.
• Judging yourself to be inferior, not "good enough," not as good as others.
• Comparing yourself to others and thinking that you are a "loser."
• Believing yourself to be unlovable.

Some says that you might Experience or Sense shame are:

• Pain in the pit of the stomach.
• Sense of dread.
• Crying, tears, sobbing.
• Wanting to hide or cover your face.
• Blushing, hot, red face.
• Jitteryness, nervousness.
• Choking sensation, suffocating.

Expressing and Acting on Shame might include:

• Withdrawing, covering the face, hiding.
• Bowing your head, kneeling before the person, groveling.
• Eyes down, darting eyes.
• Avoiding the person you have harmed or the people you know you have done wrong.
• Sinking back, slumped posture.
• Saying you are sorry; apologizing.
• Asking for forgiveness.
• Giving gifts, trying to make up for the transgression.
• Trying to repair the harm, fix up the damage, change the outcome.

Aftereffects of Shame could be:

• Avoiding thinking about your transgression, shutting down, blocking all emotions.
• Engaging in distracting, impulsive behaviors to divert your mind or attention.
• Believing you are defective.
• Making resolutions to change.
• Depersonalization, dissociative experiences, numbness, or shock.
• Intense anger, sadness, fear, or other negative emotions.
• Isolation, feeling alienated.

I'd like to comment on shame and guilt, and the distinction between them. They are closely related. The difference is that guilt means to feel bad about something that you do, while shame is to feel bad about somethign about who you are.

Guilt is productive if you have actually done something that you need to change. It can have a function to motivate you to make amends and change your actions.

Shame is more likely to freeze you in your tracks and keep you trapped in those uncomfortable feelings. Believing that there is something about your nature that is bad, wrong, inadequate, or immoral can lead to discouragement and giving up, even when there really is nothing wrong with you, or at least nothing on the scale that you feel it is. It's hard for me to figure out the function of shame. Do you have any ideas? Maybe to communicate to yourself that you feel hurt?

In the chat, it was asked if it is wrong to do some of these things, like apologizing and trying to make amends, if you really didn't do anything wrong. I don't think it's wrong to try to repair the relationship and get on better grounds where both you and the other person understand each other better and get your needs met. I do think that it needs to be balanced. If they are at fault and not willilng to address their part in it, and you keep apologizing and feeling shamed or guilty, then you stay stuck in a cycle that keeps hurting you and keeps you feeling that way. Interpersonal Effectiveness skills would be appropriate for getting out of a cycle like that.

This handout also goes through the model of emotions for love, joy, anger, sadness, and fear. I'm not going to type all of that right now, but might do specific emotions as they come up either in the chat, or if anyone has an interest in a particular one.

I really appreciate all your hard work - I am not here for the live chat so I am very grateful for the information you post - thankyou

Chat in the morning at 10:30 a.m. Eastern time.

For those who may not be aware, there is also a social group for DBT discussion and support.

http://forums.psychcentral.com/group.php?groupid=52

Anyone who wants to join is welcome. Feel free to discuss skills or information from the chats either in this thread or at the social group.

We talked about two things today. One topic was a review of "Wise Mind."

http://www.dbtselfhelp.com/html/wise_mind.html

http://www.dbtselfhelp.com/html/mf_handout_1.html

Emotional mind and rational mind are both necessary, and both have important messages for you. It is good to be aware of them and know what they are saying. However, neither emotional mind nor rational mind has a balanced perspective.

Wise mind listens to both emotional and rational, and finds what is true in both, and puts them together, and finds what is true. Everyone has wise mind. It is quiet, and peaceful, and is the place in you where you know something is true, or valid, in a centered way.

Wise mind listens to all ways of knowing something: observing, analyzing logically, kinetic and sensory experience (feeling or experiencing something in your body), knowing what we do, and intuition. Wise mind is like intuition, but knows more than reasoning or what you can observe directly. Wise mind is experiencing truth, without having to analyze it intellectually.

"Wise mind is like a deep well in the ground. The water at the bottom of the well, the entire underground ocean is wise mind. But on the way down there are often trap doors that impede progress. Sometimes the trap doors are so cleverly built that you actually believe that there is no water at the bottom of the well. Perhaps it is locked and you need a key. Perhaps it is nailed shut and you need a hammer, or it is glued shut and you need a chisel.

"Wise mind is sometimes experienced in the center of the body (the belly), or in the center of the head, or between the eyes. Sometimes a person can find it by following the breath in and out." (Marsha Linehan: Skills Training Manual for Treating Borderline Personality Disorder)

Wise mind is like riding a bicycle. After learning, and experiencing it, you will know what it feels like, and you don't have to learn it again because your body remembers.

To find wise mind, follow your breath in and out, naturally, and deeply. After some time, let your attention settle to your center. Watch where the breath naturally centers itself. That centered place is wise mind. It can help to wet your finger and dampen the place on your forehead where "the third eye" is.

Some other descriptions of wise mind:

• the calm that follows the storm
• an experience immediately following a crisis or chaos
• suddenly getting to the heart of the matter
• seeing or knowing something directly and clearly
• getting the whole picture
• feeling the right choice in a dilemma (feeling from deep within)

Wise mind can feel like emotional mind. After a heavy rain, water can collect on a trap door in the well, and might be confused with the deep ocean at the bottom of the well. When you feel intense emotion, suspect emotional mind. When you feel calm and secure, that's more likely wise mind.

The other topic from chat today was observing the tendency that people with BPD have to lack adequate nonverbal emotional cues. This is something that Linehan observes in her books, and also something that I see in myself and others. As a result of invalidatinf environments, we learn not to show our emotions most of the time. The flip side that goes along with it is that we react in extreme ways when nobody seems to understand how we feel, and then we explode and others wonder where all of that came from, because they couldn't see it coming, since we don't show signs of what we feel until it gets to that point. Much of the time, we aren't aware of our own emotions and we don't see it coming either. We learn to invalidate and discount our own emotions, hiding them to get by and protect ourselves, and then usually get some results when we finally get out of control, so that gets reinforced too.

It might not be all learned. Marsha Linehan says that it is also possible that people with BPD are born with an emotional system that is less obviously expressive than others, and the inborn tendency to underexpress emotions might set up situations in the environment where others don't get the feedback (emotional cues) from us that they need to monitor their interactions with us appropriately, which sets up the pattern and tends to continue it.

I think that people with BPD tend to also be "highly sensitive" and that our sensitivity contributes to toning down our emotional expression, as well as picking up on other people's emotional cues more readily. A lot of this happens outside of our own awareness, but still is sensed and contributes to feeling overwhelmed or overstimulated, and, ironically, also probably contrubutes to tuning out and dissociating and numbing.

I'm interested in what others think about these ideas. I'm not always sure what to do about it, other than to observe and work on being more aware of these patterns and our emotions and what we sense and what we express, and how. With awareness, maybe we can learn to express emotions more easily.

Another observation is that this may be why online communication is more comfortable or easier for some of us. Since the nonverbal cues don't get transmitted anyway, nobody is seeing them or displaying them and one disadvantage is removed or altered. But it can be a crutch because we can get into a comfort zone here and avoid real life communication and interaction.

Feedback is welcome.

Bumping so this is easier to find. Any chance of making it sticky?

Bumping to remind myself as much as anything (I have a cold and my brain is fried and I'm just so tired). Chat is in the morning at 10:30 Eastern Time. Someone wake me up if I'm not there. I'll do my best.

Chat is in progress now.

I am still sick, and I'm in and out of it if you know what I mean. But chat is in the morning and if I'm late someone please wake me up, ok?

Last week we talked about mindfulness in the sense of being mindful of emotions - paying attention to them, or observing and describing emotions. There are several things to pay attention to besides naming the emotion. What do you feel in your body, and where? How do you express the emotion? What action urges are associated with the emotion? What is the function of the emotion? Do you have other emotions related to the first emotion, such as secondary emotions (feeling mad about feeling sad, etc.)?

We also discussed the "Opposite to Emotion Action" technique. To practice this, observe what action urges you have with a painful emotion, and choose to do the opposite.

If you are sad or depressed, the emotion says to hide, sleep, avoid, shut down, etc. To change what you are feeling, do the opposite. Get moving, do something fun, exercise, call a friend, or do something that makes you feel competent.

If you are scared or afraid, you might feel like running away or avoiding the thing you are afraid of. To reduce your fear, face the thing you are afraid of instead (if safe).

If you feel guilt or shame, see where it's coming from. If you do need to apologize or set something right or make amends, then do so. But if you feel guilty or ashamed and you are not doing anything wrong, then keep doing what you are doing. Like if you feel ashamed when you go to T and talk about trauma or abuse memories, keep on talking about it until you don't feel ashamed.

If you feel angry you might feel like breaking something or being aggressive or hurting someone. The opposite could be to stay away from that person, or it could be to do something nice for them, or generally do something constructive.

See 'ya in the morning!

Today we talked more about understanding emotions, and about Opposite to Emotion.

I don't post specifics from chat, but this chat reminded me of some examples from my own life, so I'll use those.

Does anyone here subscribe to Flylady? She's great, and you can find her at flylady.net - anyway, back in 2003, Flylady's theme for the year was "Be kind to me in 2003." I had been following her program at the time, and I could not handle that theme at all, and stopped reading Flylady because of that trigger. She was suggesting tasks that involved self-care and pampering your body. I couldn't deal with it.

If I had known then about DBT skills, and what we have just been learning, I would recognize that I had strong feelings about that because I was afraid of being out of control if I didn't maintain strict discipline with my body (pampering was definitely out - I was restricting eating and also self-injuring in order to maintain control, and was afraid to let go of that). Another emotion involved is shame. I felt worth less than anybody else and undeserving of better treatment.

Opposite to Emotion means not letting the feelings be in control. If you are afraid, you need to face what you are afraid of. If you are ashamed, and not doing something wrong, then do it anyway. Baby steps are always acceptable. So the approach would be to take steps towards doing the self-care even if afraid and ashamed. Note, you don't have to do anything overwhelming. Just little things to start with. You decide what you can do.

I'm also practicing Opposite to Emotion right now by posting this. I almost deleted my personal example from this post because of fear and shame. But I will post it anyway. And then go eat some chocolate and make some warm herb tea. Even if I have to fight through fear and shame to do it.

This week we talked about emotions and Distress Tolerance. Distress tolerance strategies are for getting through the moment, or surviving a crisis. They are a temporary solution, and should not replace managing the situation and/or your emotional reactions. But it isn't always the right time to stop and process emotions. Also, if you get overwhelmed with your feelings or whatever is going on, you can stop and take a break and get back to it later.

So, in your mind, you can have a closet. On that closet, there is a top shelf. You can keep a box on that top shelf in the closet for putting your emotions in when you need to put them away until later. The thing is, you do need to come back and get them out of the box and deal with them. Don't let them pile up in there and overflow or burst out.

Emotions have a purpose. They come from somewhere, for a good reason, and they have something important to tell you. Even if you, like most of us, were taught that you couldn't have your emotions or that it wasn't safe to feel them, you need your emotions. They are an important part of what makes you who you are. They could be trying to tell you something, or to help you to communicate to someone else, or to motivate you to do something. Observe your emotions. Take a step back from them and see what you feel in your body, where it is, how it shows on your face, in your body language, in your words, etc. What does the emotion want you to do? You don't have to act on the action urges, but it helps to know where they are coming from. They you can be in control and decide what to do with it.

When you need to get through intense emotions and painful situations, you can use distress tolerance. Some of these skills build on accepting what you feel and what is happening around you. Some are about distracting, and self-soothing. There are a lot of things that you can try, so find something that works for you, and try a few that you haven't done before too.

Distracting (Wise Mind ACCEPTS )
Activities - go do something, exercise, play a game, call someone, ...
Contributing - do something to help someone else
Comparisons - compare yourself to others coping like you are, or someone less fortunate
opposite Emotions - read something or listen to music or watch a movie that creates different emotions
Pushing away - leave the situation and come back to it, or block it out of your mind for a while
Thoughts - count to ten, do a puzzle, count all the colors you can see, read, ...
Sensations - hold ice, squeeze a rubber ball, take a hot or cold shower, listen to loud music, ...

You can use the 5 senses to sooth yourself. Find something beautiful, listen to music or nature sounds, sing, put on perfume or lotion, get a scented candle, eat chocolate or peppermint candy or gum or a treat, take a bubble bath, pet the cat or dog, get a massage, ...

Some other great strategies to IMPROVE the moment:
Imagery, visualization, go to a safe place in your mind
Meaning - find purpose and remember your values and what you are living for
Prayer - especially for acceptance, or turning things over to God
Relaxation
One thing in the moment - remind yourself you just have to get through this moment right now
Vacation from adulthood (as long as you are responsible and don't check out for too long and make sure your responsibilities are covered).
Encouragement - cheerlead yourself and tell yourself you can do this, and you are doing the best that you can, and it won't last forever.

Also try making a list of the Pros and Cons of tolerating or not tolerating the distress, short term and long term. Focus on your goals, and the light at the end of the tunnel.

Anyone interested is also welcome to come to the DBT social group for more discussion.
http://forums.psychcentral.com/group.php?groupid=52

I promised in the chat that I would post a link to a list of emotions. You will find some good lists if you google "emotions list." If it is hard to figure out what you are feeling, you may be experiencing more than one emotion, or more complex emotions, or maybe you need more practice identifying emotions. I need to get a lot better at it, myself. I carry around a "cheat sheet" (a copy of an emotions list) for when I get stuck. See if you can find the ones that fit when you get stuck.

There are only a few basic emotions. The rest are related emotions - different combinations and intensities. Different theorists name different groups of basic emotions, but they are similar. This page has a chart of some of the basic emotions, and also a tree structure that groups emotions based on the basic ones.
http://changingminds.org/explanation...20emotions.htm

I have a copy of the emotions tree chart in my planner and have kept it for several years. It comes in handy sometimes.

The DBT chat continues each week. I've been keeping the summaries on the DBT social group message board http://forums.psychcentral.com/group.php?groupid=52 because having it all over the place was getting confusing and hard to keep up with. Anyone interested is welcome to check it out.

Forgot to say, we have been discussing mindfulness. So far we have covered states of mind, "what" skills, and started on "how" skills. For further explanation, look at the social group message board. We're planning to follow the outline from here, unless we decide to spend a chat working on something that somebody brings that they would like help with.

is the dbt chat still going on?

I have not been doing chats for some time, but I'm not sure if someone else might be doing a DBT chat.

Ok! Thanks for letting me know!

Okay thanks for explaining

What is emotional regulation worksheet?