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@philosophin Do you actually fill out your diary card every week? How many skills do you usually practice each week (just a guess)?

I'm working on WISE MIND today (I jump from extreme to extreme: crazy emotional mind, to the rational mind that wants to research & ruminate and not take any action). I have a hard time with the "Middle Way". I'm starting from the beginning of my workbook again. I get something more out of it, everytime I revisit! DBT offers such a great Toolkit. I thought it might be helpful for others to have a bit more of a snap shot or "cheat sheet" of the skills. I found online:

THINKING “DIALECTICALLY” MEANS:
Maintain openness to contradictory/polarised thoughts and points of view and blend these thoughts into a “truth” which best explains reality at the given moment.

WISE MIND
Emotion mind is the feeling mind (the “Sensitive Artist”). Reason mind is the factual/knowledge mind (“The Scientist”) WISE MIND is the way they intersect and work together with intuition.

OBSERVE/JUST NOTICE
Look at the situation without emotion or judgement. Just notice what is happening without trying to change it.

DESCRIBE
Put words on it. Describe the event without judgement or emotion. “Just the facts”

NON-JUDGEMENTAL STANCE
Avoid labeling something as “good or bad” Just observe, describe, participate.

EFFECTIVENESS
Focus on what works. Keep an eye on your objectives.

MINDFULLY
In the moment. Focus all of your senses on what you are doing/thinking at a particular moment. If you notice other thoughts entering your mind, follow them, but let them go.

 

6-DBT-Skills-Training-Quick-Reference-Sheet-by-Rachel-Gill.png

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ABC is so difficult for me!!

A: I try to always accumulate positive experiences, I put myself out there, I try new things, but many times something bad happens and I get triggered into the negative. For example: I push myself to be social, meet new people and initiate something fun, then I get flaked on (several times) and this "positive experience" turns into a negative triggering one! (or, people I do meet, I don't connect with at all). Other: I psych myself up to try a new fitness class or go to a concert and I don't get any pleasure out of it at all (therefore, cue negative emotions which starts negative feedback loop)...

B: Building Mastery. Ugh this is extremely difficult for me. I have a relentless inner-critic & perfectionist inside that won't stop. Any time I do anything (even if I do something well, and other people tell me I did well) The voice inside beats me down and I feel hopeless, worthless, not as good as others...why bother mentality. You know that show called "The Biggest Loser" well, I'm the "Saddest Winner" I never meet my inner unobtainable expectations.

C: Cope ahead of time. Hmmm, I'm not sure I fully get this one. Does this mean prepare in advance for unexpected setbacks? Like make a Plan B or something? Or does this mean that you should mentally/emotionally prepare in advance to better cope with a potential difficult situation?

Would love to hear anyone's thoughts/suggestions on these.

Edited by Blahblah

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Since I am still in a DBT program, yep, I fill out my diary card.

3 hours ago, Blahblah said:

ABC is so difficult for me!!

A: I try to always accumulate positive experiences, I put myself out there, I try new things, but many times something bad happens and I get triggered into the negative. For example: I push myself to be social, meet new people and initiate something fun, then I get flaked on (several times) and this "positive experience" turns into a negative triggering one! (or, people I do meet, I don't connect with at all). Other: I psych myself up to try a new fitness class or go to a concert and I don't get any pleasure out of it at all (therefore, cue negative emotions which starts negative feedback loop)...

B: Building Mastery. Ugh this is extremely difficult for me. I have a relentless inner-critic & perfectionist inside that won't stop. Any time I do anything (even if I do something well, and other people tell me I did well) The voice inside beats me down and I feel hopeless, worthless, not as good as others...why bother mentality. You know that show called "The Biggest Loser" well, I'm the "Saddest Winner" I never meet my inner unobtainable expectations.

C: Cope ahead of time. Hmmm, I'm not sure I fully get this one. Does this mean prepare in advance for unexpected setbacks? Like make a Plan B or something? Or does this mean that you should mentally/emotionally prepare in advance to better cope with a potential difficult situation?

Would love to hear anyone's thoughts/suggestions on these.

A: it sounds like you are picking the wrong things and possibly trying to do something too big?  What about something from the Pleasant Events list?  I would start with small things several times a day.  Alternatively, you can practice radical acceptance of the fact that sometimes, people are flakes and that not every "pleasant" event is necessarily going to feel that pleasurable.

B: Do easy stuff at first!  It can be something as simple as doing your laundry.  What about mindfulness of thoughts and/or mindfulness of current emotion as well?  It sounds like there's lots of emotionally-driven rumination going on.

C: I LOVE Cope Ahead!  You imagine something painful that might happen in the future and make a skills plan for how you are going to deal with the unwanted emotions that arise.

Hope that helps!

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And let's look at the diary card and see how many skills I've practiced in the past week:

1.Describe

2. Nonjudgemental stance

3.Effectiveness

4.Values

5.Pleasant Events

6.Building Mastery

7.Cope Ahead

8.PLEASE

9.TIP

10.Radical Acceptance

11. DEAR MAN

Blahblah, would you like to practice nonjudgmental stance with me today?  I'm simply observing judgmental thoughts as they arise.  It's hard to remember to do when it's a skill you have to use on the fly.

Edited by philosophin
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Wow! Go you! You are rockin' the skills, haha. Thanks for the feedback this is very helpful advice & perspective. I need to go easier on myself and learn to acknowledge & celebrate even the smallest successes. Then I can build from there.

I would totally be down for working on the nonjudgmental stance this weekend (I'm 9 hours ahead of the US so it's time for bed soon). That is one of the hardest skills for me also. I need to let my thoughts just be "neutral" objective thoughts. They are always self-judgements and it's so automatic, unconscious that I'm battling to break the pattern. Before I can even blink, I'm drowning in an emotional tsunami, I can't breathe :-(

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You can start by simply observing judgmental thoughts and saying to yourself, "That was a judgmental thought."  Acknowledging that you are being judgmental goes a surprisingly long way in placing some distance between yourself and that mindset.

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I've had a good few days...I hadn't specifically set out to practice specific skills, but there are some things that qualify..

I did many things on the self-care, mindfulness & pleasant activities lists: gym class, had 2 very nice dinners at restaurants and mindfully focused on the meals, went to an event/show and socialized with some people, and spent a rainy day in a comfy cafe and enjoyed a long coffee without looking at my phone (mindful!)

I've been trying to practice "non judgmental" letting my thoughts pass by and trying not to become too attached. Turning the mind towards future positive experiences (holiday travel/vacation).

Effective: Don't know if this qualifies, but I had 2 work meetings that went well today, despite being extremely tired from waking up at 4am...I was focused and productive. Also participated in my afternoon class.

I have been practicing "DESCRIBE" with my husband and trying to describe positive experiences (instead of voicing only negative emotions, complaining)

I'm sure there are more....like PLEASE (i do this everyday!)

Edited by Blahblah

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7 hours ago, Blahblah said:

I've had a good few days...I hadn't specifically set out to practice specific skills, but there are some things that qualify..

I did many things on the self-care, mindfulness & pleasant activities lists: gym class, had 2 very nice dinners at restaurants and mindfully focused on the meals, went to an event/show and socialized with some people, and spent a rainy day in a comfy cafe and enjoyed a long coffee without looking at my phone (mindful!)

I've been trying to practice "non judgmental" letting my thoughts pass by and trying not to become too attached. Turning the mind towards future positive experiences (holiday travel/vacation).

Effective: Don't know if this qualifies, but I had 2 work meetings that went well today, despite being extremely tired from waking up at 4am...I was focused and productive. Also participated in my afternoon class.

I have been practicing "DESCRIBE" with my husband and trying to describe positive experiences (instead of voicing only negative emotions, complaining)

I'm sure there are more....like PLEASE (i do this everyday!)

Good work!  I haven't been feeling too great and have been lazy about practicing skills...therapist wants me to focus on PLEASE and pleasant events for now.

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@philosophin It's good to go back to skills that come easily for you when you feel particularly down or lazy :-) What specific pleasant activities do you try during the week? Are there certain parts of PLEASE that are most difficult to commit to?

For today I thought I'd make a list of some SELF SOOTHE activities to use during times of stress (I realize these often wont work or may sound stupid, but they are worth trying). I try to include activities that use the 5 senses: SIGHT, SMELL, HEARING, TASTE, TOUCH. Anyone have any to add?

SIGHT: Looking at photographs or Pinterest, coloring a mandala, walking in nature/park, tidying up/decorating apartment so it doesn't look messy...

SMELL: Using nice scented shower gel, lotion or perfume, burning candles or incense, using a cucumber/avocado face mask

HEARING: Listening to music, a meditation app, rain sounds.

TASTE: Mindfully eating a piece of chocolate (or whatever you like), baking a pie with cinnamon/spice, having tea, flavored latte/coffee, cooking a new flavorful recipe.

TOUCH: Petting a cat, getting a massage (or hug), napping under a soft blanket, wearing your favorite comfy robe, sweater, scarf or hoodie, slippers, etc.

OTHER: Watching Youtube for random videos (cats, music videos, etc), painting nails a bright color, stretching, yoga or dancing, taking care of a plant, working on a craft or art, jewelry making, playing an instrument, reading, movies, talking to therapist or supportive family member/friend............

Does anyone know any productive techniques to deal with intense emotions like Anger (ex: holding an ice cube and counting backwards, snapping a rubber band on wrist, screaming into a pillow, going for a run, journaling/writing down all your emotions,focusing on your breath.....)??

 

 

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11 hours ago, Blahblah said:

@philosophin It's good to go back to skills that come easily for you when you feel particularly down or lazy :-) What specific pleasant activities do you try during the week? Are there certain parts of PLEASE that are most difficult to commit to?

For today I thought I'd make a list of some SELF SOOTHE activities to use during times of stress (I realize these often wont work or may sound stupid, but they are worth trying). I try to include activities that use the 5 senses: SIGHT, SMELL, HEARING, TASTE, TOUCH. Anyone have any to add?

SIGHT: Looking at photographs or Pinterest, coloring a mandala, walking in nature/park, tidying up/decorating apartment so it doesn't look messy...

SMELL: Using nice scented shower gel, lotion or perfume, burning candles or incense, using a cucumber/avocado face mask

HEARING: Listening to music, a meditation app, rain sounds.

TASTE: Mindfully eating a piece of chocolate (or whatever you like), baking a pie with cinnamon/spice, having tea, flavored latte/coffee, cooking a new flavorful recipe.

TOUCH: Petting a cat, getting a massage (or hug), napping under a soft blanket, wearing your favorite comfy robe, sweater, scarf or hoodie, slippers, etc.

OTHER: Watching Youtube for random videos (cats, music videos, etc), painting nails a bright color, stretching, yoga or dancing, taking care of a plant, working on a craft or art, jewelry making, playing an instrument, reading, movies, talking to therapist or supportive family member/friend............

Does anyone know any productive techniques to deal with intense emotions like Anger (ex: holding an ice cube and counting backwards, snapping a rubber band on wrist, screaming into a pillow, going for a run, journaling/writing down all your emotions,focusing on your breath.....)??

 

 

Hi Blahblah!  Yeah, certain parts of PLEASE are very difficult for me.  Avoiding ("A") mind-altering substances altogether is not really possible at this point.  I've been working with my therapist for some time on this.  I really think rehab is the ideal solution but my husband doesn't think I need it, so that's out of the question for now.  Also, sleep ("S") is the other thing I struggle with.  I don't sleep a consistent schedule, and often wake up multiple times a night and get out of bed.  I've got some ideas on how to correct the issue, I just need to implement them.

As far as pleasant activities go, I have a hard time making myself do them due to the inertia of depression, but when I do, I usually get at least a little enjoyment out of them.  I do stuff like paint my nails, put on makeup, watch Youtube or TV, go shopping or window shop, and read magazines.

I think your self-soothing ideas are great!  I might be able to add a few more but I think it's a pretty individual thing in terms of what you are going to find soothing.

About anger--there are a few things you can do to act opposite to the emotion.  You can try looking at the situation from the other person's point of view, being as charitable as possible (I find this VERY difficult though).  You can try progressive muscle relaxation.  You can do willing hands and half-smile.  You can do paced breathing.  You can exercise.  I wouldn't recommend screaming into a pillow because it's thought to feed into anger.  I think any of the other ideas you listed might work though.  Thanks for bringing this up because anger is a big issue for me and it's good to review what to do about it.

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@philosophin Are there DBT skills that help with addiction that you are trying to use (you mention pot/booze?)? Alcohol is a tough one for me as well, I know it is really bad for depression and it often has the delayed effect (where I feel buzzed and good and then a couple days later after the hangover wears off I feel more depressed). I am often able to cut out the hard liquor, but I find myself being unable to avoid drinking altogether if I go out socially (I had 2 glasses wine and 2 margueritas last night) ;-/ Another factor is I'm trying to meet new people here and meeting up with complete strangers is stressful and anxiety-producing. Anyhow, I struggle with that too.

as far as anger, my problem is anger turned inward (= depression). I never lash out at others (although often my anger is triggered by other people) then I'm alone and I get so angry at myself and the ruminating thoughts start up about being a failure, worthless or whatever. Many of the techniques don't work on this, I usually just ride it out, continue to take meds, try to relax or whatever until it dissapates. oh I totally forgot about the half smile thing that one is sort of bizarre!

I was going to add (but I just noticed that you are already on 300mg Wellbutrin) Wellbutrin had the effect of completely wiping out all alcohol & food cravings for me. It didn't do a thing for my mood, but I'm curious if you ever noticed that effect when you started it? Ironically, Cymbalta had the opposite effect (I drank much more on it for some reason, and craved it) Meds are wierd.

 

Edited by Blahblah

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Yeah, there are DBT skills that help with addiction.  I don't know if you saw this in your materials as I don't think it's included by default, but there's a bunch of modified distress tolerance stuff (since DT is pretty much what resisting cravings/urges is) that can be used.  Here's what my binder says are the skills you can use--let me know if you want more details about any of them:

1.Plan for Abstinence

2.Plan for Harm Reduction

3.Clean mind behaviors vs. clear mind behaviors

4.Reinforcing nonaddictive behaviors

5.Burning bridges and building new ones

6.Alternate rebellion/adaptive denial

Right now, I am focusing on my sex addiction, which I don't mention in my sig.  I am married so being a sex addict is quite problematic, to say the least.  I have managed not to engage in any unwanted behavior for a couple of months now.  

Anger turned inward is tricky to deal with.  If you think it's ultimately depression, though, I would use opposite action skills for depression to take mental attention away from the angry ruminations.  What do you think about that idea?  You could try it a few times and see how it goes.

No, I never noticed any decrease in appetites when I started WellB many years ago.  In fact, I restarted a cigarette habit while taking it--wtf?!  Thankfully, I have since quit the cancer sticks.  I'm probably doing enough damage to my lungs with the pot as it is.

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Well...I'm not sure if I used any skills in the last few days. I've been busy and occupied so less time to sit and stew about things. Plus, the Effexor is really kicking in. I've felt unemotional and spaced out since the day i started it. I've done various activities, work, was social, exercised, went out for dinner/drinks...took care of some cleaning & chores like organizing the closet. But I didn't really focus on any skills. I just feel like a space cadet, it's bizarre, but nice for my overwhelmed mind to have a break. My head feels empty/void of any thoughts. disconnected from my body. No cares, no worries. I hope it doesn't screw me up cognitively, or mess with my memory.

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