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I just plain didn’t get to writing up separate posts for the last couple of weeks of DBT, so today you get a double-plus emotion regulation extravaganza! This module has been pretty helpful for me so far as I struggle with emotion regulation more than I ever understood.

Week 22 focused on mindfulness of the current emotion. Some of this goes against instinct, but it works. Step one is to observe the emotion – notice that it is there and try to view it objectively. You can’t do anything to change the emotion if you don’t know that it’s taken over.

Second, experience it. Instead of blocking or suppressing or holding on to the emotion, let it come and go without making more of it than it is. That’s where you have to get totally zen and it’s going to take some practice for anyone to get there. Personally, if it’s a panic attack or worsening anxiety, I do this until the Ativan kicked in. There’s a reason I have that stuff, and no reason to let the pain go on longer than necessary.

Third, remember that you’re not your emotion and you don’t have to act on it. The instructions say to remember when you’ve felt different, but I also find it helpful to think about when I’ve felt the same and everything turned out OK, e.g. the panic attack didn’t kill me the last time, so it probably won’t this time either.

Finally, the kicker: practice “loving” your emotion. There’s a cheesy “dandelion” story that goes with this, but I’m not going to perpetrate it upon you here. The instructions say not to judge the emotion, be willing to experience it, and  radically accepting your emotion. You feel what you feel, not what you’re supposed to feel or what you want to feel. Admit it and reduce a little suffering in your life.

A random quote about mental illness that I particularly like.

This sparked an interesting conversation about the difference between pain and suffering. An enlightening comment was that pain is the problem of the moment, but suffering is letting the problem cause pain for longer than necessary. It’s an interesting perspective that I think merits a little thought. It certainly justifies the occasional PRN anxiolytic.

The homework was to repeat the worksheet for reducing painful emotions. I think the repetition, each week adding a new section, is really helping. I’m being more conscientious about trying to take care of things like sleep, exercise, and eating (of course, the better I feel, the easier that is.) I’m trying to do things that make life a little more pleasant, forcing myself to recognize that I’m making progress, admitting that I’ve been pretty isolated, and owning up to avoidant behaviors that inevitably worsen the situation. As for mindfulness of the current emotion, well, I’m trying. Experiencing difficult emotions and just sort of surrendering to them is challenging when I work so hard to try to control them.

On to week 23. This is more effort than I expected. But here we go…

The new strategy for the week was changing emotions by acting opposite to the current emotion. That’s not a fake-it-til-you-make-it proposition, however. We watched Marsha Linehan’s own video lecture for this content (on a VCR, can you even imagine?) which had a lot of good details.

There were specific strategies for four categories of emotion: fear, guilt or shame, sadness or depression, and anger. An important concept is that each emotion has a related action. With fear, it’s avoidance; for guilt and shame, it’s hiding. Withdrawal is the in/action of depression and sadness, and anger goes with attacking. I’m not going to go into a lot of detail here, but basically all of the strategies involve approaching the cause of the emotion and facing whatever triggers it, except for anger, in which case it’s better to avoid whomever/whatever is pissing you off.

The steps that Linehan outlined for “acting opposite” are:

  1. Identify the emotion
  2. Identify the action associated with the emotion
  3. Decide whether you want to reduce the emotion
  4. If so, figure out the opposite action.
  5. Do it.

This was followed by discussion of what makes an emotion justified or not. The video discussed what justifies fear and anger and the group leaders provided their own handout for guilt/shame. Then I had to open my big mouth. I pointed out that some of the criteria and strategies focus on relationships, but what if the person you’re angry at or harm by your actions is yourself? I had to clarify by saying how Hippie Dude says I’m too hard on myself and that I’m a perfectionist to a fault (a lot of people say they’re perfectionists but have no idea how far that can go…)

After the session, one of the group leaders slipped me a note with a book title on it, I Thought It Was Just Me (but it isn’t): Making the Journey from “What Will People Think?” to “I Am Enough”, by Brene Brown. That sort of hit a sore spot. I actually convinced myself that I wasn’t a perfectionist for years, but let’s admit it. I filled in a few assessments and am unquestionably guilty as charged. Although it seems related to Imposter Syndrome somehow, perfectionism wasn’t something that I recognized as an “issue” until only recently, so I ordered a couple of books from Amazon. Seems I’ve found yet another issue to work on in therapy. Yeeha.