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The final module in DBT, Emotion Regulation, was the turning point at which I got with the program, because it really worked when I really needed it.

The goals of emotion regulation in DBT are to understand emotions, reduce emotional vulnerability, and decrease emotional suffering. Hands-down, the most valuable parts for me were learning to observe and describe emotions, and also to accept them, because fighting your emotions just makes the hurt worse. Those skills built off the mindfulness components of DBT and gave me the evidence that it was all valuable if I could be brave enough to accept it.

Describing and Understanding Emotions

The Great Wave by Hokusai makes a great metaphor for emotions.

The Great Wave by Hokusai is a great metaphor for emotions.

DBT uses “wave” model for describing emotion:

  1. Prompting event: something (shit) happens.
  2. Interpretation: how you understand what happened <- YOU CAN CHANGE THIS: it’s a judgment, not a fact.
  3. Emotional experiences: changes in the brain, face, body, sensations, and action urges <- biological, involuntary, automatic, and autonomic reactions to your interpretation.
  4. Emotional expressions: body language, facial expressions, words and actions <- YOU CAN CONTROL THIS: expressions are intentional because you do not have to act on your urges, and at this point, you can also use your physical experience to recognize and name the emotion.
  5. Aftereffects: consequences of your actions — memories, thoughts, physical functioning, behavior, and secondary emotions, e.g., shame in response to expressing anger inappropriately. By exercising control at steps 2 & 4, you can have positive aftereffects, like pride for having acted like an adult instead of a spoiled child. This can lead back into step 1 by creating vulnerabilities to react again; for example, a shame reaction means some trivial thing can become a prompting event when it otherwise wouldn’t.

At first, I didn’t believe that I had any control over any part of my emotions because they had run rampant over me for so long — a very common belief among DBT newbies. It all happened too fast for me to respond deliberately, or so I thought.

I didn’t actually know what emotions I was experiencing… If you’re avoiding your emotions, it’s easy to be clueless about them.

I quickly realized that I didn’t actually know what emotions I was experiencing. They just felt “bad” and I couldn’t differentiate between them very well. Doing the post-hoc analyses helped me learn to associate my physical experience with the emotion I was experiencing, so eventually I recognized that feeling sick to my stomach meant I was afraid. It sounds very basic, but if you’re avoiding your emotions, it’s easy to be clueless about them. Once I was clued in, I could make conscious decisions about how to handle the situation instead of acting on autopilot and regretting it later.

Here’s a rather dramatic example from one of my worksheets, on the second time through the module, which shows that I had actually learned the skills quite well:

  1. Prompting event: Husband got stung by a bee and started having an anaphylactic reaction.
  2. Interpretation: He could die. We have to go to the hospital right now.
  3. Emotional experience: Heart racing, hands shaking, sudden loss of appetite, felt sick to my stomach. Wanted to rush out to the hospital immediately.
  4. Emotional expressions: Calmly said, we’re going to the hospital now. Put food away, made sure I had the stuff needed (wallet, insurance card, book, snack), took my meds, left the house. Dropped husband off at ER, parked car, and then just stayed calm and kept him company.
  5. Aftereffects: Proud that I managed the emergency so well. Relieved that husband was seen right away and quickly improved with medicine. Thankful I knew what to do and didn’t hesitate. Affection for husband.

It was also really useful to have the huge range of words we use to describe emotions boiled down to a few basics: love, joy, anger, sadness, fear, and shame. By reducing the range of emotions I was trying to understand, I started recognizing that frustration is actually anger, anxiety is fear, etc. That might not sound very profound, but by simplifying things, I could associate the physical experience with the right label and then match it to an appropriate response.

I had no idea that I was so afraid so much of the time until I slowed down and took a closer look.

Most people probably don’t need to process emotions so deliberately, but I really did need help to figure it out. I had no idea that I was so afraid so much of the time until I slowed down and took a closer look. At that point, I could start asking myself what I was so afraid of, what was the worst thing that could happen, and whether I was OK with letting fear control me (yeah, not so much.)

Letting Go of Emotional Suffering

Aside from developing some shockingly basic emotional literacy, the other big win for me was applying mindfulness and acceptance to my emotions. This wasn’t easy — no, actually, it’s very easy — but it was terrifying at first.

Surfing is more fun than suffering! Image from Athens Counseling.

Surfing is more fun than suffering! Image from Athens Counseling.

This is one of those things where it sounds like voodoo bullshit and you have to initially take it on faith. First, observe the emotion: recognize it’s happening and don’t engage, just observe. Then experience it. Just let it happen; emotion comes and goes like a wave (the analogy really works here) but if you struggle against it, you’ll exhaust yourself getting nowhere. Likewise, if you let yourself get sucked in, amplifying and embracing the emotion, that also makes it worse. You know what I’m talking about — we’ve all done that, especially with “righteous” anger.

It’s hard at first, but you have to stop trying to control and understand the emotion, and just let it be. At the same time, remember that you don’t have to act, and it will get better. Biochemically, your body can only produce freak-out hormones for 45 minutes before the supply is completely depleted, so things will get better in 45 minutes or less. Yes, it might feel like forever, but if you stop resisting and just let yourself experience the emotion, it probably won’t even last that long!

I discovered that when I was extremely upset, if I just laid down and let myself feel miserable, doing nothing else — not feeding it or struggling against it, literally just focusing on being miserable — I’d get bored within about 20 minutes. At which point, I’d mop up my tears and get on with things. After doing that a couple of times, I realized my emotions weren’t going to kill me and it’s really OK to just let them be what they are.

The last part is to “love” your emotion, which basically means this: don’t judge yourself for being emotional, but be willing to experience it — it’s a big part of what it means to be human. Accept the emotion: you feel what you feel, like it or not, and that’s OK. It’s actually much easier than wasting your energy uselessly resisting reality, which will only make you feel worse. Accepting emotions is very powerful because it’s also validating, and it became part of self-compassion for me. When I felt so rotten that I had to just lay down and cry, I’d tell myself, “It’s hard to feel this way, but that’s just how it is right now. Letting yourself experience your emotions is brave and you will be OK.

And that’s how I handle it today: when I’m overtaken by emotion, I just let it be. I’m self-aware enough to understand what I’m experiencing and I’m strong enough to experience difficult emotions. Sometimes that means excusing myself to the ladies’ room and crying my eyes out in private, but at least I’m not running away from myself anymore.

Pain is a problem of the moment, but suffering is letting the problem cause pain for longer than necessary.

As I learned from another group member, pain is a problem of the moment, but suffering is letting the problem cause pain for longer than necessary. We’re much more in control of our suffering than we’re led to believe. If you can accept your emotions instead of wanting things to be what they aren’t and never will be, you’ll suffer a lot less for it. And if you’re not busy making yourself suffer needlessly, you can be joyful instead — which I highly recommend!