How can emotions be helpful?
1) Motivating one's action: emotions make you do stuff.
2) Communication to others: they convey important information to others without having to actually tell them directly.
3) Communication to yourself: they tell us important information about ourselves; what is important and meaningful.
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Specifically referred to as the “ABC Please” skills in DBT, we try to do what we can to reduce negative emotion[1], we try to re-implement those things that don’t take a lot time to do and provide a great deal of benefit over the near term. Sleep is one of those:
There’s a syndrome called sleep inertia which is the cognitive impairment, disorientation, and groggy feeling we experience when we first awake from sleep. Sleep inertia can negatively impact the brain’s ability to think clearly and our ability to function effectively in performing tasks right after we wake up (Donatelle, 2009). Just think about the challenge it takes to brush your teeth when you wake up after only four or five hours of sleep.
I’ve never heard of “sleep inertia” but I’m not a sleep guy. I just know that it’s important. The term makes conceptual sense, even if it’s just a fancy name for begin groggy.
The stages of sleep include: wakefulness, drowsiness, light sleep, and deeper sleep. It is in the deeper sleep phase where rapid eye movement (REM) sleep occurs. REM sleep is absolutely essential. In fact, missing REM sleep is responsible for our feeling groggy and sleep deprived (Donatelle, 2009).
I recommend that my patients get through at least 2 REM cycles of sleep/night in order to feel well rested. At the very least, make sure you get through at least one REM cycle. For most people, that’s about 4 hours or so.
There are so many little things that you can do to adjust your life to make it a bit better. None of them may be earth-shattering changes, but taken together, they can make a big difference.
Footnotes:
[1]: This is the "ABC Please" skill in the emotion regulation module. In the currently published manual (Linehan, 1993), the skill is referred to as "PLEASE MASTER" but it's going to be changed in the next version.
Answer these questions and I think you’ll have a nice understanding of how one might look at emotions in a different light.
We know how to predict when it’ll rain. We understand the science behind it, but we can’t make it rain or make it stop once it’s started. Sometimes all we can do is prepare ourselves.
Similarly, we understand what creates an emotion. We can pretty well predict what might make someone emotional but we have little control over emotions.
We do have control over how we respond to them.
If it’s raining outside, and you happen to be out there, you’re probably going to get wet. That is, unless you’ve prepared by bringing a raincoat, umbrella, poncho or trash bag. This truism is often the way I frame my discussion of emotion. It’s generally accepted by most people that when it’s raining outside, you’ve got a couple options to avoid getting wet - prepare by bringing the aforementioned gear or don’t go outside. To expect not to get wet without doing either of those things is kind of absurd1. Natural reactions - getting wet - to everyday occurrences - rain - are, umm, natural, and, double ummm, normal.
We don’t expect people not to get wet just by willing themselves to be dry or by believing that if they only thought about things differently, they’d stay dry.
Or that if “normal” people were in the same situation, they’d be dry.
It’s. Just. Not. True.
If someone is able to stay dry in a rain storm, chances are they’ve got a nice big golf umbrella, a good pair of hiking boots and a fancy Gore-tex jacket. You may not have any of those things right now, but you can learn to get them. And, in the meantime, you can work on using what you’ve got, maybe a trash bag or an old newspaper, to keep yourself as dry as possible.
With that tidy metaphor out of the way, let’s get down to the business of learning about emotion. Understanding it so that we know what we’re dealing with. Emotion comes from prompting events. These events can be internal (e.g., thoughts) or external (e.g., a car accident). They can be actual or they can be just perceived. It doesn’t really matter because in dealing with emotions, perception is reality.
A prompting event can lead to an interpretation of that event. These interpretations are deeply personal and are often what people think of when they try to deal with emotions. I don’t know how many times I’ve heard, “If I could just think differently, I wouldn’t feel so bad.” That’s sort of true. And sort of not true at the same time. In other words, just thinking about things differently (or changing your interpretations), is not always going to work to change how you feel2. If it always were so easy, self-help books would be all anyone ever needed for therapy and I’d be out of a job!
A prompting event can also lead to any number of physiological reactions. When you get frightened and get goosebumps? That’s the sort of thing I’m referring to. Flushing face, tension in your shoulders. Additionally, interpretations can also lead to physiological reactions. “Someone’s broken into my house and my life’s in danger” will lead to a racing heart and quickened breathing, for example. These physiological reactions are hard-wired and not something that we can just stop doing3 right away.
We then have what are called, in DBT parlance, “action urges.” These are the things that you are driven to do as a result of the situation/interpretation/physiological reaction. When you’re scared, you run. When you’re angry, you lash out. When you’re ashamed, you hide. Again, these are all considered hard-wired reactions. Think of it from an evolutionary perspective. Back in the day, things that caused fear were often life threatening. It made sense to run when your life was threatened. Right?
So, we have at least 3 sources for the formation of an emotion. There are other potential sources, such as history and vulnerability factors, and we’ll get to those in another post. But, to get back to our metaphor, there are 3 storm fronts that are moving your way and there’s not much you can do to keep them from getting to you. At least right now, all you can do is cope with them4.
Footnotes:
The topic of PMR came up today in one of my groups and I encouraged them to do a google search on progressive muscle relaxation. I figured I’d do the same and post my results here.
I found a site at Arizona State University that has audio of someone reading a PMR script. I haven't heard the audio but the transcript looks good. Have a listen.
In yet another example of how many resources there are on the web, I found Jon Kabat-Zinn teaching mindfulness. Dr. Kabat-Zinn is the author of many mindfulness tomes and one of the creators of Mindfulness Based Stress Reduction. Needless to say, he’s an expert on mindfulness and psychotherapy. Here he is teaching mindfulness.
Marsha Linehan is brilliant. Funny, smart and an extremely good therapist. Most importantly, an extremely good teacher. Here she is at her best teaching mindfulness.
I used to blog my DBT-U class and this is an entry that I have heard is particularly helpful to people. I thought I’d repost it here just to give people more exposure to it.
For homework we reviewed some of the myths and challenges to those myths as well as cheerleading statements in the Interpersonal Effectiveness section. These worksheets were on pages 118 and 119. We again went through some of the challenges and while we were in class, we had several people help one another out with some convincing challenges.
After the break, we covered a lot of material. The new material started on page 121 and went through 126. First we talked about factors to help you determine the intensity of your response to a situation (either asking for something or saying no to a request). The thing to remember with this is that you need to vary your intensity based on a number of factors:
These are things to consider when trying to weigh the intensity of asking for things or saying no. You can find more complete examples and explanation on page 121-122.
We then went into some suggestions for practice (this was also the homework). You can find these examples on page 123 in your book. The homework was to try to do one “easy” thing on the list and one “hard” thing to do. It might help to rank order each item 1-3, with 1 being easy and 3 being hard.
Finally, we talked about DEAR MAN. This is the first of many acronyms we’ll use to help you remember what we talked about in class. You use DEAR MAN when you’re making a request or trying to say no. It’s a nice framework to help you remember an effective way to do this. Remember that you don’t always have to use each thing in every situation, but it helps to do them all if you’re not sure.
D: Describe the situation.
E: Express how you feel about it.
A: Assert your request.
R: Reinforce the other person for giving you what you want.
M: Stay mindful.
A: Appear confident.
N: Negotiate if needed.
It was a very full class, as you could see. We’ll continue talking about Interpersonal Effectiveness next week.