Category: DBT Skills

This transcription was auto-generated by YouTube. I’ve only added minimal editing, so I apologize for any errors, run-on sentences, etc.

Think about what it feels like to be sad or anxious or angry. How do you know that you’re experiencing a certain emotion? What is it that signals to you that you’re sad rather than happy or content? Or that you’re anxious or angry rather than calm or relaxed?

We generally experience our emotions through our bodies. And we often use the words emotions and feelings interchangeably. And talk about feeling sad feeling angry and so on. And that’s because we really do feel our emotions. There are actual physical feelings in our bodies that we associate with them. In my last video we learned how to regulate our emotions by naming validating and accepting them. In this video we’ll learn to regulate emotions through how we relate to the physical sensations in our bodies associated with our emotions.

There’s often a general physical feeling that accompanies an emotion. Our bodies feel heavy when we’re sad, jittery or tense when we’re nervous or anxious. We might feel hot if we’re angry or warm all over when we’re happy, and so on.

There’s also usually a sensation in a specific and localized part of our bodies that goes along with our emotions. We might feel a lump in our throats or broken-hearted if we’re sad. Or a tightness in our throats or chests, or heart palpitations or butterflies in our stomachs if we’re anxious. Or our heads might feel like they’re going to explode if we’re angry.

So because of this close relationship between our emotions and physical feelings in our bodies, if we’re able to calm the physical manifestations of our emotions and they start to subside, our emotions tend to calm down and feel less intense as well.

So in terms of a general feeling throughout your body associated with an emotion, if you’re feeling some sort of physiological arousal like with stress or anxiety or anger and your heart rate or blood pressure are elevated, or you have a lot of pent up energy and have trouble sitting still, in order to regulate your emotion you need to calm this physiological response.

One way to do this is by slowing down your breathing, and a good way to do this is to breathe in through your nostrils and then breathe out through pursed lips because the pressure of your lips forces your exhalation to be slower. And once you slow your breathing down for a couple of minutes your level of physiological arousal will naturally start to decrease.

And doing something a little active like going for a walk can also help, but a slow relaxing mindful walk not a frantic pacing back and forth. And perhaps tying your walking in with your slowed down breathing, so walking relatively slowly and then taking three or four steps per breath. So in, step, two, step, three, step. And out, step, two, step, three, step. And walking like this is a great way to decrease physiological arousal and calm yourself down.

Or in the case of feeling lethargic or a lack of energy that often accompanies sadness or depression, doing something a little more active can help lift the feeling of heaviness in your body. And i talk about this in more detail in my video on behavioral activation that you’ll find in the playlist that accompanies this video, in the description and pinned comment.

And now let’s look at the more localized physical sensations like a tightness in our throats or chests or, butterflies in our stomachs that often accompany our emotions. But first we’re going to do a quick exercise.

So in a moment I’m going to ask you to take a deep breath and hold it for as long as you can. And I’ll keep a timer on the screen, but try not to look at the timer until you’re done. And then make a note of how long you held your breath for. And I’ll keep talking about emotions while you’re holding your breath so you don’t get bored and go watch something else instead.

So I’ll count down from three and then take a deep breath and hold it for as long as you can. Three, two, one, go.

Now these localized physical sensations that we feel in our bodies that are related to our emotions can be very distressing. Sometimes they can be acute and come and go throughout the day and when we do become aware of them they can feel extremely intense. Other times they can be more chronic and we notice that feeling in our chests or throats or stomachs from the moment we wake up until the moment we go to bed and fall asleep. And if we wake up during the night it’s still right there.

And these sensations can be so distressing, not just because they’re so uncomfortable, but because they’re so persistent. We’re sure there’s a physical medical issue that’s causing them. And it’s not uncommon for people to make multiple trips to multiple doctors to try to figure out what’s wrong with them. And when the doctors can’t find any underlying medical issue it can be hard to believe that all of this physical discomfort can be caused by emotions and psychological distress.

So what can we do to try to calm these physical sensations, and as a result help calm our emotions as well. Like with all of our unpleasant internal experiences the first step is to accept them. Not because we like them, but because anything other than acceptance is only going to make things more unpleasant. And if you don’t know what we mean by acceptance in this context check out the videos i link to in the pinned comment and description.

Okay it’s been a while now so you’re probably not holding your breath anymore, so just make a note of how long you held it for and we’ll talk about why you just did this in a few minutes.

Unfortunately we can’t just make these body sensations go away because we don’t like them. And when we fight with our internal experiences like thoughts emotions and body sensations and try to ignore them shut them out, or force them to go away they only gain more strength.

Our bodies tense up as we strain to fight these feelings, which exacerbates the feelings of tension in our throats chests or stomachs. And any negative reactions we have to them like, damn it’s still there, why do i always feel this way, when is it going to end, it’s just going to make them more difficult to tolerate, because our subjective experience of them will be worse, because now we’re faced with not just the unpleasant physical sensation but with our negative thoughts about them as well.

And our negative thoughts have a negative effect on our mood and will tend to increase the intensity of our emotions, which in turn will make the physical sensations more intense as we get stuck in this vicious cycle. And that’s something i talk about more in my video on distress tolerance and the difference between pain and suffering. So once again we’re left with the problem of how do we accept these things that we find so unpleasant.

Well first we can try to adopt an attitude of acceptance through calming thoughts and statements that we say to ourselves such, as whatever’s here right now is okay. This is my experience right now. Whatever it is, is already here. There’s nothing i can do to keep it out. There’s no need to fight it or struggle with it or try to make it go away. And just allowing myself to be open to it.

And the more you stop resisting your unpleasant body sensations the less they have to fight to be acknowledged. And as a result the more likely they are to lessen a bit in intensity. Now this doesn’t mean they suddenly go away. Our emotions and corresponding body sensations are like waves. They may seem like a constant and monolithic force but when we start to pay attention to them we can start to notice their ebbs and flows.

They often come into our awareness when they’re at their peak, either because that’s why they’ve drawn our attention, or because when we check to see if they’re still there they tend to perk up like they know we’re talking about them and they start to swell a bit. But if we’re able to just allow them to be there, after the initial swell they tend to crest and then start to dissipate and trough. And then they’ll swell up again and then contract and continue like this to ebb and flow and wax and wane.

And so when you have an uncomfortable feeling in your body rather than fighting it, just allowing it to be there and noticing what’s going on in your body as you hold it in awareness. And tuning into any feelings of tension or tightness or discomfort, and then breathing into these sensations using your breath to bring your awareness to them on the in-breath, and then breathing out of these sensations and seeing if they soften or relax on the out breath. And just letting your experience of these sensations be whatever and however they are from moment to moment. And if you’d like to try a short guided meditation that incorporates some of what we’ve just talked about in the last section of the three-minute breathing space we practice breathing in and breathing out a physical sensations in our bodies.

So let’s go back to the holding your breath exercise. We’re going to do it again now but this time with some guided instructions. While you’re holding your breath, and again there’ll be a counter on the screen but try not to look at the time until you’re done and then make a note of how long you held your breath for, so counting down from three, two, one, start holding your breath.

And now while you’re holding your breath, whenever you notice you’re having the urge to breathe, try to notice exactly where you’re feeling this urge in your body and whatever the body sensations associated with this urge to breathe are.

And then seeing if you can just allow these uncomfortable feelings to be here without taking a breath yet. And seeing what happens to this urge to breathe as you just open yourself up to it, allow it to be there, and allow yourself to experience it however it feels, without fighting it. And seeing if you can continue to hold your breath despite the uncomfortable feeling you’re having. And then when the urge to breathe starts to become overwhelming, take a breath and record how long you held your breath for. And I’ll just leave the timer up for a little bit longer in case you’re not done yet.

Now take a moment to think about any differences you noticed between the two times you held your breath both with respect to how long you were able to hold your breath for and what your experience was like while holding your breath.

Most people find that they hold their breath longer the second time, when they’re simply accepting of their experience for what it is allowing in that discomfort and urge to breathe and just watching it and letting it be there without resisting fighting or trying to change it or make it go away.

And so this exercise can help illustrate that the way we respond to discomfort and unpleasant feelings can change how we experience them. And that if we simply let them in and allow them to be there instead of engaging in our tendency to try to fight them or shut them out, they can become more tolerable and manageable.

And this is borne out by research into pain management that shows that responding to chronic physical pain with mindfulness and acceptance can reduce subjective pain intensity ratings by an average of forty percent. Now that’s a lot less than a hundred percent, so acceptance isn’t a magic cure that automatically makes discomfort go away, but a forty percent reduction is significantly better than nothing.

So when we don’t have the option to make our uncomfortable or unpleasant body sensations related to our emotions just disappear, why not try accepting them and make them significantly more tolerable and manageable? And the more we’re able to just accept these uncomfortable physical sensations, the more likely they are to lessen in intensity. And as a result we begin to experience a corresponding reduction in the intensity of the emotions associated with these sensations. So by learning to accept these uncomfortable physical sensations we learn to regulate our emotions as well and in the next video we’re going to look at the difference between emotion regulation and distress tolerance.

This transcription was auto-generated by YouTube. I’ve only added minimal editing, so I apologize for any errors, run-on sentences, etc.

Stop is a distress tolerance skill from dialectical behavior therapy and a great tool to use whenever we’re feeling overwhelmed or in distress or experiencing uncomfortably strong emotions. Stop is an acronym that stands for stop, take a step back, observe, and proceed.

When we stop we stop whatever we’re doing right away. If we’re talking or arguing with someone, we stop. We shut up. We don’t say anything more. If we’re working, either at our jobs or doing something around the house, we stop working. Not as soon as we finish whatever we’re working on. We stop right now. If we’re doing something on our phones, we stop and put them away. If we’re engaging in some impulsive or self-destructive behavior. We stop that.

Stop sounds like a really simple instruction, but sometimes it’s hard to stop, either because we’ve already gathered so much momentum it can be hard to put on the brakes, or because we want to keep going so we can just finish whatever we’re in the middle of. Or we don’t want to stop because stopping means we’re going to have to acknowledge something we’re trying to avoid, like a conflict, or some uncomfortable thoughts or feelings, and we’d rather just keep going so we don’t have to think about this problem, and can just keep ignoring it.

But the longer we wait to stop, the more dangerous things become, and the more likely it is we end up past the point of no return and find ourselves in the middle of some sort of crisis that can be really difficult to get out of. So as soon as we notice we’re starting to feel distressed, or overwhelmed, or panicky, or frustrated, or angry, or engaging in some impulsive or unwanted behaviors, or having any other sort of strong negative experience, that’s when we need to stop right away.

And then as soon as we stop we take a step back. The t in stop stands for take a step back, but i also like to think of it as t for time out. Taking a step back is like taking a time out. It gives us a chance to remove ourselves from the situation, get some perspective, and calm ourselves down.

And the t can also stand for take a breath. One of the best things we can do to help calm ourselves down is to take a few breaths, slow down our breathing, and follow our breath for a few moments, using our breath to help reconnect ourselves with the present.

And then we observe. We observe what’s going on outside ourselves, and in particular what other people are doing. We observe our own behavior, what we’re saying and doing and how we’re acting. And we observe what’s going on inside ourselves, observing our thoughts feelings and emotions and the physical sensations in our bodies.

Observing makes us more aware, gives us some perspective, and it helps us see things more clearly and gives us the information we need to take the final step, p, which stands for proceed. But i also like to think of the p as standing for plan. So before we proceed we can take a moment to reflect on what we’ve observed, figure out our goals for the situation and the most effective way we can accomplish them.

If we’re having a conflict with someone else, we can plan how to de-escalate, how we’d like to resolve the situation, and what we’d like to say. If we’re acting impulsively or out of emotional mind, we can plan to connect with our wise mind. And if we’re frustrated with something we’re working on, we can plan what we need to do to complete the task. And if we’re experiencing negative thoughts or our minds are racing, we can plan to do something to help calm our minds. And if we’re experiencing some uncomfortable emotions or physical sensations, we can plan to do some emotion regulation.

And then once we’ve come up with a plan, or even if we didn’t feel it was necessary to come up with a plan and have just stopped, taken a step back and observed, now it’s time to proceed mindfully, perhaps re-engaging with whatever prompted us to stop in the first place. And now acting with more awareness, taking into account our thoughts and our feelings, and our goals for the situation. And if other people are involved, their thoughts feelings and goals as well.

This transcription was auto-generated by YouTube. I’ve only added minimal editing, so I apologize for any errors, run-on sentences, etc.

Distress tolerance involves learning to tolerate and survive crises without making things worse. The two elements of distress tolerance are crisis survival skills and reality acceptance skills. And i have a couple of videos about acceptance that explain reality acceptance in a lot more detail, and you’ll find links to these in the pinned comment and description. But basically reality acceptance involves a willingness to accept reality as it is and by doing so we relieve any excess distress we cause ourselves when we try to fight against reality and struggle against things that are outside of our control.

Crisis survival skills are skills for tolerating painful events urges and emotions when we can’t make things better right away. A crisis often but not always starts with an external trigger like some interpersonal conflict, which could be an argument with your partner or falling out with a friend. Or some conflict at work. Or maybe you’re overwhelmed by stress at work, with your family, or a combination of things. Or there’s some distressing event like finding out you’ve lost your job a relationship ending, the death of a loved one, and so on.

And then this external situation triggers a number of distressing inner experiences like difficult and painful feelings and emotions, negative thoughts, and uncomfortable physical symptoms and sensations. And this inner distress can also arise without anything external to trigger it. And then when our emotions reach a boiling point and it all becomes too much we find ourselves in crisis

There are six basic crisis survival skills we’re going to look at, starting with techniques to help stop the crisis and allow you to take a step back from it. And then once you’ve been able to get some distance from the crisis, the skills focus on helping you recover from the aftermath and calm whatever after effects remain.

The first skill is called stop which is an acronym for stop, take a step back, observe and proceed mindfully. So when you stop you don’t react. You freeze. Don’t move a muscle. Your emotions may try to make you act without thinking, but stay in control.

And then take a step back from the situation. Take a break. Take a deep breath .and don’t let your feelings make you act impulsively.

And then observe. Notice what’s going on inside and outside you. What is the situation? What are your thoughts and feelings? And what are others saying or doing?

And then proceed mindfully. Act with awareness. In deciding what to do consider your thoughts and feelings, the situation, and other people’s thoughts and feelings/ think about your goals, and ask wise mind which actions will make it better or worse. And if you’re not sure what wise mind refers to check out the list of videos in the pinned comment and description.

So stop is basically an advanced form of time out. Sometimes stop alone is enough to calm the crisis. But it can also be a great first step before proceeding to another distress tolerance skill, like the next distress tolerance skill we’ll look at, pros and cons.

Now a pros and cons list is nothing new, but for distress tolerance we use a specific type. When we’re in a crisis we’re driven by our emotions, which creates urges for us to act impulsively often in ways we’ll later regret. So first we consider the pros and cons of acting on these impulsive urges and giving into them, giving up, or avoiding what needs to be done. So the pros might look something like this. It’s what we want to do right now based on what our emotions are telling us to do. It might release our pent-up energy and frustration, and it might make us feel better at least for a few moments. And it’s hard and takes a lot of effort to resist such a strong urge.

And then the cons of acting on these urges, such as it’s not strategic, it doesn’t help the situation, and there’s no regard for the consequences. It’s often self-destructive and leads us to do things we later regret. And it can damage our relationships and friendships.

And then we look at the pros of resisting our impulsive urges, of doing what needs to be done and not giving in or giving up. These can be things like, it allows us to make better choices and act strategically in ways that benefit us and have positive consequences. In the long run we’ll feel better about ourselves if we stay in control and don’t act impulsively. And it’ll improve our relationships with people we care about.

And finally the cons to this might be things like in the short term we continue to feel bad. We have to keep tolerating some distress and discomfort. And it can take all of our self-control to try to resist doing what our emotions are telling us to do.

And once you have all these pros and cons in front of you it can allow you to see that acting on your impulsive urges isn’t in your best interest, and help you resist regardless of how strong the urge is. And then instead of relying on your ability to come up with this list in the midst of a crisis when you’re probably not thinking very clearly, plan ahead and create a pros and cons list in advance. And then keep it with you perhaps in your phone. Because when we’re in a crisis and our emotions are driving our thoughts it can be hard to access the rational reasonable part of our minds that we need in order to be able to create something like a pros and cons list.

The next skill is tip which stands for: tip the temperature of your face with cold water, which is pretty self-explanatory. Splash some cold water on your face. Dunk your head in a sink of cold water, or hold some ice up to your face. You can even take a cold shower. These can all help shock you out of your emotional state of mind and help snap you out of a reactionary crisis mode long enough to be able to start acting a little more strategically.

And then intense exercise. A lot of times doing some intense exercise can give an outlet to the physical energy and adrenaline that’s been building up during a crisis and get it out of our system enough to calm some of our distress. Many people find that when their mind is racing and they’re feeling distressed exercise is the only thing that can clear their minds enough to allow them to start to calm down.

And then paced breathing so slowing down your breathing and a good way to do this is to breathe in through your nostrils and then breathe out through pursed lips because the pressure of your lips forces your exhalation to be slower and once you slow your breathing down for a couple of minutes your level of physiological arousal will naturally start to decrease.

Paired or progressive muscle relaxation, which is a relaxation exercise in which you move through your body tensing and relaxing each muscle group along the way. And for instructions on progressive muscle relaxation check out the link in the description.

Next we have distraction. Distraction is just temporary: you’re not completely ignoring problems or emotions. You’re just setting them aside for a while until they’re cool enough that you can handle them, just like they were a hot pan on the stove, and then once they’ve cooled down you can return to them if you need to and resolve any outstanding conflicts or issues. Or engage in some emotion regulation.

The complete list of distraction skills in dbt form the acronym accepts and some of these skills along with the ones in the next couple of sections will resonate with you and make sense and others probably won’t and that’s fine. The comfort level that people have with these techniques varies from person to person so just focus on the ones that feel right for you.

Distracting yourself with activities: this can be any sort of activity from chores around the house to watching TV or reading a book, to playing a video game to doing something with your friends. Just any activity to take your mind off what’s distressing you long enough for the most intense distress to start to calm down and become cool enough to touch.

Contributing: doing some volunteer work or helping a friend or family member or just doing something thoughtful for someone, which not only provides some distraction, but can help you feel better about yourself by doing something nice for someone else.

Comparisons: compare how you feel now to a time when you felt different think about people who are coping the same or less well than you. Compare yourself to those less fortunate.

Distracting yourself with different emotions: read an emotional book or story or watch an emotional film or TV show or listen to some emotional music. And be sure that what you’re doing creates a different emotion than the one that’s causing you distress.

With pushing away, push the situation away by leaving it for a while. Or leave the situation mentally or put your pain on a shelf box it up and put it away for a while.

With other thoughts: count to 10, repeat words to a song in your head, or work on a puzzle. Watch some TV or read.

And finally with other sensations: squeeze the rubber ball very hard. Listen to some really loud music or hold an ice cube in your hand or mouth. Go out in the rain or snow. Or take a hot or cold shower.

And starting from here the skills shift from focusing on getting some distance between yourself and the worst of the crisis to calming and soothing yourself in the aftermath. And the next skill is self-soothing with your senses. So looking at listening to or smelling something that gives you pleasure or that you find calming or relaxing. Or for taste eating some comfort food or having a soothing drink like a cup of tea or coffee or a smoother or treating yourself to something that you wouldn’t usually eat. And make sure to eat mindfully savoring the taste rather than just binging. And for touch doing something like taking a shower or long bath or soaking your feet getting a massage or feeling the warmth of the sun on your skin or a cool breeze on your face.

And finally improving the moment with the acronym improve. So improving the moment with imagery: imagining a relaxing scene. Remembering a happier time and imagining yourself in it indulging in some pleasant daydreams

With meaning: find purpose or meaning in a painful situation. Focus on any positive aspects of the situation that you can find any silver linings.

With prayer or spirituality: opening your heart to a supreme being or wherever you find meaning in the universe. Practicing some meditation opening yourself up to wise mind. Listen to or read about spiritual values.

With relaxing activities: taking a hot bath massaging your neck or scalp or practicing some yoga or other stretching. Or just doing some deep breathing.

Improving the moment with one thing in the moment. Focus all of your attention on just what you’re doing be mindful and keep yourself in the present moment.

Improving the moment with a brief vacation. Just give yourself a brief vacation get into bed and pull the covers over your head. Go to the beach or the woods for the day. Or turn off your phone go to the park and have a picnic.

And finally improving the moment with encouragement and rethinking the situation. Using some positive self-talk to encourage yourself. I’ll make it out of this. I’m doing the best that i can. Repeat to yourself that whatever this is i can stand it. This too shall pass. Everything’s going to be okay. It’s not going to last forever.

So when you find yourself in distress or in the midst of a crisis you can use these crisis survival skills to help calm things down enough to pull yourself out of emotion mind, step back from what’s distressing you, and get a little distance between yourself and the crisis.

And then once things have calmed down you can return to the situation and resolve things if necessary. Or attend to any emotions you’re still feeling in the aftermath by using some emotion regulation skills. Or just do whatever you need in terms of self-care to help yourself continue to recover from this crisis and the distress that you found yourself in.

So once you’ve become familiar with the skills and had a chance to try them and find out what works for you, come up with a crisis survival plan that lists the steps you want to take and the skills you want to remember to use when you find yourself in a crisis. And then keep this plan with you in your phone so it’s always there when you need. It for more on distress tolerance and how we can stave off a crisis by the way we react to things that have the potential to set one off check out my video on distress tolerance and how pain doesn’t have to lead to suffering.

This transcription was auto-generated by YouTube. I’ve only added minimal editing, so I apologize for any errors, run-on sentences, etc.

When we’re feeling sad and depressed and just don’t feel like doing anything, acting based on how we feel and cutting back on our level of activity, and spending too much time in bed, or wasting time on the Internet, or not wanting to socialize or make plans with friends, just feeds back into how we’re feeling making those feelings even stronger. But when we’re sad or depressed one of the best things we can do for ourselves is to increase our level of activity. We call this behavioral activation and it’s often the first step in lifting our mood or pulling ourselves out of a period of depression.

Behavioral activation involves starting small and gradually increasing our level of activity. And we focus on three types of activities: activities that give a sense of pleasure or enjoyment; activities to give a sense of accomplishment or achievement; activities that involve some social interaction, which is going to be a lot harder now with everyone practicing social distancing.

As difficult as it can be to imagine something being pleasurable when you’re depressed, just doing anything is usually more enjoyable than isolating yourself, or sitting around just doing nothing. And you might find that activities aren’t as enjoyable as they used to be, or as you’d like them to be, but even things as small as getting out of bed having a shower, eating breakfast, or going for a walk can all make a difference in how you’re feeling. And so it’s important to do at least some small things like this every day to give yourself a chance to feel a little better, or at least help prevent yourself from sinking even deeper.

And when you’re depressed it’s hard to imagine you could do anything that could give you a sense of achievement or accomplishment. But there’s no need to be ambitious. These can be simple things—answering an email, doing the dishes, paying some bills—no matter how small these things may seem they can still give you some sense of accomplishment, which in turn usually helps improve your mood even if just a little bit.

And when you’re depressed sometimes you just want to isolate yourself from people. Socializing can seem impossible, and you can feel like nobody would want to be around you the way you are and you’d just be a burden. But a sense of isolation can be a big contributing factor to feeling depressed, so it is important to find some way to have contact with other people.

Things like going to a party or being with a big group of people can seem overwhelming, so focus on things that are more manageable, whether it’s talking to someone on the phone, or texting with them, going for a coffee, or even just going out by yourself and being around other people. Though obviously these last couple are not good ideas right now which makes staying connected to others during the coronavirus crisis that much more difficult as we need to find ways to socialize that don’t involve physically being around other people. But the more you isolate yourself the more depressed you’re likely to feel, and just having any sort of social interaction can help lift your mood and make you feel a little better.

Now if your mood is really low and you go for a little walk everything’s not going to be sunshine and rainbows all of the sudden, but you’ll probably feel at least a little bit better. And being aware of even small shifts in your mood is important, because when you’re feeling this way it can be so difficult to notice anything positive or have any hope. And so even the smallest improvement in how you’re feeling is worth recognizing because it is a big step compared to not being able to get out of bed or up off the couch and just feeling worse and worse as the day goes on.

And another reason why being more active is so important is because when we’re feeling sad or depressed we tend to ruminate a lot. And research has found that the amount of rumination associated with an emotion is the determining factor in how long that emotion lasts. And because we ruminate so much when we’re feeling sad, sadness is by far our longest lasting emotion, and so anything we can do to cut down on how much we’re ruminating when we’re feeling sad or depressed helps limit how long those feelings last. And even something as simple as going for a walk can help us get out of our heads start ruminating less and as a result our mood starts to improve.

Behavioral activation can often be hard to put into practice because when we’re feeling depressed we tend to be very pessimistic and have lots of negative thoughts, and these thoughts can sometimes get in the way of increasing our level of activity. To help counteract this type of negative thinking and these negative expectations one thing that we encourage with these activities is that you use a behavioral activation diary, which you’ll find a link to below in the description, to help you predict beforehand how much pleasure or enjoyment, sense of achievement or accomplishment, or sense of social connection you’ll get from doing the activity.

And then after you’ve done it record the actual amount of pleasure you got, the actual sense of accomplishment that you felt, and the actual sense of social connection you experienced, as often these will be higher than predicted. And this can help counteract that negative thinking you have that tells you there’s no point in doing anything, why bother, it’s not gonna help, or it’s gonna make you feel worse.

And then this is a way of giving yourself some evidence that even though you don’t want to do anything, can’t see the point in doing anything, when you actually do do something you tend to get more out of it than you think you will. And then this can help motivate you to do more in the future even if your depression and negative thoughts are telling you not to bother.

This transcription was auto-generated by YouTube. I’ve only added minimal editing, so I apologize for any errors, run-on sentences, etc.

My first video on mindfulness and dbt was an overview of the goals of mindfulness and six of the core mindfulness skills. In this video we’re going to go into more detail about how we can practice mindfulness, and especially how we can be mindful of our thoughts.

One way to practice mindfulness is through meditation. In a mindfulness meditation we’re noticing, paying attention to, and observing whatever we’re experiencing in the present moment, focusing on our inner experiences: our breath, our thoughts, our feelings and emotions, and the physical sensations in our bodies. And then whenever we get distracted and our minds start to wander, we simply acknowledge whatever’s distracted us, and then as best we can we let it go and redirect our attention back to what we’re trying to pay attention to, which is usually our breath. And if you’d like to learn how to practice mindfulness meditation check out the videos that i link to in the pinned comment and description.

But the fact is most people aren’t going to practice mindfulness meditation on a regular basis. But all of the things we do in a mindfulness meditation, we can also do as we go about our daily lives. We just need to focus our attention on whatever we’re doing in the present moment. If we’re working, we’re focused on our work: what we’re doing, and thoughts related to what we’re working on. And we’re aware of other thoughts and feelings and emotions and body sensations that arise while we’re focused on our work, but we just observe these thoughts, feelings and sensations. We don’t allow them to carry our minds away. We acknowledge them, and then as best we can we let them go and redirect our attention back to whatever it is we’re trying to pay attention to.

Now the two main ways that we practice mindfulness in dbt are by observing, and describing and labeling. So as we go about our daily lives, we’re being mindful when we’re able to take a step back from what we’re doing, stay in the present moment, and observe what’s going on with our thoughts, feelings and emotions, and body sensations.

But often instead of just observing what we’re experiencing, we start getting pulled into our experiences. Rather than simply observing our thoughts, we get stuck in our heads, our minds racing, and we can get completely caught up in our thoughts. Or our emotions and body sensations can become so strong that they begin to overwhelm and subsume us. One way to stay mindful in the face of strong uncomfortable feelings emotions and body sensations is to practice radical acceptance, and we can also use various emotion regulation skills and i have videos that go into more details about these topics that i link to in the description and pinned comment. And in the remainder of this video we’re going to look at how to stay mindful of our thoughts by observing and describing or labeling them.

There are always lots of thoughts passing into and out of our minds. And while we can’t control what thoughts come into our minds at any given time, we do have the ability to choose which thoughts we want to pay attention to. When we’re being mindful we’re aware of and observing the thoughts that come into our minds. And then when we notice ourselves having a thought that’s not related to what we want to be paying attention to at the time, we’re mindful of this thought, we notice we’re having it, but that’s all we do with. It we don’t engage with it. We don’t think about it. We just acknowledge that we’re having that thought. And then as best we can let it go and redirect our attention back to what we’re trying to pay attention, to without allowing that thought to distract us and carry our minds away.

And the best way to explain how we practice being mindful of our thoughts is to use some metaphors. One way we can be mindful of our extraneous thoughts that aren’t related to what we’re doing at the time is to treat them as if they were just sounds going on in the background. We generally don’t pay attention to these sounds or think about them very much, and we just allow them to pass in one ear and write out the other. And we can do the same sort of thing with our thoughts: not give them any undue attention and think about them or try to figure out what they mean, and just treat them like mental noise in the background, allow them to pass into our mind and then right out again.

Another metaphor for this way of relating to our thoughts is to simply treat our thoughts as if they were clouds passing through the sky: noticing as a cloud or a thought passes into our field of awareness, sticks around for a while, and then continues to float through the sky or through our minds until it passes away.

Or sitting back and observing our thoughts as if we were at the movies and watching our thoughts being projected on the screen in front of us. Not actively participating or getting caught up in the action on the screen that is our thoughts, and just sitting back and watching them as they unfold. And remember that the thoughts that we’re trying to simply watch and observe and allow to pass from our minds without interacting with them aren’t the thoughts related to what we’re doing at the time, but extraneous thoughts that act as distractions that can pull us away from what we’re trying to focus on. And if you’d like to try an exercise that leads you through these metaphors with a guided audio file, please check out the link in the description and pinned comment.

But often it’s not that easy to just sit back and watch our thoughts. And so if we find ourselves getting caught up in our thoughts rather than just observing them, describing or labeling our thoughts is a great way to take a step back. When we’re describing our thoughts we’re observing our thoughts and simply describing to ourselves what’s going on in our minds.

So instead of just observing the thought, i hate my life, describing what’s going on in your mind: first that you’re having a thought, and then noting what you’re thinking about. I’m having the thought, i hate my life. Instead of just observing the thought ,what if i can’t get this done on time, describing what’s going on in your mind. I’m worrying, what if i can’t get this done on time? Or I’m wondering, why haven’t they emailed me back yet? Or I’m having the thought, how could he do that to me?

Now instead of describing the content of our thoughts we can simply label our thoughts with a couple of words or a short phrase that labels what’s going on in our minds so merely noting that we’re thinking thinking; or worrying about work; or I’m obsessing; or I’m dwelling on an argument. When we label our thoughts, we’re shifting our focus away from the content of what we’re thinking about, and merely observe that we’re engaged in the act of thinking or worrying, or obsessing, or dwelling, and the content of our thoughts loses its power.

If we’re observing ourselves having the thought, i hate my life, or why haven’t they emailed me back yet, those thoughts generate an emotional reaction that makes them more difficult to let go. But if instead we describe our thoughts with a simple label like thinking or worrying, there’s really no emotional pull to that label. So labeling helps us become aware of and acknowledge our extraneous thoughts, while making it less likely that these thoughts end up carrying our minds away from what we’re trying to pay attention to.

So even if you don’t practice mindfulness meditation there are lots of ways that you can learn to be more mindful of your thoughts. And remember that being mindful takes practice, so try to use these strategies on a regular basis to build up your mindfulness skills, so if you’re feeling overwhelmed or a crisis arises they’ll be ingrained enough that you can rely on them to help you through it. And if you missed my first video on dbt and mindfulness please check out the link in the description and pinned comment, where you’ll also find a link to my guided mindfulness of thoughts exercise.

This transcription was auto-generated by YouTube. I’ve only added minimal editing, so I apologize for any errors, run-on sentences, etc.

Dialectical behavior therapy is a type of cognitive behavioral therapy originally developed by Marsha Linehan to treat borderline personality disorder. And there’s a growing body of research that’s found dbt effective in treating a number of other issues. And dbt is also very helpful in teaching people how to manage and regulate emotions and tolerate distress better.

So like traditional cbt, dialectical behavior therapy looks at how our thoughts and our behaviors contribute to various mental health and psychological issues; and how if we change how we think and change how we act, we can change our emotions and how we feel and help treat these issues and the symptoms associated with them. So in this sense dbt is a type of change-based therapy.

But dbt is also an acceptance-based therapy. So what does that mean? Well since the 1990s mindfulness has played an important role in a number of approaches to therapy including dbt. And so dbt is a type of cognitive behavioral therapy that integrates elements of mindfulness.

Now acceptance is a big part of mindfulness. And what does mindfulness mean? In simple terms mindfulness is a non-judgmental awareness of how things are in the present moment.

So when we’re being mindful we’re accepting our experiences, and not judging them as good or bad, pleasant or unpleasant, desirable or undesirable, and so on. We’re simply accepting them however they are in this moment.

If we’re sad in this moment, we accept that we’re sad in this moment. If we’re anxious or angry in this moment, we accept that we’re anxious or angry in this moment. If we’re having a distressing thought, we accept that we’re having that thought. And if we find ourselves in an unpleasant or distressing situation, we accept that this is our experience right now in this moment. We also practice self-acceptance.

And so something that’s often hard to wrap our minds around is, if we accept something aren’t we resigning ourselves to that and giving up? Isn’t acceptance the opposite of change?

And this discrepancy between acceptance and change is at the heart of dbt. Dbt is about finding a balance between these two opposing ideas of change and acceptance. And this is one of the dialectical elements of dbt. And dialectics involves reconciling the tension between two opposing ideas, a thesis and an antithesis, into a synthesis that integrates what is true of both ideas. And so dbt is the synthesis of the change aspect of cbt, and the acceptance aspect of mindfulness. And a lot of people have trouble grasping both the concept of acceptance in general and also how acceptance can be compatible with change, and I talk about this more in a couple of videos about acceptance that I’ll link to in the description.

So those are some of the basics of the theory behind dbt now let’s look at the practical side,

So there are two main components to dbt: individual therapy, plus dbt skills training. Now we’re not going to talk about what goes on in a dbt therapy session because this is a self-help video. But you can learn dbt skills on your own. And dbt skills alone have been found effective in treating a number of issues and disorders, and are a great way to learn how to tolerate distress and manage and regulate emotions better. So now we’re going to go through an overview of these skills. And I have a number of videos to go into more details about each of these skills that I’ll link to in the description.

So there are four dbt skills: mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. Mindfulness and distress tolerance are acceptance-based skills and emotion regulation and interpersonal effectiveness are change-based skills.

So first core mindfulness skills. We refer to mindfulness skills as core skills because they’re fundamental to dbt: each of the other skills rely on our abilities to be mindful. And so mindfulness skills are the first skills we learn, and then a comprehensive dbt skills program, mindfulness skills are repeated between each new skill. The order in which we learn the skills doesn’t matter, as long as we start with mindfulness and repeat mindfulness skills before each new skill.

There are seven core mindfulness skills. The first is called wise mind which is a synthesis of reasonable mind and emotion mind. Reasonable mind refers to approaching things intellectually and thinking and acting rationally and based on logic. Whereas emotion mind involves thinking and acting based on our emotions and how we’re feeling. And I have a whole video that explains wise mind reasonable mind and emotion mind.

Next there are the what skills: what do we do when we’re being mindful? We’re observing, both what’s going on outside ourselves—external things that we’re taking in through our senses, and what’s going on inside ourselves with our thoughts feelings and emotions and bodies.

And we’re also describing we’re taking a step back and watching and observing what we’re doing we’re observing ourselves observing and acting describing or putting words to what we’re experiencing, I’m watching the sun rise. I’m thinking about work. I’m arguing with my partner. I’m feeling some tightness in my chest.

And we’re participating, turning ourselves completely towards the present moment. Participating is the opposite of automatic pilot and we engage directly with what we’re experiencing in the present moment and don’t allow ourselves to be distracted by anything else.

Then there are three how skills, how do we practice mindfulness? Non-judgmentally, and we’ve looked at what this means already and it’s related to acceptance; one mindfully, focusing on just one thing at a time; and effectively, doing what needs to be done in any given situation and I also have a whole video about these what and how skills.

So next let’s look at emotion regulation skills. So this is a change based skill: we’re learning ways to change our emotions and how we feel now. We can’t control our emotions we can’t make ourselves feel or not feel a certain way. Instead, emotion regulation increases our abilities to influence our emotions and how we feel. So with emotion regulation we can sometimes modify our emotions so that we’re no longer experiencing a particular emotion. Or simply calm our existing emotions and make them less intense.

And the first step in being able to regulate our emotions is to be mindful of our emotions and how we feel. And so even though this is a change-based skill, we’re starting from a place of mindfulness, which involves accepting our current emotions before deciding whether we then want to try to change these emotions.

And if we would like to change how we’re feeling, we learn to influence our emotions by changing our thoughts, changing our behavior, or through problem solving. And I have a whole section about emotion regulation where we look at various strategies to help us do this on my selfhelptoons.com website that I’ll link to in the description.

Next distress tolerance skills, which are acceptance-based skills. In dbt distress tolerance helps us accept, in non-judgmental fashion, both ourselves and our current situations. Distress tolerance skills build upon the non-judgmental awareness we learn practicing mindfulness. Distress tolerance helps us cope with distressing situations and feelings of distress such as strong negative emotions as best we can. We learn to accept what’s going on around us without demanding it to be different. And to experience our current emotions without needing to change them. And to observe our thoughts without attempting to change or control them.

Sometimes we find ourselves in situations where we can’t avoid being in a certain amount of distress. So when that’s the case we need to accept that that’s what we’re experiencing right now, which doesn’t mean we still can’t try to change things to make them better. But while we’re actually experiencing the distress in the moment, by accepting it we help prevent things from getting worse, while we work on trying to make them better. And this is a theme that keeps coming up in dialectical behavior therapy finding this balance between acceptance and change.

So in dbt there are two types of distress tolerance skills. Crisis survival skills involve getting through crises without making things worse. Reality acceptance skills help reduce suffering and increase the sense of freedom by helping us find ways to accept the facts of our lives and things we can’t change. And you’ll find a whole section with videos that teach these distress tolerance skills on selfhelptoons.com.

And then there are dbt interpersonal effectiveness skills. Interpersonal effectiveness skills help us navigate interpersonal interactions more effectively, and as a result avoid the negative emotions and damage to relationships that can accompany interpersonal conflicts.

There are three components to interpersonal effectiveness skills. The first is objectives effectiveness, which refers to learning to communicate assertively in order to get our objectives met, and have our rights and wishes respected, and get what we want or need from other people. Next are skills to build close healthy relationships, and end destructive ones. And finally there’s walking the middle path, which involves finding a balance in relationships between acceptance and change.