TKC DBT Handbook

DBT SK ILLS H A NDBOOK

The Knight Center’s aim is to provide our clients and their family members with the tools they need to live a happy and
fulfilling life. The Center has helped hundreds of people to rebuild their futures, and to once more experience the rich
beauty of a balanced and healthy existence. The Knight Center provides individualized clinical care and educational

training to help you back on the path to joy and success. We hope you find this handbook useful in your journey
towards wellness and we look forward to helping you experience the life you deserve.

Best Wishes,

Stephanie Knight MSW, LSW
CEO, The Knight Center

DBT SK ILLS H A NDBOOK : TABLE OF CONTENTS

8 Mindfulness MODULE I: MINDFULNESS
9 Mindfulness Practice Exercise
10 Wise Mind 13 How and What Skills Practice Exercise
11 Wise Mind Practice Exercise 14 Putting It All Together
12 How And What Skills 15 Putting It All Together Practice Exercise
16 Behavior Chain Analysis
17 Behavior Chain Analysis Practice Exercise

MODULE II: INTERPERSONAL EFFECTIVENESS

19 Interpersonal Effectiveness 28 Factors That May Reduce Effectiveness
20 DEAR MAN: Objectives Effectiveness 29 Myths About Interpersonal Effectiveness
21 DEAR MAN Practice Exercise 30 Guidelines for Using Interpersonal Skills
22 GIVE: Relationship Effectiveness 31 Conflict Resolution Techniques
23 GIVE Practice Exercise 32 Sharing and Listening
24 FAST: Self-Respect Effectiveness 33 Understanding Communication Intensity
25 FAST Practice Exercise 34 Behavior Chain Analysis
26 Validation 35 Behavior Chain Analysis Practice Exercise
27 Validation Practice Exercise

MODULE III: EMOTION REGULATION

37 The Function of Emotions 48 Opposite to Emotion Action
38 The Function of Emotions Practice Exercise 49 Opposite to Emotion Action Practice Exercise
39 Understanding How Emotions Operate 50 Middle Path
40 Naming Emotions 51 Middle Path Practice Exercise
42 Emotional Myths We Live By 52 Creating A Meaningful Life
43 Emotional Myths Practice Exercise 53 Creating A Meaningful Life Practice Exercise
44 Cognitive Distortions 54 Behavior Chain Analysis
45 Cognitive Distortions Practice Exercise 55 Behavior Chain Analysis Practice Exercise
46 ABC ~ PLEASE ~ STRONG

MODULE IV: DISTRESS TOLERANCE

57 ACCEPTS: Crisis Survival Skill 64 Willingness vs. Willfulness
58 ACCEPTS Practice Exercise 65 Willingness vs. Willfulness Practice Exercise
59 IMPROVE The Moment 66 Turning The Mind
60 Pros and Cons 67 Turning The Mind Practice Exercise
61 Pros and Cons Practice Exercise 68 Behavior Chain Analysis
62 Radical Acceptance 69 Behavior Chain Analysis Practice Exercise
63 Radical Acceptance Practice Exercise

71 Daily DBT Exploration V: APPENDIX
72 Diary Card Week I
74 Diary Card Week II 76 Diary Card Week III
78 Diary Card Week IV
80 DBT Skills Cheat Sheet

GUIDELINES FOR PARTICIPATION

Keep all group discussion confidential to the group.
If you are going to be late or miss your group session, please let staff
know ahead of time.
If you ask a peer to assist you in engaging your skills, try to be open
and receptive to their ideas.
Attacks on others will not be tolerated. Please use your skills to manage
your urges and do not lash out at your peers.
Give your peers in the same kind of courtesy and respect that you
would like to receive from them.
Please keep any triggering, trauma-related and self-harm
information within your individual therapy sessions; do not
share "war stories" directly with your peers.
Always strive to be non-judgmental about what other group members
share. Try to find something that you can agree with, even if there
may be part of it that conflicts with your personal views.
If a peer needs more help than you can offer, encourage them to talk
to any member of staff within the facility.

WHAT IS DBT?

INTRODUCTION TO DIALECTICAL BEHAVIOR THER APY

DBT is a skills-based therapy that focuses on turning one’s suffering into growth and healing through awareness, change,
and acceptance. It is a compassionate kind of cognitive behavioral therapy that is intended to help people build the skills
they require in order to lead a healthier and more balanced and meaningful life.
DBT addresses mental health disorders and maladaptive coping behaviors including substance use disorders, eating disorders,
self-injurious behaviors, suicidal thinking, panic attacks and mood and personality disorders. These imbalances of thought,
emotion and behavior can make it incredibly difficult to function in a way that is effective and fulfilling.

WHAT IS A DIALECTIC?

The term “dialectic” refers to the idea that two seemingly opposing concepts can both be true at the same time. For example,
there are multiple ways to see any given situation and there is more than one opinion, idea or thought present within you at
any one time. The following concepts are also true of dialectics and DBT:
• Two things that seem like opposites can both be true
• All people have something unique and worthy to teach us
• A worthwhile life has both comfortable and uncomfortable moments (i.e. happiness and sadness, hope and discouragement)
• All points of view have elements of truth and falsity within them
DBT allows us to accept that two opposing concepts can co-exist in the same moment. Examples of dialectical thinking
include the following statements:
• “I am doing the best that I can AND I also have room to improve”
• “I am right AND the other person is also right”
• “I can take care of myself AND I also need help and support from others”

LEARNING TO CHANGE AND PR ACTICING ACCEPTANCE

DBT asks people to learn new behavior and new skills (change), yet with the understanding that people are doing the best
that they can right now (acceptance). DBT skills training allows people to learn how to effectively analyze their behavior
and to make necessary changes by learning new skills in four key areas: mindfulness, interpersonal effectiveness, emotion
regulation and distress tolerance.

5

DBT: THE FOUR MODULES

MINDFULNESS

To be mindful is to simply be aware of the present moment without judging, reflecting or thinking; it is simply observing the moment
you are in. When we are vulnerable to negative emotions, we lose touch with what is going on around us. It is a sort of tunnel vision in
which we cease to notice the moment when a painful emotion overtakes us.
Mindfulness practice helps us to see the patterns of our minds more clearly and to learn how to recognize when our mood begins to
switch. Practicing mindfulness allows us to catch ourselves in the moment and understand our feelings much earlier than we
might have been able to before. Painful emotions can bring back memories and thoughts of the past and can affect how we see our
future. Mindfulness helps us to regain control over our negative thinking by teaching us to focus on the present, rather than regretting
the past or worrying about the future.
Feelings of depression can eventually lead us to dread all negative emotional states, and leave us feeling as if our emotional pain may
never end. At the first sign of sadness, we may try to suppress it or pretend it isn’t there. Coping strategies like emotional suppression
don’t work, and the sadness we try to suppress may come back with renewed force. Mindfulness helps us develop our willingness and
our capacity to be more accepting of painful emotions. It gives us the courage and compassion to allow negative moods, thoughts and
sensations to come and go without fighting or avoiding them.

INTERPERSONAL EFFECTIVENESS

Interpersonal effectiveness skills are an integral part of a healthy life. Respectful and productive social interactions are a key component
to our effectiveness and success in life. Social skill building allows us to integrate boundaries and emotional responsibility into our daily
lives while engaging in healthy and adaptive activities we find enjoyable.
Becoming interpersonally effective will allow us to balance our personal priorities and boundaries while still meeting other people's
requests and needs. Practicing interpersonal effectiveness can help us build social mastery, while allowing us to maintain our personal
dignity and our self-respect. Ultimately, the goal of the interpersonal effectiveness module is to provide us with healthy strategies for
building, managing and maintaining happy and healthy social relationships.

EMOTION REGULATION

The emotion regulation module shows us how to master our our negative emotional states. By understanding the meaning behind our
emotions, we are better equipped not only to accept our feelings, but also to manage the intensity of negative emotions when they arise.
This skill set also teaches us how to identify, observe and describe our emotional states without getting stuck in them. This detached
observation allows us to gain a deeper understanding of the function and purpose of experiencing all emotional states, be they positive
or negative. One of the goals of this module is to simultaneously reduce our vulnerability while increasing our awareness of the
thoughts, feelings and events that are inherently positive in our lives. This allows us to decrease emotional suffering while letting go of
painful emotions through the practice of mindful awareness.

DISTRESS TOLER ANCE

Most approaches to mental health treatment focus on changing distressing events and circumstances. DBT distress tolerance skill
building places more emphasis on learning new coping skills that will allow us to bear painful emotions that might otherwise overwhelm
and upset us. Distress tolerance skills are intrinsically linked to the development and practice of mindfulness skills. Distress tolerance
and mindfulness are focused on the acceptance of oneself and of the current situation we are engaged in, free from judgment or
evaluation.
Distress tolerance strategies assist us in surviving crises and allow us to accept ourselves and our circumstances, just as they are in that
moment, without needing to engage in impulsive or reckless behaviors to manage the intensity of our negative feeling states.

6

MODULE I: MINDFULNESS

M Moment to moment attention
I In the here and now
N Non judgmental attitude
D Detach from unhelpful thoughts
F Forgive and be grateful
U Unconditional acceptance
L Learn with beginner’s mind

MindfulnesS

“Mindfulness is paying attention in a particular way:
with purpose, in the present moment and without judgment...”
MINDFUL BREATHING

Focus your attention on abdominal breathing, noticing as your stomach rises on the inhalation and falls on the exhalation.
This style of breathing regulates your body by bringing breath back into the stomach. During periods of stress and anxiety,
your breathing can become shallow, rapid and sporadic. By bringing your attention back to the stomach and practicing
normal diaphragmatic breathing, you allow your body to center itself.

BODY SCANNING

Body scanning is a mindful relaxation practice. Allow your entire focus to enter into your body and directly notice whatever
feelings and sensations are there to experience. In doing this exercise, we begin to discover where we are holding tension
in our bodies, and we might become aware of feelings that may not have fully integrated with our minds. As we learn to
acknowledge and notice the wave of sensations and emotions that are present within ourselves, letting them go wherever
they need to go, we are better able to reduce stress and promote full relaxation.

MINDFUL INQUIRY

Begin to investigate any thoughts that underlie feelings of depression or anxiety. Allow your feelings to be what they are,
without judgment, while staying open to and noticing any other thoughts and feelings as they arise.

TEFLON MIND

Begin to utilize the Teflon Mind skill, which allows thoughts to move through our minds without letting them stick and
without creating stories about them. Know that you are not your thoughts and that thoughts move through you. Imagine
that your thoughts are moving freely within a non-stick teflon pan.

8 Module I: MINDFULNESS

Mindfulness PRACTICE EXERCISE

Write down your thoughts without censoring them. Simply notice whatever comes into your mind and put
it down on paper. When you are finished writing, circle any judgments, future thoughts or past thoughts
that may be there. Count each of these and enter the number of times they appear in your writing.

JUDGMENTS FUTURE PAST

9 Module I: MINDFULNESS

WISE MIND

REASONABLE WISE EMOTION
MIND
MIND MIND

REASONABLE MIND

At its best, your reasonable mind is both rational and logical. It is the "cool" part of your brain that plans and evaluates things logically.
Reasonable mind is what has helped civilizations build cities and make scientific discoveries. The difficulty in accessing ands using this
part of your brain is that often we are prone to cognitive distortions such as exaggeration, minimization or misperception.

EMOTION MIND

Emotion mind is the "hot" part of your brain that allows decision making based on emotions. It can be very beneficial in that it has held
relationships together, allowed people to persevere in accomplishing difficult tasks, and motivated parents to sacrifice for their children.
Emotion mind can also have negative influences, such as fueling conflict in relationships and wars. You are in emotion mind when your
emotions are in control--when emotions overly influence and control your thinking and behavior. Emotion mind can be influenced by
tiredness, unhealthy lifestyle habits, stress and drugs and alcohol.

WISE MIND

Reasonable Mind + Emotion Mind = Wise Mind: Wise mind understands the meaning, significance and truth of an event without having
to analyze it. Such intuitive knowing combines emotional experience and logical analysis, yet goes beyond both of them. Wise mind is the
quiet, centered and deeply intuitive place within. It is a place of inner certainty and is only accessible when you become calm inside.

HOW TO USE THE SKILL

Observe your thoughts, feelings and environment, and endeavor to create a balance between cognition and emotion. If you tend to
get easily emotionally upset, try to access more of your reasonable mind. If you tend to over-analyze situations, bring in more of your
emotion mind.

REMEMBER THE PAIN

Before acting on an urge, use wise mind to remember the negative consequences of your problem behaviors from past situations.
Give an example below:

PLAY IT FORWARD

Visualize the negative consequences that may occur if you act on problem behavior. How will you and other people be affected?
Give an example below:

10 Module I: MINDFULNESS

WISE MIND PRACTICE EXERCISE

The purpose of this exercise is to examine a situation from reasonable mind, emotion mind and wise
mind perspectives. Begin by describing a relationship, experience or situation that you are currently
struggling with:
What my reasonable mind says about this situation. Reasonable mind is the logical part of my brain
that plans and evaluates, but which can also distort or catastrophize situations:
What my emotion mind say about the situation. Emotion mind is the part of my brain that can get
emotionally intense and “hot” about things:
What my wise mind says about the situation. Wise mind balances thoughts and emotions; it is the
deeper, calmer and more intuitive part of me that sometimes perceives things clearly:
Gains I have recently made using the wise mind skill. Gains are new behaviors, new ways of coping
with feelings and new perceptions of myself and others:

11 Module I: MINDFULNESS

HOW AND WHAT SKILLS

TAKE A NON-JUDGMENTAL STANCE

See but don’t evaluate, try to take a non-judgmental stance using just the facts. Try not to focus on the “good”, “bad”, “should” or the
“should not”. These are judgment words and can cloud our perception of events. Remove your personal or emotional opinions from the
facts (i.e. who, what, when, where, how and why). Accept each moment and event much like the grass accepts both the rain and the
sun and each leaf that falls upon it. Acknowledge the helpful and wholesome thoughts and feelings you have without judging them.
Acknowledge the harmful and the unwholesome thoughts as well. When you find yourself judging, don’t shame yourself for judging.

ACT EFFECTIVELY

Focus on what works for you. Do what needs to be done in each situation in order to meet your goals. Stay away from judgment
thoughts (i.e. what is right, wrong, fair and unfair). Act as skilfully as you are able to meet the needs of the situation you are in, not
the situation you wish you were in. Let go of vengance, useless anger and self-righteousness, which only hurts you and is emotionally
ineffective.

DO ONE THING AT A TIME

Do one thing at a time. For example, when you are driving, focus all your attention on only driving. When you are in a conversation
with someone, focus your attention solely on the moment you are in with the other person. If other thoughts or feelings distract you, try
to let go of those distractions and return to what you were initially doing. Continue to bring your attention back to the original activity.
Concentrate your mind. If you find you are doing two things at once, stop and go back to doing just one thing at a time.

OBSERVE

Start to become curious about what you are feeling and become aware of your emotions without trying to make them stronger, weaker,
disappear or last longer. Notice how long your feelings last and if they change in nature or intensity. Notice how your feelings flow in
and out, like waves move within the ocean. Ask yourself which of your senses are currently stimulated. Touch, smell, sight, sound and
taste are all part of your awareness. Allow your mind to be like a non-stick Teflon pan, letting things slide off of your mind without
sticking

DESCRIBE

Use fact words to describe your experiences, call a thought a thought and call a feeling a feeling. Use words that are both objective
and to the point without distortion or hyperbole. Try not to paint a descriptive picture or magnify a situation with words, try to avoid
emotion words as much as possible. Try to let go of the associations of being “right” or “wrong”; search for the words that accurately
describe your experience

PARTICIPATE

Get lost in an activity by going into a zone of concentration and participation and begin to let go of your sense of time while you
are participating in the activity. Allow yourself to be gentle, natural and at ease in situations that may arise. Practice your mindful
participation skills until they become an easy and natural part of you

12 Module I: MINDFULNESS

HOW AND WHAT SKILLS PRACTICE EXERCISE

TAKE A NON-JUDGMENTAL STANCE

Focus on something and describe it without making it good or bad, just give the facts, letting go of any opinions:

ACT EFFECTIVELY

Write about something in your life you want to be more skilled at. Describe how you can be more effective and focused on those
objectives:

DO ONE THING AT A TIME

Describe a situation where you tried to do more than one thing at a time and it was not effective:

OBSERVE

Notice your thoughts coming and going; see if you can observe them without delving into their story or drama:

DESCRIBE

Write down what you observed:

PARTICIPATE

Describe a time that you became fully involved and “in the flow” of something. What did that feel like:

13 Module I: MINDFULNESS

PUTTING IT ALL TOGETHER

BREAKING THE LINK BETWEEN PAINFUL FEELINGS AND NEGATIVE THINKING
New research shows that during an episode of depression or intense anxiety, painful feelings occur alongside negative thinking, such as
“I am a failure”, “I am inadequate”, “I am worthless” and so on. When the episode has passed and your emotional state has returned to
normal, the negative thinking tends to disappear as well. However, during the episode, a connection has formed between the emotion
that was present at the time and the negative thinking pattern. This means that when painful feelings occur again, for any reason, a
relatively small amount of feeling can trigger or reactivate the old thinking pattern.
Even when people feel well, the link between painful emotions and negative thoughts remain ready to be reactivated, which is of
enormous significance. It means that sustaining recovery from depression and anxiety depends on learning how to keep mild states of
negative emotion from spiraling out of control.

REMEMBER: NEGATIVE THOUGHTS BECOME LINKED TO PAINFUL FEELINGS

HOW MINDFULNESS KEEPS EMOTIONS FROM BECOMING OVERWHELMING
When we experience intense anxiety or sadness, we often lose clarity and perspective on what is going on around us. We engage in a
sort of tunnel vision where we can only see part of the landscape. We are not noticing the moment when our emotions are spiraling out
of control. Mindfulness helps us to see the patterns of our minds more clearly and can teach us how to recognize when our feelings are
intensifying. This means we can identify intense negative emotional states earlier and address them more effectively than we were able
to before.
Losing touch with our emotional states can put a barrier between us and the things in life that might give us pleasure. We all know the
feeling of disconnection, when we are under too much pressure, for example; at school, at home or when we are preoccupied with too
many things, we can lose touch with the small pleasures around us. Mindfulness teaches us to get back in touch with the experience of
being alive by developing our willingness to experience the whole range of our emotions. Low moods can bring back painful memories
and thoughts from the past, making us worry about the future. Mindfulness helps us to halt the escalation of these negative thoughts
and teaches us to focus on the present moment, rather than reliving the past or pre-living the future.
When we have been depressed or anxious, we dread those feelings coming back. At their first sign we may try to suppress them,
pretend they aren’t there, or push them away, but suppression does not work and the very feelings we try to avoid come back with
renewed force. Mindfulness takes a different approach by helping us develop our willingness to experience all emotions and helps build
our capacity to manage them. Mindfulness helps give us the courage to allow distressing feelings, thoughts, and sensations to come and go
without needing to battle them. Instead, we bring warmth and compassion to our entire experience.

14 Module I: MINDFULNESS

PUTTING IT ALL TOGETHER PR ACTICE EXERCISE

DESCRIBE A SITUATION WHERE YOU WERE TRIGGERED OR HAD STRONG
URGES TO ACT OUT

What was it about the trigger that challenged you the most?
What was your emotional response to the trigger?
What thought was connected to the emotion?
What urges did you experience?
Where in your body did you feel the urge?

What behavior did you engage in based on that urge?

Will that behavior be effective for you? YES NO

Identify 3 skills you might use and how you could use them

1
2
3

What obstacles could prevent you from using these skills?

Is there any stubbornness in using these skills? YES NO

What might prevent these skills from being effective?

Am I willing to commit to using these skills? YES NO

15 Module I: MINDFULNESS

BEHAVIOR CHAIN ANALYSIS

A Behavior Chain Analysis can help you identify why you are
engaging in problem behaviors

It will help you figure out all the things that you may be contributing to a problem behavior and in so doing,
a behavior chain analysis can give you insight into how to change that problem behavior.
1: The first step is to identify the behavior that you want to change. For example, do you want to stop engaging in deliberate self-harm
or self-medication through alcohol? Maybe binge eating? Try to identify a behavior that is causing problems in your life.
2: Next, think about what happened prior to engaging in the problem behavior. What were you doing? What was going on around
you? Were you in an argument? Did you remember a triggering traumatic event? The aim of this step is to identify the event or
situation that served as the starting point for your problem behavior.
3: Identify what kinds of thoughts accompanied the situation you identified in Step 2. How did you evaluate the situation or
yourself in that situation? Did you engage in catastrophic or all-or-nothing thinking?
4: Think about what emotions you were feeling as a result of that situation. Try your best to list as many emotions as you can (for
example; fear, sadness, anger, shame, guilt, embarrassment or dread).
5: Pay attention to what you felt in your body. Try to recognize and label all the sensations that you felt. For example, did you
experience shortness of breath? Muscle tension? An increased heart rate? Think about how your body reacted to the situation.
6: List what behaviors your thoughts, emotions and bodily sensations made you want to engage in. Did they make you want to
escape the situation or do something to make those feelings stop? Did you feel a need to engage in your problem behavior?
7: Finally, think about the consequences of engaging in your problem behavior. Did you feel better afterwards? Did you feel
disappointed in yourself or ashamed? List as many consequences, both positive and negative as you can.

TIPS FOR THIS EXERCISE

It can be helpful to go through a behavior chain analysis soon after engaging in a problem behavior. This way, your experience is fresh
in your mind and you will likely be able to remember more information about the factors that led up to your problem behavior.
Identify what may have made you more susceptible to responding to the situation as you did. For example, when people do not eat well
or get enough sleep, they may be more prone to experiencing negative moods or having more intense emotional experiences.
Behaviors can serve multiple functions. Therefore, it helps to go through a behavior chain analysis for a number of different situations
that may have led to a problem behavior and to try and identify all the functions that a problem behavior serves.
After you complete a behavior chain analysis, indentify different coping strategies that you could use at each stage.
In addition to identifying the function that a problem behavior serves, it is also important to figure out how to “break the chain”
through use of healthier coping strategies.

16 Module I: MINDFULNESS

BEHAVIOR CHAIN ANALYSIS PRACTICE EXERCISE

Problem behavior

Describe exactly what you did or said and try to be as specific and detailed as possible:

Links: Past Chain of Events Solutions: New Chain of Events

What were the feelings, thoughts and behaviors which led New suggestions for solving the problem. What could
up to the problem behavior? Try to write your thoughts as you have done differently to avoid the problem behavior?
direct quotes as they occur. Describe in specific detail how you could use each skill.
Solutions to
Vulnerabilities Vulnerabilities
Prompting Alternative
Event ways to think
Thoughts and act
before Alternative
behavior thoughts
Body Skills to cope
sensations with body
& changes sensations
Emotions Skills to cope
before the with emotions
behavior Alternative
Problem behavior
behavior Skills I can
Thoughts commit to
after behavior practicing
Emotions this week,
after behavior relating to
the problem
Consequences that make problem behaviors behavior
more likely to reoccur:
Obstacles to using the skills above:
Consequences that make problem behaviors
less likely to reoccur: (What makes it difficult for me to use my skills effectively?)

17 Module I: MINDFULNESS

MODULE II: InTERPERSONAL EFFECTIVENESS

DOING OUR

PARRT

P Personal best
A Active listening
R Respect
R Responsibility
T Trustworthiness

INTERPERSONAL EFFECTIVENESS

Objectives Effectiveness (using skills to get what you want)

• Getting another to do something for you • Resolving an interpersonal conflict
• Refusing an unwanted or unreasonable request • Getting your opinion or point of view taken seriously

1. What do I want to gain from this interaction?

2. What do I have to do to get the results I want or need?

Relationship Effectiveness (using skills to maintain a relationship)

• Acting in such a way that the other person still likes and respects you
• Balancing immediate goals with the health of the long-term relationship
• Remembering why the relationship is important to you both now and in the future

1. How do I want the other person to feel about me after the interaction?

2. What do I have to do to keep this relationship healthy?

Self-Respect Effectiveness (using skills to maintain your self-respect)

• Respecting your own values
• Acting in a way that makes you feel good about yourself
• Behaving in a way that makes you feel capable and effective

1. How do I want to feel about myself after the interaction is over?

2. What do I have to do to feel that way about myself? Module II: INTERPMEoRSdOuNlAeLI:EMFFIENCDTFIUVELNESS

19

Dear Man: OBJECTIVES EFFECTIVENESS

A helpful way to learn objectives effectiveness
is to remember the term “DEAR MAN”

DESCRIBE Describe the current situation. Tell the person exactly what you are reacting to and stick to
EXPRESS the facts.
ASSERT Express your feelings and opinions about the situation. Assume that your feelings and
REINFORCE opinions are not known. Use phrases such as “I want” or “I don’t want” instead of “I need” or
MINDFULLY “You should” or “I can’t”.
Assert yourself by asking for what you want or saying no clearly. Assume that others cannot
read your mind. Don’t expect others to know how hard it is for you to ask directly for what
you want.
Reinforce the reward to the person ahead of time. Tell the person the positive effects of
getting what you want or need. Help the person feel good ahead of time for doing or
accepting what you want.
Mindfully keep your focus on your objectives and maintain your position. Don’t get
distracted.

APPEAR Appear confident, using a firm voice tone and physical manner and make good eye contact.
NEGOTIATE Try not to stammer, whisper, stare at the floor, retreat or say “I’m not sure,” etc.
Negotiate by being willing to give something in order to get your needs met. Offer and ask
for alternative solutions to the problem. What am I willing to “settle for” or “give up” in
order to gain what I want in the situation?

20 Module II: INTERPERSONAL EFFECTIVENESS

DEAR MAN PRACTICE EXERCISE

Think of a time when you needed to ask someone for
something important or a time when you had to say no

to a request.
Describe the situation and how you might use the “DEAR MAN” skill in order to create a more
successful interaction. Use descriptive language, be direct and assertive and try to give the other person

a reason to understand your needs.
Try to be open to the idea that you may have to sacrifice something in order to come to
an amicable agreement. Practice maintaining your flexibility and open-mindedness while making a

request of someone. Be firm in saying no to requests that you cannot accommodate.

DESCRIBE
EXPRESS
ASSERT
REINFORCE
MINDFULLY
APPEAR
NEGOTIATE

21 Module II: INTERPERSONAL EFFECTIVENESS

GIVE: RELATIONSHIP EFFECTIVENESS

A HELPFUL WAY TO LEARN OBJECTIVES EFFECTIVENESS
IS TO REMEMBER THE TERM “GIVE”

(BE) GENTLE Be courteous in your approach; try not to use verbal or physical attacks. Attempt
(ACT) INTERESTED to express anger directly, without using threatening or manipulative statements.
Learn to tolerate a “no” to your request. Stay in the discussion even if it gets
VALIDATE painful. Try not to judge, moralize or use “should” statements.
Listen to other people’s points of view, opinions, reasons for saying no, or
their reasons for making requests of you. Try not to interrupt or talk over
people. Be sensitive to other people’s desire to have a discussion at a later
time. Try to be patient.
Acknowledge other people's wants, difficulties and opinions about a
given situation. Be non-judgmental with your words, for example: “I can
understand how you feel, but…” or “I see that you are busy, so…”

(USE AN) EASY MANNER Use a little humor when possible; smile and try to be light-hearted. Adjust
your body language to convey a sense of openness and ease in order to give
your listener a sense of comfort, which will enable your listener to better
acknowledge your needs.

22 Module II: INTERPMEoRSdOuNlAeLI:EMFFIENCDTFIUVELNESS

GIVE PRACTICE EXERCISE

CHOOSE A SITUATION IN YOUR LIFE WHERE YOU HAVE HAD TROUBLE
COMMUNICATING WITH ANOTHER PERSON OR MAINTAINING
A RELATIONSHIP.

Utilize the “GIVE” skill to explain how you might deal with the situation in an effective manner

Describe ways in which you may have criticized, judged or threatened the other person:

GENTLE Describe how you could be more gentle in your approach (alter tone of voice, give eye contact,
use “I” statements):

Describe ways in which you may have interrupted, spoken over or tuned out the other person:

INTERESTED Describe how you could show more interest in the other person:

Describe ways in which you may have invalidated the other person i.e. simplified the problem,
were non-empathic, struggled for control:

VALIDATE Describe how you can be more validating of the other person i.e. try to feel what it’s like to be in the
other person’s shoes, express empathy:

EASY MANNER Express ways you can be lighter in your approach i.e. by using humor, by smiling and by using open
body language:

23 Module II: INTERPMEoRSdOuNlAeLI:EMFFIENCDTFIUVELNESS

FAST: SELF RESPECT EFFECTIVENESS

A HELPFUL WAY TO LEARN OBJECTIVES EFFECTIVENESS IS TO
REMEMBER THE TER M “FAST”

Asking for what you want or need while respecting your own values and beliefs helps to build and keep your self-respect.
The objective is to build your self-respect by not selling out your values to get what you want.

When you practice self-respect effectiveness you will begin to feel better about yourself and increase your self-esteem. Self-respect and
self-esteem are related; what you respect is what you consider worthy of esteem and what you esteem is what you respect. To build

self-respect, you must have the conviction of your own values. Value yourself as you would value other things that you treat with care.
Displaying self-respect will get your opinions taken more seriously by other people who matter to you.

You have to honor who you are, how you think and feel and what is going on in your life in order to get your views taken seriously.

(BE) FAIR Be fair to yourself and to the other person.
(NO) APOLOGIES Apologize less. Try not to apologize for making a request, for having an
STICK TO VALUES opinion or because you disagree with someone.
Know your values and commit to them.
(BE) TRUTHFUL Be truthful and don’t lie, don’t act helplessly, exaggerate, or make excuses.

What are ways that you already use these skills in your interpersonal interactions?

F
A
S
T

Describe a time when you felt like your self-respect was being threatened or challenged; i.e. someone didn’t listen to you, you
didn’t follow your own morals or you went along with the crowd, sacrificing your own values:

24 Module II: INMToERdPuERleSOI:NMAILNEDFFUECLNTIEVSESNESS

FAST PRACTICE EXERCISE

PR ACTICE USING YOUR “FAST” SKILLS TO ENHANCE YOUR FEELING OF
SELF-WORTH AND SELF-RESPECT

Describe a recent situation in which you tried to maintain your self-respect:

Describe how you used your “FAST” skills in that situation:

F
A
S
T

Now think of a situation in the past where you could have used your “FAST” skills more effectively:

Were you unfair to the other person? Module II: INTERPMEoRSdOuNlAeLI:EMFFIENCDTFIUVELNESS

F How could you have been more fair?

Did you over-apologize?

A Could you have apologized less?

Did you move away from your morals or values?

S How could you have better maintained your values?

Were you dishonest in your interaction?

T How could you have been more honest in your interaction?

25

VALIDATION

VALIDATION MEANS ACKNOWLEDGING ANOTHER PERSON’S
EMOTIONS, IDEAS AND ACTIONS

Validation is letting people know that they have been heard. Self-validation is acknowledging your own emotions, ideas and actions, it
means recognizing that what you feel, think and do is acceptable in a given situation.
Validation does not equal agreement. You may not like or agree with the way someone is acting, feeling or speaking but validation is
acknowledging that you understand where they might be coming from.

RULES OF VALIDATION:

We validate emotions, ideas and actions.
We validate because it demonstrates understanding, concern and care and that we are listening, that we care about our
relationship and that we care for ourselves.
We validate others by actively listening, maintaining direct eye contact, displaying non-verbal body language such as nodding, ver-
bal reframing (for example “I see that you are really upset”). Remain non-judgmental while trying to appreciate how another person
feels and why, even if you don’t agree or approve.
We validate ourselves by observing and describing our own ideas, emotions and behaviors and by remaining non-judgmental
and working to accept how you feel and why you might be feeling that way.

LEVELS OF VALIDATION:

Level 1: Show interest in another person through verbal and non-verbal cues and demonstrate that you are paying attention by
nodding and maintaining eye contact. Ask questions such as “what happened next?” and “could you please tell me more?”
Level 2: Use accurate reflections, for example “I understand you must be frustrated because your son hasn’t cleaned his room”.
Try to summarize what the person is sharing, then ask “is my understanding of the situation correct?”
Level 3: Try to read a person’s behavior and imagine what they could be feeling, thinking or hoping for. It feels good when someone
takes the time to think about our life experiences. Remember to check your understanding of the situation; it is always best not to
make assumptions
Level 4: Validate the person’s behavior in terms of cause within the context of past and present events. For example, “it makes sense
that because you have had panic attacks on the bus before, it is understandable that you don’t like to use public transportation now”
Level 5: Communicate that the person’s behavior is reasonable, meaningful and acceptable. Validate their feelings with statements
like “it seems very normal to be nervous before a job interview, it makes sense to me” or “it sounds like you were very clear and direct
with your doctor, I’m glad they were able to help you”
Level 6: Treat the person as valid without patronizing them or acting condescending. Recognize the person for who they are, with all
their strengths and limitations. Give the person equal status and respect and be genuine and honest with your responses toward them.
Believe in the other person while seeing their struggles and pain

26 Module II: INTERPERSONAL EFFECTIVENESS

VALIDATION PRACTICE EXERCISE

THINK OF A DIFFICULT CONVERSATION YOU’VE HAD RECENTLY

Describe ways in which you might have been more effective in validating another person and practice using
your validation skills in the spaces provided below:

Describe the situation:

Ways in which I validated the other person:

Ways in which I invalidated the other person:

USE THE LEVELS OF VALIDATION TO DESCRIBE WAYS IN WHICH YOU
COULD HAVE CREATED A MORE SUCCESSFUL AND LEGITIMIZING
INTER ACTION:

Level 1:
Level 2:
Level 3:
Level 4:
Level 5:
Level 6:

27 Module II: INTERPMEoRSdOuNlAeLI:EMFFIENCDTFIUVELNESS

FACTORS THAT MAY REDUCE EFFECTIVENESS

28 Module I: MINDFULNESS

MYTHS ABOUT INTERPERSONAL EFFECTIVENESS

29 Module I: MINDFULNESS

GUIDELINES FOR USING INTERPERSONAL SKILLS

30 Module I: MINDFULNESS

CONFLICT RESOLUTION TECHNIQUES

31 Module I: MINDFULNESS

SHARING AND LISTENING

32 Module I: MINDFULNESS

UNDERSTANDING COMMUNICATION INTENSITY

33 Module I: MINDFULNESS

BEHAVIOR CHAIN ANALYSIS

A Behavior Chain Analysis can help you identify why you are
engaging in problem behaviors

It will help you figure out all the things that you may be contributing to a problem behavior and in so doing,
a behavior chain analysis can give you insight into how to change that problem behavior.
1: The first step is to identify the behavior that you want to change. For example, do you want to stop engaging in deliberate self-harm
or self-medication through alcohol? Maybe binge eating? Try to identify a behavior that is causing problems in your life.
2: Next, think about what happened prior to engaging in the problem behavior. What were you doing? What was going on around
you? Were you in an argument? Did you remember a triggering traumatic event? The aim of this step is to identify the event or
situation that served as the starting point for your problem behavior.
3: Identify what kinds of thoughts accompanied the situation you identified in Step 2. How did you evaluate the situation or
yourself in that situation? Did you engage in catastrophic or all-or-nothing thinking?
4: Think about what emotions you were feeling as a result of that situation. Try your best to list as many emotions as you can (for
example; fear, sadness, anger, shame, guilt, embarrassment or dread).
5: Pay attention to what you felt in your body. Try to recognize and label all the sensations that you felt. For example, did you
experience shortness of breath? Muscle tension? An increased heart rate? Think about how your body reacted to the situation.
6: List what behaviors your thoughts, emotions and bodily sensations made you want to engage in. Did they make you want to
escape the situation or do something to make those feelings stop? Did you feel a need to engage in your problem behavior?
7: Finally, think about the consequences of engaging in your problem behavior. Did you feel better afterwards? Did you feel
disappointed in yourself or ashamed? List as many consequences, both positive and negative as you can.

TIPS FOR THIS EXERCISE

It can be helpful to go through a behavior chain analysis soon after engaging in a problem behavior. This way, your experience is fresh
in your mind and you will likely be able to remember more information about the factors that led up to your problem behavior.
Identify what may have made you more susceptible to responding to the situation as you did. For example, when people do not eat well
or get enough sleep, they may be more prone to experiencing negative moods or having more intense emotional experiences.
Behaviors can serve multiple functions. Therefore, it helps to go through a behavior chain analysis for a number of different situations
that may have led to a problem behavior and to try and identify all the functions that a problem behavior serves.
After you complete a behavior chain analysis, indentify different coping strategies that you could use at each stage.
In addition to identifying the function that a problem behavior serves, it is also important to figure out how to “break the chain”
through use of healthier coping strategies.

34 Module II: INTERPERSONAL EFFECTIVENESS

BEHAVIOR CHAIN ANALYSIS PRACTICE EXERCISE

Problem behavior

Describe exactly what you did or said and try to be as specific and detailed as possible:

Links: Past Chain of Events Solutions: New Chain of Events

What were the feelings, thoughts and behaviors which led New suggestions for solving the problem. What could
up to the problem behavior? Try to write your thoughts as you have done differently to avoid the problem behavior?
direct quotes as they occur. Describe in specific detail how you could use each skill.
Solutions to
Vulnerabilities Vulnerabilities
Prompting Alternative
Event ways to think
Thoughts and act
before Alternative
behavior thoughts
Body Skills to cope
sensations with body
& changes sensations
Emotions Skills to cope
before the with emotions
behavior Alternative
Problem behavior
behavior Skills I can
Thoughts commit to
after behavior practicing
Emotions this week,
after behavior relating to
the problem
Consequences that make problem behaviors behavior
more likely to reoccur:
Obstacles to using the skills above:
Consequences that make problem behaviors
less likely to reoccur: (What makes it difficult for me to use my skills effectively?)

35 Module II: INTERPMEoRSdOuNlAeLI:EMFFIENCDTFIUVELNESS

MODULE III: EMOTION REGULATION

E Encouraging effective action
M Making thoughtful decisions
O Orienting to the present moment
T Truth (recognizing truth)
I Insight (providing insight)
O Operating effectively
N Navigating through life
S Sensing Wise Mind

THE FUNCTION OF EMOTIONS

the Emotional Experience

Emotions communicate to and influence others

We communicate our emotions to others with verbal and non-verbal cues (i.e facial expressions, body language or postures).
Some expressions of emotion have an automatic effect on others. When there is a difference between what a person communicates
verbally and non-verbally, the other person will usually respond to the non-verbal expression.

Emotions organize and motivate action

There is an action urge connected to any given emotion; it is a hard-wired response, which means the action urge is an an automatic
and built-in part of our behavior. For example, if you see your two year-old child run into the middle of the street and a car is
coming, you will feel an emotion (fear). This emotion will prompt you to run to try and save your child. You don’t stop to think
about it, you just do it. Your emotion has motivated your behavior without conscious thought.

Emotions give us information and can be self-validating

Emotions can send us unconscious signals that something is happening or about to happen. Sometimes signals about a situation
can be picked up unconsciously and we may have an emotional reaction without knowing what initially set it off. Thoughs such as
“something doesn’t feel right here” or “I had a feeling something was going to happen” are some types of signals we might notice.

Defining the Emotional Experience

In naming our feelings, we can begin to reduce the intensity of painful emotions which gives us
greater control over our behavior

Brain researchers at the University of California have conducted a brain imaging study indicating that by simply identifying and
naming what emotion we are experiencing decreases the intensity of the response in the amygdala (the part of the brain that manages
fear, panic and other strong emotions). What lights up in the brain is the right ventrolateral prefrontal cortex - the part of the brain
that controls our impulses and behavior. This is the only region of the entire brain that is more active when you name an emotion.

UNDERSTANDING the Emotional Experience

Triggers Physical Reactions

Being reminded of something wrong, immoral, or Crying or sobbing, blushing, hot or red face,
shameful you did in the past, being laughed at choking sensation, feeling suffocated

Feelings Action Urges

Embarrassment, guilt, humiliation, shame, Eyes down, slumped posture, avoiding the
invalidation, remorse person you have harmed

Beliefs After Effects

Thinking that you are bad, immoral or wrong, Engaging in impulsive behaviors, believing
judging yourself as inferior you are defective

37 Module III: EMOTION REGULATION

THE FUNCTION OF EMOTIONS PRACTICE EXERCISE

Write about a time that you struggled to cope with a difficult or painful emotion. Describe the
emotion in detail and include the triggers, feelings, beliefs, physical reactions, action urges and
after effects that you experienced:

SUMMARIZING THE EMOTIONAL EXPERIENCE

Triggers Physical Reactions

Feelings Action Urges

Beliefs After Effects

What helped you cope with the difficult emotion? What was not helpful?

The next time you experience this emotion, how might you cope more effectively?

38 Module IIMI:oEMduOlTeIOI:NMRINEGDUFLUALTNIOESNS

UNDERSTANDING HOW EMOTIONS OPERATE

What are primary emotions?

When our emotions do what they are supposed to do and serve a purpose, they are known as our primary emotions. These emotions
are uncomplicated in nature and are automatic responses that are fundamental to human functioning and survival.

The following are examples of primary emotions:

FEAR GUILT JOY SURPRISE LOVE
ANGER SADNESS SHAME INTEREST DISGUST

What are secondary emotions?

When we have other reactive feelings about our primary emotions, these are known as our secondary emotions. The following are
examples of secondary emotions:

FEELING GUILTY FEELING EMBARASSED FEELING ANGRY
ABOUT BEING ANGRY ABOUT BEING SCARED ABOUT BEING SAD

Identifying the emotional experience:

The chart below demonstrates how each component of our emotional experience feeds the next, creating a bio-feedback loop that
affects how we think, behave and react to our emotions in the future.

TRIGGERS PHYSICAL
FEELINGS REACTIONS
ACTION URGES
BELIEFS
AFTER EFFECTS

39 Module III: EMOTION REGULATION

NAMING EMOTIONS

40 Module I: MINDFULNESS

“You know what truly aches?
Having so much inside you
and not having the slightest
clue of how to pour it out.”

~ Karen Quan

41 Module MIVo: DdIuSTleREI:SMSSITNODLFEURLANNECSES

EMOTIONAL MYTHS WE LIVE BY

42 Module I: MINDFULNESS

EMOTIONAL MYTHS PR ACTICE EXERCISE

43 Module I: MINDFULNESS

Cognitive Distortions

What are cognitive distortions?

Cognitive distortions are thought patterns that our minds use to convince us of something that isn’t necessarily true. These warped and often innacurate
patterns of thought are usually our brains’ way of re-enforcing negative beliefs that we hold. Cognitivie distortions tells us things that might sound
rational and accutate, but they really only serve to keeps us feeling emotionally trapped. The following are some examples of the most common cognitive
distortions people tend to engage in:

Polarized Thinking: In polarized thinking, things are either “black or white”. You have to be perfect or you have failed - there is no middle
ground. You place people or situations in “either/or” categories, without seeing shades of gray and without allowing for the inherent complexities
within most people or situations. If your performance falls short of perfect, you might see yourself as a total failure.
Filtering: You take the negative details and magnify them while filtering out all positive aspects of a situation. For example; you may pick out a
single unpleasant detail and dwell on it exclusively so that your vision of reality becomes distorted.
Overgeneralization: In this cognitive distortion you may come to a generalized conclusion based on a single incident or single piece of evidence.
If something bad happens only once, you expect it to happen over and over again. You may see a single unpleasant event as part of a never ending
pattern of defeat.
Jumping to Conclusions: Without a person saying so, you might think you know what that person is feeling and why they are acting the way
they do. In particular, you are able to determine how people are feeling toward us. Two specific subtypes of this cognitive distortion are identified
here: 1: Mind reading: This is when you assume you have special knowledge of the intentions or thoughts of others. 2: Predicting the Future: This
is when you might exaggerate how things will turn out before they happen.
Catastrophizing: You expect disaster to strike, no matter what. This is also referred to “magnifying or minimizing”. You hear about a problem
and use what if questions, for example: “what if this happens to me?” You might exaggerate the importance of insignificant events such as
people’s mistakes or achievements or, you may inappropriately minimize the magnitude of significant events such as a person’s desirable qualities
or someone else’s imperfections.
Control Fallacies: If you feel externally controlled, you might see yourself as a helpless victim of fate. The fallacy of internal control has you
assuming responsibility for the pain and happiness of everyone around you. For example, “why aren’t you happy? Is it because of something I
did?”
Fairness Fallacy: You might feel resentful because you think you know what is fair, but other people might not agree with you. As our parents
tell us in childhood when something doesn’t go our way, “life isn’t always fair”. People who go through life applying a ruler against every
situation, judging its “fairness” will often feel badly and negative because of it. Because life isn’t always fair in reality, things will not always work
out in your favor, even when you think they should.
Blaming: You hold other people responsible for your pain or take the other track and blame yourself for every problem. Nobody can make you
feel any particular way. Only you have control over your emotions and emotional reactions.
Shoulds: You have a list of iron-clad rules about how you and others should behave. People who break those rules make us angry, and you feel
guilty when you violate these rules yourself. You may often believe you are trying to motivate yourself with “shoulds” and “shouldn’ts”. The
emotional consequence is guilt. When you direct “should” statements toward others, they often feel anger, frustration or resentment.
Emotional Reasoning: You beleive that what you feel must be true automatically, if you feel stupid and boring, then you must be stupid and
boring. You assume that your unhealthy emotions reflect the way things really are.
Fallacy of Change: You expect that other people will change to suit you if you pressure or cojole them enough. You need to change people
because your hopes for happiness seem to depend entirely on them.
Global Labeling: You generalize one or two qualities into a negative, global judgment. These are extreme forms of generalizing and are also
referred to as “labeling” and “mislabeling”. Instead of describing an error in the context of a specific situation, you may attach an unhealthy label
to yourself or someone else.
Always Being Right: You are continually trying to prove that your opinions and actions are correct. Being wrong is unthinkable and you will go
to any length to demonstrate your correctness, even at the expense of other people’s feelings.
Reward Fallacy: You expect your sacrifice and self-denial to pay off as if someone is keeping score. You feel bitter when the reward doesn’t come.

44 Module III: EMOTION REGULATION

Cognitive Distortions PRACTICE EXERCISE

Think of a time when you felt distressed, upset or anxious and where your reaction might have
been out of proportion to the situation. Try to identify the triggering event, emotional experience
and behavioral response below.
What was the triggering event?

What was the emotional experience?

How did you respond to the situation?

Now use the chart below to analyze any possible cognitive distortions that may have impacted
your emotional or behavioral functioning.

Triggering
Event
Negative

Thought
Emotional

Impact
Physical
Reaction
Cognitive
Distortion
Alternative
Response

45 Module IIMI:oEMduOlTeIOI:NMRINEGDUFLUALTNIOESNS

ABC ~ PLEASE ~ ~STRONG

Engaging in healthy habits and reducing vulnerabilities are an important part of managing mood swings,
depression, anger and irritability. Please select one of the skills below to work on over the next few weeks, and
tell your therapist which goal you’ve chosen to exercise, while monitoring your progress on your diary card.
When you have mastered one area of healthy behavior, pick another goal to work on

ABC

ACCUMULATE Incorporate positive experiences into your life and be mindful of them. Research has shown that
POSITIVES having pleasurable, positive experiences is one of the best ways to prevent and treat depression.
BUILD Do pleasant things that are possible now and work towards long term goals.
MASTERY Engage in a slightly challenging activity that makes you feel confident. Research has shown that
COPE developing an enjoyable, skillful activity reduces depression and increases positive emotions.
AHEAD Practice managing your negative emotions before a triggering situation. Identify triggers and
picture the situation clearly, envisioning exactly how you will feel and respond. Identify the
skills to use and imagine yourself using them in the situation.

PLEASE

Take care of your body to take care of your mind. We are more vulnerable to our emotions when our bodies are under stress.

STRONG

SLEEP AS MUCH AS YOU NEED
TAKE MEDICATIONS AS PRESCRIBED
RESIST USING PSYCHOACTIVE DRUGS OR ALCOHOL
ONCE A DAY, DO SOMETHING THAT GIVES YOU A FEELING OF MASTERY
NUTRITION - EAT A BALANCED DIET, AVOID EMOTIONAL EATING
GET EXERCISE - DO 20 MINUTES A DAY TO HELP IMPROVE YOUR MOOD

46 Module III: EMOTION REGULATION

“A crucial element of the
real self is its unconditional

acceptance of itself.”

~ Michael Adzema

47 Module III: EMOTION REGULATION

OPPOSITE TO EMOTION ACTION

What is Opposite to Emotion Action?

Every emotion has an accompanying action urge and each emotion will cause you to want to do something different. For example, if you’re in a movie
theater and someone yells “FIRE”, you might feel afraid (emotion) which would then cause you to run (action urge). Because emotions have accompanying
action urges, you can actually change the emotion by changing the action response.

This skill is known as “opposite to emotion action”. For opposite to emotion action to work effectively, you must identify “does the situation actually justify
my emotion?” The following situations may warrant the use of opposite to emotion action: When the emotion is not justified by the situation or when the
emotion is too intense for the situation

Using Opposite to Emotion Action

Listed below are the primary emotions we experience and their accompanying opposite actions. For each listed primary emotion, examine the
opposing action urges or behaviors and try to imagine yourself engaging in these behaviors, when opposite to emotion action is appropriate.

ANGER FEAR

• Gently avoid; imagine empathy • Do what you are afraid of repeatedly, over and over
• Do something a little bit nice • Approach that which you are avoiding
• Relaxed posture: willing hands, half smile
• Do what gives you a sense of mastery and control

DISGUST SHAME

• Move close; embrace • Do what makes you feel ashamed repeatedly, over and over
• Take in what feels repulsive • Make your behavior public to those who won’t reject you
• Be kind and have empathy
• Utilize a proud posture and maintain eye contact

ENVY JEALOUSY

• Count your blessings • Let go of trying to control others
• Keep an attitude of gratefulness • Share what and who you have with others in your life
• Don’t exaggerate other people’s worth and check the facts
• Don’t avoid, try to listen to all the details

SADNESS GUILT

• Engage in activating behavior, approach don’t avoid • Do what makes you feel guilty repeatedly, over and over
• Do things that make you feel confident, build mastery • Don’t apologize or try to make up for transgressions
• Utilize an upright posture, head up, eyes open, shoulders back
• Maintain an innocent and proud posture, keep eye contact
48
Module III: EMOTION REGULATION

OPPOSITE TO EMOTION ACTION PRACTICE EXERCISE

Think of a time in the past when you had difficulty managing a strong emotion. Identify
the triggering event, the emotional response and the accompanying action urge.

What was the trigger?
What was the emotion?
What urges did I feel?

Now identify if using the opposite to emotion skill is appropriate:

Was the intensity of the emotion effective? YES NO Would reducing the intensity help me in the long term? YES NO

Which opposite action would have been most effective?

How might I have felt differently after doing this opposite action?

Practice Opposite to Emotion Action:

If you are feeling really anxious about an upcoming event (for example, giving a speech in public), and you are avoiding thinking about
it, the opposite action might involve stopping the avoidance you are engaging in (i.e facing the fear), and writing out a plan of how to
accomplish the task.
If your emotion is tiredness, your opposite action might be getting energetically involved in an activity such as cleaning or organizing your
room, completing your school work, or writing a letter to a family member or friend.

EMOTION:
OPPOSITE ACTION:
HOW I FELT AFTER:

EMOTION:
OPPOSITE ACTION:
HOW I FELT AFTER:

EMOTION: Module IIMI:oEMduOlTeIOI:NMRINEGDUFLUALTNIOESNS
OPPOSITE ACTION:
HOW I FELT AFTER:

49

MIDDLE PATH

Walking the Middle Path

Walking the middle path means being able to think, feel and speak dialectically, to validate both self and others, and to strive to achieve a
harmonic balance inside yourself and in your environment.

Utilizing dialectical or “Middle Path” reasoning involves a dialogue between two or more people who hold differing points of view about a
subject and wish to establish the truth of the matter with dialogue and reasoned argument.

“Middle Path” communication is different from debate, wherein the debaters are committed to their points of view and try to win the
debate. “Middle Path” or dialectical reasoning is the concept of taking two opposite ideas and merging them into a cohesive whole.

Some things to consider in using Middle Path thinking:

• Opposing truths can both be true (i.e. I am doing the best that I can, and I can also do better)
• There are always be shades of gray within black and white thinking
• Things don’t always have to make perfect sense to be acceptable
• Different people can see the same situation in very different ways
• Flexible thinking allows us to see other’s points of view and empathize with them

These are some techniques for acheiving Middle Path thinking:

• Move away from either/or reasoning and try to move towards both/and thinking
• Use “I” statements; stay away from “You...”
• Verify that you understand what others are saying, and that they understand what you are saying too
• Remind yourself that no one has the absolute truth. Look at a situation from all sides and perspectives

Here are examples of dialectical dilemmas you may recognize in your own life:

I want to be sober I want to drink/use

I want Peanut M&M’s I want to be healthy

I want to feel better I don’t want to work to feel better

I can’t control other people I want everyone to do it MY way

50 Module III: EMOTION REGULATION