The Emotional Regulation module in Dialectical Behavior Therapy contains two skills designed to separate actions from emotions. The first, Opposite to Emotion, is about doing things you don’t feel like doing. Feeling fear? Approach the situation that scares you. Feeling guilt? Repair the transgression. Feeling shame? Do what makes you feel ashamed. Feeling sad? Do something that makes you feel competent. Feeling angry? Do something kind.
99% of the time I use this skill when I’m feeling anxious about a situation, or wanting to back out of plans I’ve made. I take a deep breath, tell myself “Opposite to Emotion”, and go participate in the activity anyway. It works. Usually things go better than I feared, the anxiety fades once I get involved, and I don’t have the regret of missing out on life to compound any depression I may be feeling.
The other skill, Feeling Not Acting, is about not doing things you feel like doing. Not acting on harmful urges: to overspend, to gamble, to drink, to take drugs, to self-harm, to binge/purge. You take a moment to identify the impulses you’re feeling, then choose to act in a healthier way. This may be by using the Ride the Wave skill to just feel the emotion and then let it go. This may be by using another skill to self-soothe or to distract. The third suggestion is to “act on the impulse in less problematic ways” but I fail to see how accepting an action that is “less bad” is helpful in the long run.
I usually take the Ride the Wave approach. Most of the time I mark those two skills down together on my diary card. I rarely think to mark Feeling Not Acting when my way of avoiding the action has been by using another skill. Riding the Wave is uncomfortable. It’s hard to sit and just feel an emotion, an impulse without acting on it in any way.
I’m doing it, though, because I have a goal in sight. A while back I notified Sierra and Nadia that I would be quitting DBT group, but then when something enlightening happened during a Mindfulness exercise I reconsidered. When discussing my ambivalence with Sierra, she brought up the notion of graduating from group. Not just randomly leaving, but completing the program. It’s supposed to be roughly 1 year, with the series of modules being completed twice during that time, and I’ve reached the point that I’ve been through them twice, with the exception of missing a little of Emotional Regulation both times due to work.
Sierra’s suggestion was that I set a goal to show that I have learned and applied the skills. My goal is to go two months without any harmful actions on my diary card. Since starting diary cards in September 2014, my record is 5 weeks and 2 days. At this point, I’ve almost reached 4 weeks, and the two month mark falls on January 2nd. This is before the first January meeting of DBT group, so assuming I don’t slip up before then, I will not have to attend group at all in 2016.
Sadie and I have completed all the DBT skills from the material she uses, with the exception of her needing to look at my last two worksheets. We are moving on to other approaches, and I’ve asked her if I still have to do diary cards after I graduate from group. She said I don’t if I really don’t want to, and I think I don’t want to. Rating my negative urges causes me to think about those possible actions even when I haven’t thought about them all day, and I find that sometimes I start feeling urges that I otherwise wouldn’t. I just want to close the DBT chapter of my life and move on.
Of course I will still use the skills I’ve learned. I just won’t sit there at the end of each day struggling to remember which ones I’ve used and trying to reinterpret all my experiences of the day in terms of DBT skills. I will be able to color without thinking “oh, I’ll mark down Self-Soothe tonight” or give myself a pep talk during the work day without thinking “hey, this is the Encouragement part of IMPROVE”. I’ll use the skills for their own benefit, and not because it gives me something to write down on my diary card.