DBT in Practice: Mastering The Essentials

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Last Updated Nov 30, 2022|

DBT Emotion Regulation Skills: Emotion Psychoeducation & Mindfulness

By Stephanie Vaughn, PsyD

This presentation is an excerpt from the online course “DBT in Practice: Mastering the Essentials”.

Highlights

  • Emotion dysregulation is a common experience for DBT patients.
  • It is important to discuss the benefits of emotion and challenge desires to eliminate emotions.
  • Identifying and labeling emotions helps to reduce their intensity.
  • The Emotion Regulation module involves psycho-education about emotion, teaches skills to change unwanted emotions and reduce vulnerability to Emotion Mind.
  • Mastery involves taking small action steps toward long-term goals; PLEASE skills refer to self-care activities; Opposite action involves engaging in a behavior opposite to one that is mood congruent.

 

Transcript

When an individual’s core issue involves difficulty in managing emotions, it is likely that DBT may be a good fit.
Problem behaviors may be the result of emotion dysregulation or they may be an attempt to regulate emotions. This module, the emotion regulation module, teaches skills to assist members in changing unwanted emotions, in reducing vulnerability to emotion mind and provides them with a general psychoeducational overview of emotions.

One of the most popular and well-known skills to help change unwanted emotions is referred to as opposite action.
In order to practice the skill of opposite action, one must first identify an emotion that they would like to change. If they would like to change the emotion of sadness, then it would be important to identify the urge, the action urge associated with the emotion.
So for sadness, a person may have the action urge to withdraw, to pull a blanket up over their head, perhaps to watch sad movies.
The action opposite to this urge would be to get active, to listen to fun music and dance and potentially to socialize. Although an individual would be most unlikely to want to do these things, that is the purpose of the skill. It is to change the desire to want to. If a person continues with mood congruent behavior, it is likely to increase the emotion that they’re experiencing. So therefore, we want to engage in the opposite of the urge in order to make a change.

The psychoeducational piece of the emotion regulation module relies on the backbone of CBT. When teaching members about emotions, we discuss the evolutionary benefit of our emotions, the fact that as a species we would be unlikely to survive had we not had fear, anger, jealousy, any of the other emotions that you might identify. We discuss the biologic portion of emotions, how we’re hardwired and what makes it difficult to change emotion and to engage in different behavior. And we discuss how eliminating emotions entirely might seem on the surface to be the most effective strategy for managing emotions but would likely cause a horrible impact on our social life.

Mindfulness is interwoven throughout the emotion regulation section in that members are encouraged to observe their emotions and label them. The act of observing and labeling emotions actually causes them to decrease. Members are encouraged to identify multiple emotions in any given situation and to differentiate between primary emotions which may seem to be the most prominent and secondary emotions which are just under the surface. For example, anger has been suggested to be a primary emotion while the secondary emotion of feeling hurt or disappointed is just below the surface.

The skills for helping reduce vulnerability to emotion mind include the PLEASE skills which is an acronym for treating physical illness, healthy eating, avoid mood-altering substances, sleep and exercise.

And other ways of reducing vulnerability to emotion mind include increasing pleasant events and positive experiences in a deliberate fashion rather than waiting for these experiences to come from out of the blue.
Mastery is a skill taught in this module which involves identifying long-term goals or life worth living goals and breaking them down into small action steps which one could complete on a daily basis. Engaging in some master activities seems to be essential in regulating emotions for the long term. Another popular skill is the cope ahead skill which is somewhat of an imaginary rehearsal activity. When using the cope ahead skill, one might imagine coping well with a situation that causes distress. So not only is the person engaged in problem solving, they’re engaged in somewhat of an exposure when they’re imagining the worst case scenario but then we’re actively imagining coping well.

Mastery is a skill taught in this module which involves identifying long-term goals or life worth living goals and breaking them down into small action steps which one could complete on a daily basis. Engaging in some master activities seems to be essential in regulating emotions for the long term.

Another popular skill is the cope ahead skill which is somewhat of an imaginary rehearsal activity. When using the cope ahead skill, one might imagine coping well with a situation that causes distress. So not only is the person engaged in problem solving, they’re engaged in somewhat of an exposure when they’re imagining the worst case scenario but then we’re actively imagining coping well.

Overall, the emotion regulation module involves psychoeducation about emotion and how to stay regulated rather than experience drastic swings from emotion mind to reasonable mind with very little time spent in wise mind.

Key points: Emotion dysregulation is a common experience for DBT patients.
It is important to discuss the benefits of emotion and challenge group member desires to eliminate any or all emotions. Identifying and labeling emotions helps to reduce their intensity.
The emotion regulation module involves psychoeducation about emotion and teaches skills to change unwanted emotions as well as to reduce vulnerability to emotion mind.
Mastery involves taking small action steps toward long-term goals. PLEASE skills refer to self-care.
Opposite action involves engaging in a behavior opposite to the one that is mood congruent.

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