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Calming Tools for Troubling Times

These powerful DBT techniques can help you take back control of your inner life


Coronavirus has turned the world as we know it upside down. We’re struggling with lockdown, illness, and finances. It’s all too easy to get caught in a downward-spiraling cycle of negative emotions and actions. These powerful DBT techniques can help you take back control of your inner life

What a week it’s been! And it’s only Day 7 (as of this writing).

If you’d thought you were juggling a lot before coronavirus, our current situation has added so many other balls (and flaming objects) to keep aloft. Most of us are feeling a mix of emotions: anxiety about health and finances, overwhelm, gratitude for our families, stress about making Pesach, loneliness.

We may feel pride in the kids’ learning — or a sense of failure when they won’t get on the conference call. We vacillate between enjoying the children and not enjoying the children (ditto with our husbands). We may be feeling inadequate and dysfunctional.

Dialectical behavioral therapy (DBT) is a therapy designed to help you manage your emotions, and thereby your actions, so you can build a life full of meaning. It’s based on the dual assumptions that you’re doing the best you can — and that when you fall short of your ideals, you need to learn skills that enable you to do better. Let’s look at how these DBT skills can give you the tools to enable you not just to scrape through this time, but to be the person you want to be.

It’s well known that our thoughts affect our emotions, actions, and physical state. But they’re actually all intertwined and feed into each other, as illustrated in the chart below.

It’s our emotions that most frequently get us off track. When our brain goes into what psychologists call an “amygdala hijack,” meaning that our emotions are running the show, it makes us think and act in ineffective and often destructive ways — yelling, mentally beating ourselves up, overeating, shutting down, etc. In order to treat others and ourselves well in action, we need to be able to manage our emotions.

But simply willing an emotion to change isn’t enough. (How often do we become more incensed when told to “just calm down”?) What to do? There are three ways to change our emotions: alter our thoughts, our actions, or our physical state.

Sometimes it’s easiest to change our actions. Sometimes it’s easiest to change our physical state. And sometimes it’s most effective (although often not easiest) to change our thoughts. Having a smorgasbord of skills to choose from will ensure you’re most equipped to deal with whichever dragon is pursuing you at the given moment.

With this in mind, here are DBT skills selected to help you thrive and reach these goals during a crisis. Choose whichever skills or whichever combination of skills works best.


STEP ONE: Mindfulness

To know which solution will help, first you need to figure out exactly what’s bothering you. You’d never go to a doctor who prescribed antibiotics without any examination or testing; getting to the root of your emotional difficulties requires a similar process.

Here, the “exam” is “Observing and Describing.” Here’s what it looks like: Notice that you’re getting upset (Observe), then name your emotions and thoughts (Describe) by asking yourself, “What am I feeling?” and “What am I thinking?” For example, you might notice that you’re snapping at your children (Observe) and then think, “I’m really anxious. I keep wondering whether my boss is going to lay anyone off” (Describe).

Step one is only step one. Just like you wouldn’t go to a doctor who doesn’t base his prescription on a thorough exam, you also wouldn’t go to a doctor who’d say, “The test shows you have strep. Now that you have that insight, you should get better.” You’d want to know which antibiotic to take.

In terms of managing your emotions, you now want to figure out which skill will help you with your specific emotion and thought. Read through the different skills and choose the ones you’d like to try first. Once you’ve become more familiar with those, you can come back for more skills to add to your emotional toolbox.

Change Your Thoughts: Validation

Validation means telling yourself or other people that what they’re thinking and feeling makes sense. It doesn’t mean that you agree, although you might. It means stating or acknowledging that the response is based on life experiences. For example, if your daughter wants to read her new book instead of listening to her teleconference or doing her English assignments, you might not agree with her decision — but you can probably understand it. If you’re getting annoyed with her, you might not approve of your reaction, but you can understand that you’re feeling pulled in a million directions and have less patience than usual.

Without validation, such situations can quickly devolve into a power struggle.

Mother: It’s time to call into the teleconference for your Chumash class.

Daughter: (ignores her)

Mother: I said, it’s time to call into the teleconference for your Chumash class.

Daughter: I don’t want to. I want to finish my chapter. I only have ten more pages.

Mother: It’s late already! Close the book this second and go make that call!

Daughter: I’m not calling.

Validation is a great skill because it (1) keeps you and others calmer and (2) it improves your relationships by validating others’ feelings and thoughts (even if not always their actions).

Imagine if the conversation with your daughter could go this way:

Mother: It’s time to call into the teleconference for your Chumash class.

Daughter: (ignores her)

Mother: I said, it’s time to call into the teleconference for your Chumash class.

Daughter: I don’t want to. I want to finish my chapter. I only have ten more pages.

Mother: I don’t blame you. It’s hard to stop in the middle of the chapter. Let’s call now, and you’ll have a lot of time to read afterwards. I know it’s hard — but you can do it.

Daughter: Okay, fine.

 

Change Your Thoughts: Mindfulness in the moment and awareness of assumptions

Once you know what you’re thinking, ask yourself these questions:

  1. Am I catastrophizing? Are there other equally or more likely outcomes? (In the moment)
  2. Am I making assumptions that may not be true? How can I check out whether my assumptions are accurate? (Awareness of assumptions)

These questions apply both to fears about coronavirus and to interactions you’re having with others. For example, if you texted your sister but she doesn’t answer for a few hours, don’t automatically assume that she doesn’t care about you; rather, wait to speak to her and check out your assumption.


Change Your Thoughts: Balance Your Expectations

Another really helpful skill is dialectics. In our case, that means having balanced expectations of ourselves and others. Instead of vacillating between wanting to be perfect or giving up in despair, dialectics helps you find a middle, more viable position.

For example, you might have spent time and effort writing up what you thought would be a great schedule to make sure the children lose out on as little as possible while you “homeschool” them. But they wake up later than planned and drag their feet through your schedule so you don’t have time to fit in every activity. If you’re not being dialectical, you might conclude the day was a failure. Furthermore, you might feel like a failure and think of giving up on your schedule entirely.

Using dialectics will help you find a middle position that allows you to achieve some of your goal, instead of sticking rigidly to unattainable perfection or becoming despondent. You can ask yourself about the following areas:

Expectations of yourself: Am I expecting myself to be perfect? What goals can I reasonably achieve, especially in the current situation?

Expectations of others: If (when!) my children don’t want to follow my schedule, it doesn’t mean we’re dysfunctional! What parts of my schedule can still work?


Change Your Thoughts: Radical Acceptance

There are many things we don’t like and can’t change. (Maybe your father refused to stay home and now isn’t feeling well; your teenage son only wants to spend time on his phone or the computer and won’t learn; it looks like schools may stay closed until September.) When we focus on these things, we use up our valuable (and limited) energy on battles we simply can’t win. If you can win the battle and change things, do so! This section is for when you can’t.

You know you’re fighting reality when you think things like: “I can’t do this”; “This has to end by next week”; “I’m going to go crazy”; “I don’t care — I’m not listening”; or even “I give up, there’s no point” and “Nothing matters, let them do whatever they want.”

Instead of fighting reality, don’t get angry at the situation and don’t get resigned; figure out what you can do given this immutable reality. In the above examples, you can daven for your father, you can make it as likely as possible that your son learns by not fighting every battle and by showing him how you value whatever he does learn, and you can make a plan to help you get through a far longer period of homeschooling than you’d ever imagined.

But what can you do when, inevitably, you go back to non-acceptance (possibly every ten seconds)?

DBT calls this “turning the mind.” Think to yourself: What would I do if I did accept reality? And then do the first step of that action. For example, to deal with your father’s going out, radical acceptance would mean that when you get worried, you open your Tehillim instead of futilely obsessing over how upsetting it is. To cope with homeschooling being extended indefinitely, make a list of which skills you think will be helpful and what you’ll need to access them. It’s completely normal to have to “turn your mind” over and over and over and over, every few seconds, especially in the beginning. After some time, though, your mind becomes stronger and it becomes easier to stay in “acceptance mode.”

This skill can bring a lot of relief. Paradoxically, by accepting a reality you cannot change, you open up the possibility of changing what you can, and making things at least somewhat better for yourself.


Crisis Survival Skills (CSS)

When you’re feeling so upset that you simply cannot use other skills, use these CSS skills until you calm down enough to move on.

Many of the DBT Crisis Survival Skills teach you to distract yourself so that (1) you don’t do something that makes it worse (think: yelling, overeating, saying something nasty, shutting down) and (2) you don’t keep scaring yourself over and over again with catastrophic, judgmental, or non-dialectical thinking, which just keeps escalating your emotions, often to a dark place.

CSS skills allow your emotions to go through their natural cycle of rising and then falling (which emotions will do on their own if you don’t keep retriggering them) — so you can then go on and use other skills and feel better!

Examples of CSS Skills

  1.          Activity— Get involved in doing something you enjoy or that makes you feel productive. Read a book, play a game, bake, do yoga, go through old photo albums.
  2.          Contribute — Helping someone else has a double benefit: It distracts you and you’ll feel good about helping. If you’re feeling stressed out because the kids are fighting and rejecting your offers to play Monopoly (again), refocus your attention on someone who may be lonely or having a hard time by calling or texting them.
  3.          Push away negative thoughts — Tell yourself you’ll think about them later, but right now you need to help your son with his worksheets / start lunch / finish cleaning the freezer for Pesach. Note: This is different from trying to shut down a thought, which only makes the thought come back stronger.
  4.          Self-soothe — Choose a soothing action that involves your senses: listen to music (hearing), look at a picture of someone you love (sight), snuggle up with a cozy blanket (touch), or drink a hot drink (taste, touch, and smell). Combine these skills for a greater effect.

Change Your Actions: ABC Please

In uncertain or highly stressful situations, it’s important to lower your vulnerability to emotion. A stressor can happen at any moment, and you want to be calm enough that you can use your skills. Think of the skills below as making deposits into your emotional bank account. Since you’re going to need to make many “withdrawals” to handle this situation, the more deposits you make, the more easily you’ll manage.

  1.          Accumulate positive experiences — Find at least one enjoyable thing to do each day. It can be a cup of coffee with cream. It can be playing a game with your children or calling a relative. It can be going outside onto a back porch if you have one. (Disregard the joke going around that you should save the porch for a Chol HaMoed trip!)

You can also do something that has more meaning: learn that sefer you never had time for, spend one-on-one time with each of your children, speak to the friend who was always too busy.

What’s most important is that whatever you do, do it mindfully: focus your thoughts on your activity to distract yourself from thoughts leading to anxiety, etc.

  • Build mastery — Do something each day that brings a sense of accomplishment. Clean for Pesach. Dust off the guitar and practice. Find some drawing lessons online. Make a nice cake for Shabbos.
  • Cope Ahead — While sometimes unexpected challenges happen, there are even more challenges that happen regularly. Cope Ahead helps us stay calmer by making sure we have a plan for the inevitable things that upset us. For example, if you know your children always fight when they play a certain game, to Cope Ahead, name the emotion you feel when they do so (Describe). Then, decide which DBT skill you’ll use when they start fighting. Imagine the situation as vividly as possible, then rehearse your response in your mind — this time, with you using the DBT skill you’ve selected. Troubleshoot with what you think might get in the way, and see if you need to add any other DBT skills.
  • PLEASE skills — Take care of yourself physically, so you can be calmer and take care of whatever needs to be done more easily and consistently.

PL: Take care of your physical health, corona-related and not

E: Exercise. Research shows that a balanced amount of exercise helps anxiety and depression

A: Avoid mood-altering substances. Drinking too much caffeine makes hearts race and causes feelings of anxiety.

S: Sleep. Get a balanced amount of sleep, not too much and not too little.

E: Eating. Your eating should also be balanced — not too much, not too little; not too much junk, not too restrictive (which can lead to overeating or feelings of deprivation — something none of us need more of now).


Change Your Actions: Problem Solve

Another way to defuse an emotion is by solving the problem causing the emotion. DBT emphasizes that if it’s possible to solve your problem, this is the first (and then only) skill needed. Imagine if your child had a headache — you’d offer him Tylenol, not validate and try to distract him!

There are five steps of problem-solving:

 

  1. 1.         Identify the problem: I want to clean for Pesach, but my kids keep eating chometz all over the house.
  2. 2.         Come up with as many possible solutions, without evaluating them as you go: Give away all the chometz now / reward each child who eats only in designated areas / make a buddy system so you’re not the only person watching / get children to help clean so they’ll be more respectful of a clean area. This lack of judgment helps you stay creative and come up with a variety of solutions.
  3. 3.         Choose one of your solutions or combine a few: I might combine the last two ideas and have two children clean an area together. We can make progress reports at supper.
  4. 4.         Try the chosen solution and evaluate whether your plan worked.
  5. 5.         If it worked, keep going! If it didn’t, either troubleshoot (make different pairs / have each child share how hard he worked on his area at supper to awaken his siblings’ empathy and desire to keep the area clean) or choose a different solution and try again from step 4.
Change Your Emotions: Do the Opposite Action

Sometimes your emotions or the intensity of your emotions do not fit the facts. The best way to change your emotion or reduce their intensity is to do the opposite of what your emotion is “telling you” to do.

Here’s where Observe / Describe is crucial: Use this skill to determine which emotions you’re feeling and what they’re telling you to do (i.e., your thought or urge).

Here’s what this process might look like for anxiety, shame, and frustration.

 

EMOTION URGE OPPOSITE ACTION
anxiety avoid approach
shame hide be open
frustration yell or shut down speak quietly, calmly, and kindly
sadness isolate, give up get active, do something pleasant, exercise, smile

For example, if you live in an area where people are not (yet) taking the virus or the quarantine seriously, you might feel embarrassed about being anxious about the situation. You might therefore have the urge to pretend you don’t feel that way. But by pretending you’re not anxious (hiding your opinion), you’re only increasing your sense of shame. And you may be increasing your anxiety as well.

What can you do instead? Express your true feelings — if not to everyone, then at least to the people you’re closest to.

It’s also crucial that you do the opposite action “all the way.” All the way means that in addition to acting opposite, you also need to keep your thoughts from retriggering you. In this example, to combat your shame, you’d make sure not to get stuck in thoughts like, “They probably think something’s wrong with me for feeling this way.” You’d also validate your emotions with thoughts like, “A lot of people are really anxious, so it makes sense that I am too, even if not everyone feels this way.” To be less tense, you can breathe deeply and smile gently, which can help reduce tension. By “acting opposite all the way” to your feelings, you’ll feel less embarrassed.

Change Your Actions: Interpersonal Effectiveness

This skill teaches you how to communicate with others to get your needs met in a way that protects your relationship and self-respect.

You’ll probably get a lot of use out of this skill because when people are spending all their time together 24/7, it’s inevitable there will be differences of opinion about who does what and when. Now’s a great time to put this skill into practice.

The skill is called DEAR MAN.

D — Describe what’s bothering you.

E — Emotions and opinions you’re having.

A — Ask for what you need.

R — Reinforce or Reward by explaining why this will be a win-win situation and how the other person will also have his/her needs met.

D and E involve explaining to the other person what’s bothering you. A is the solution to that problem. R explains why your solution works for both of you. Figure out your “A” first — then the other parts will fall into place.

For example, imagine you tell your husband you’re tired of washing the dishes every night, hoping he’ll offer to pitch in; instead, your husband suggests you use disposables every other night. If your goal was for your husband to be the one in charge of cleanup, you didn’t achieve your goal. But it’s possible your husband didn’t offer to take over because he didn’t know that that was the solution you wanted.

Using DEAR would look like this: “I’m serving and cleaning up three meals a day for the whole family. (Describe.) With Pesach nearly here, it’s getting hard for me to always be in charge of cleanup and also have time and energy to clean other rooms. (Emotions.) Could you take over cleaning up from supper? (Ask.) That way, I can start cleaning for Pesach right after supper each night and the cleaning will go more smoothly. (Reward, win-win solution).

The MAN skills tell us how to say the DEAR: be Mindful (don’t get side-railed into other topics), Appear confident (don’t apologize for having this need), and Negotiate another win-win solution if the other person doesn’t agree with your original R proposal.

Change Your Physical State: Relax!

When you use these skills, focus your attention on fully experiencing what you’re doing to relax, with all five senses. This keeps your thoughts from pulling you into worrying and frustration, which would increase your tension all over again!

 

  •  Self-soothe skills (see above)
  •  Exercise — Turn on music and dance! Do jumping jacks or push-ups!
  •  Relaxing exercises — Listen to music, take a warm bath.
  •  Research shows that each emotion makes us breathe differently — but that breathing can also influence our emotions. Breathing deeply and slowly will make you more relaxed.
  •  Press your “reset button.” Making yourself very cold can trigger the parasympathetic system, which then slows down your heartbeat and helps your body relax. Drink an ice-cold beverage quickly until you (almost) get brain freeze, splash your face with cold water, hold an ice cube in each hand, or put an ice cube on your inside wrist or under your eyes for a few seconds. (No ice burn, please!)
HOW DO I ACCESS THESE SKILLS WHEN I’M JUST TOO UPSET?!!??

Rehearse, rehearse, rehearse — the power of our minds!

It’s hard to remember to use skills when you’re really upset. Here’s how to make it more likely you’ll succeed in doing so:

 

  • ⎫ Choose a situation that generally upsets you
  • ⎫ Ask yourself: What am I usually thinking during that situation? What emotion do I usually feel?
  • ⎫ Decide which skill / combination of skills would help most
  • ⎫ Mentally rehearse using the skill, three times a day, for 30 seconds each time.

 

Research shows this rehearsal causes your brain to develop neuro-pathways for the skilled behavior, making the skill your new “go-to” response. The more you practice, the more automatic skill use becomes!


Conclusion

DBT skills are both life skills and life lines during difficult challenges. The more you try them and the more you rehearse them, the easier they get and the more you can benefit.

And please remember dialectics: Congratulate yourself for what you did do, and look at whatever you didn’t do today as an area in which to grow in the days to come — whether it’s during the corona crisis or when it’s b’ezras Hashem soon over.


Nina Kaweblum, LCSW, DBT-LBC, MA, MEd is a certified DBT therapist with a private practice in Lakewood, New Jersey.

(Originally featured in Family First, Issue 687)

 

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