Help with DBT
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Help with DBT
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Behavior Chain Analysis
The behavior chain analysis or "BCA" is often the first step in DBT. It's also one that can be revisited throughout the course of treatment and even after. It is designed to help you process through a behavior and assess the chain of events, including vulnerability factors, triggers, thoughts, emotions, actions, and events, that lead up to the behavior. It also assesses any consequences or outcomes there were a result after the behavior occurred. This allows you, and your therapist, to know where to best implement DBT skills and predict future possible behaviors and outcomes that will be more effective in coping with different emotions.
1. Identify the problem behavior.
2. Identify the trigger.
3. Identify vulnerability factors.
4. Identify the chain of events.
5. Identify the consequences of the problem behavior.
6. Identify DBT skills that could have been used during the chain of events.
7. Identify consequences of using DBT Skills.
Diary Card
A diary card is a tool used in DBT skills groups and individual sessions to help the client track their emotions and behaviors along with coping skills to assess their effectiveness of use. They are typically used on a weekly basis and utilized in sessions with the therapists to discuss if skills were used and how useful they were to the client in different situations. An example diary card that I often use with clients is below. I will also often include the list of all DBT skills on the back as a reminder for the client to use.
Cognitive Distortions
Also known as "Thinking Mistakes," these are patterns of thinking that we all often find ourselves getting into on a regular basis. They can cause us to become more emotionally vulnerable and feeling stuck in our emotion mind. We can get out of these patterns by challenging ourselves to think in different ways and getting different perspectives on situations.
1. ALL OR NOTHING THINKING: If you’re not perfect, you’re a total loser. If you don’t get everything you want, it feels like you got nothing. If you’re having a good day, the rest of your life is perfect and you don’t need therapy anymore.
Alternative thinking: Challenge yourself to take a look at other viewpoints and interpretations of the situation
2. OVERGENERALIZATION: One thing goes wrong and your whole life suddenly becomes one lousy thing after another.
Alternative thinking: Question if evidence exists that things could be different
3. MENTAL FILTER: You develop selective hearing and vision and only hear and see the one tiny negative thing surrounded by the many positive things.
Alternative thinking: Look for the good in every situation.
4. DISQUALIFYING THE POSITIVE: The good stuff doesn’t count because the rest of your life is miserable.
Alternative thinking: Challenge yourself to find reasons you are deserving and capable.
5. MAGNIFICATION/MINIMIZATION: The “screw ups” or losses are HUGE and the good stuff or your positive qualities are nearly invisible.
Alternative thinking: Question if things are truly as bad as you make them out to be.
6. SHOULD STATEMENTS: You should on yourself. That line always gets a laugh out of my clients. But it is relatable in all contexts because we all do it. You start beating yourself up with all the “shoulds.” “I SHOULD be able to deal with this better.” “I SHOULD be able to handle this.” “I SHOULD have said this or that.”
Alternative thinking: Question if things need to be done in a certain way. Is there another way you haven’t considered?
7. EMOTIONAL REASONING: You start thinking your emotions are fact. You assume that your negative emotions necessarily reflect the way things really are: “I feel it, therefore it must be true.”
Alternative thinking: Question if your emotional state is preventing you from seeing things clearly.
8. JUMPING TO CONCLUSIONS:
a.) Mind Reading: You suddenly become a psychic mind reader. You know the answer to everything without even asking. You know that people have it in for you. Everything you try is going to turn out miserably.b.) Fortune Telling: You know that any question you ask, the answer will be NO!
Alternative thinking: Question if other possibilities or explanations exist.
9. LABELING/MISLABELING: An extreme form of over-generalization. You use extreme language to describe things. Instead of describing your error, you attach a negative label to yourself or others.
Alternative thinking: Challenge yourself to find the evidence that disproves the label you are making in this situation.
10. PERSONALIZATION: You see yourself as the cause for things you have absolutely no control over or the target of things that may have nothing to do with you. “It’s all about me” but not in a good way.
Alternative thinking: Question what part you played in the outcome and how you might not be totally to blame.
Managing Mindset
Below you will find the most common mindset issues that all of us face. Read that again. These are all mindset issues that every single person comes up against at some point in their life. There are ways to work through and challenge each of them so that you can find yourself thinking and making decisions more effectively.
Blame
What you might be doing: You find fault and judge others. If you get hooked by your judgments and do not challenge them, you can easily fall into the blaming mindset. You don’t want to own up to your mistakes. It means you have done something wrong. So instead, you choose to focus on others. You need to feel in control. When you don’t, you go into attack mode. you jump on attacking others or even yourself.
Thoughts to be aware of: “It’s all my/their fault.” “I/They should have...” Why did I/they do that?”
Emotions to be aware of: Anger, Judgment, Frustration
How to reframe and overcome: Try to find a mindset of compassion and empathy. Try to see the situation from all perspectives
Comparison
What you might be doing: You compare yourself to others. Social relationships matter to humans. We compare because we feel we need to know how we are doing. We fear if we don’t measure up, we will be excluded and isolated. Here’s a huge secret, the mind cannot discern to any degree of accuracy how we are doing as compared to the general population. It’s far too complex! When we want to avoid being different, we look for exactly how we are different or not measuring up. Then our mind wants to convince us that we are different and not as good as our neighbor or friend or colleague. People either compare themselves too negatively or favorably. Therefore, our perceptions are inaccurate.
Thoughts to be aware of: “I am worried what people will think of me.” “My performance is not at the level of others.” “I thought by this age I would have accomplished...” “Everyone else seems to know what they want.”
Emotions to be aware of: Insecurity, Envy, Discontent
How to reframe and overcome: Bring your focus back to who YOU want to be. Develop a mindset of appreciation and acceptance of what you DO have. Be curious and attempt to learn from others and situations. Learn to connect with others.
Close Mindedness
What you might be doing: You get stuck in your own way of thinking. You often convince yourself that YOUR reality is the ONLY reality. You also assume that others know what you are thinking and feeling. Just because someone else has a different life experience, doesn’t mean that one is right and the other is wrong. A sense of conflict and disconnection will develop from this mindset.
Thoughts to be aware of: “He should know...” “I can’t believe she didn’t realize...” “They obviously don’t care.” “I know they’re tired of showing me what to do.”
Emotions to be aware of: Argumentative, Defensiveness, Self-Righteousness
How to reframe and overcome: Be curious and inclusive to all views. Welcome differing opinions. Resist becoming defensive or argumentative. Don’t assume you know what others are thinking. Think of how you would talk to a friend about what you are going through. This can help you shift into a more realistic viewpoint.
Overcomplication
What you might be doing: You make things too complex. You love to ruminate and solve problems. Often, you will find yourself creating new problems out of nothing and for no apparent reason. This can cause us to have overactive minds and can happen due to high intelligence or a trauma history. Trauma puts our brains into overdrive by frequently trying to protect by continuously scanning for threats, that might not even truly be present.
Thoughts to be aware of: “I feel overwhelmed.” “This is all too much.” “Life is complicated.” “I can’t make decisions.”
Emotions to be aware of: Confusion, Overwhelm, Exhaustion
How to reframe and overcome: Try to simply how you think about things. Create systems that are automated and simplify your life. Write things down and categorize them, even your thoughts. Look at the separate parts of a situation and determine what you can and can’t do. Give yourself a deadline to make decisions. Go with your intuition. Focus on what you can control. Take action when needed.
Avoidance
What you might be doing: You resist authority. You obsess over the past or worry about the future and forget about the present. You fantasize and create imaginary situations. While imagination can be wonderful, we can very easily slip too far into it and avoid the here and now. This makes it almost impossible to take action and make change.
Thoughts to be aware of: “But...” “If only...” “It shouldn’t be like this.” I can’t believe this is happening.” “I refuse to accept this.”
Emotions to be aware of: Defiance, Complaints, Resentment
How to reframe and overcome: Accept the situation as it is because it will help you deal with it easier. Once you accept it, you can decide how you need to change things. Set goals, but don’t spend all day worrying about the future. Focus on changes you can make RIGHT NOW!
Perfectionism
What you might be doing: You set your expectations too high. It’s great to have high standards and expect more out life. But when we use it to measure our self-worth, self-esteem, and confidence, that is where we fail. Don’t be so hard on yourself. It’s hurting you and making things more difficult.
Thoughts to be aware of: “I expect more.” “He should know.” “I should be feeling.” “Why is it taking so long for....?” I should have this figured out.”
Emotions to be aware of: Self-doubt, Avoidance, Procrastination
How to reframe and overcome: Relax and let it go. If it were only that simplistic. Keep your expectations realistic. If you feel your expectations are stopping you, you might be pushing too hard. Pull back and set a smaller goal. You will still get to the bigger goal. Progress not perfection. Aim for imperfect action. It’s better than taking no action at all.
Use of information for this site
This website is intended for information and educational purposes only. No information presented is intended for counseling or treatment. Use of this website does not form a counseling relationship. For more information please contact me at blair@helpwithdbt.com
