Tag Archives: Emotional Mind

Track Your Emotional Level Using “The Levels of Emotion Chart” from the DBT-CBT Workbook (with Estimates of Emotional Mind and Rational Mind)

The Levels of Emotion Chart provides descriptions of how we FEEL and FUNCTION when we’re experiencing different levels of negative emotion. The levels range from 0-10. At Level 0, we are at peace. At Level 10, we are desperately overwhelmed with negative emotion. Notice the far right columns.  They show how active Emotional Mind and Rational Mind are at each level (this is just a guess though!) This chart helps to gauge or measure our emotional intensity and to better understand the effect our emotional levels have on our ability to participate effectively in our life.

Use the link below to check out the chart and to read the text from the workbook related to the chart.  I don’t know why, but you’ll go to a page view that doesn’t open the file…BUT, if you click the link again when you get to that page…it’ll come up like it’s supposed to!  

The Levels of Emotion Chart – from the DBT-CBT Therapy Workbook by Melanie Gordon Sheets, Ph.D.

Review the levels of emotion in the chart and answer the following questions.

What level are you currently at?

What has been you lowest and highest level today?

What is the level of your best functioning over the past week? the last month?

At what level were you at when “Something Happened” and you ended up having to go into treatment?

At what level should you seek help so you can prevent going into treatment?

Most group members believe we should call our support person, sponsor, counselor, or crisis worker at level 5 or 6. Knowing what they know now, they want to get help BEFORE things begin to get out-of-control. At levels 5 and 6, we still have a fair amount of Rational Mind going on. This helps us to seek support…and to accept the Rational Mind and Wise Mind understandings and suggestions offered to us!

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The Dynamics of Emotional Mind and It’s Role in Driving Destructive Coping Behavior: When Emotional Mind Drives…We Wreck Out…and Our Lives Become a Total Wreck

The Dynamics of Emotional Mind - hand-out  092010b

View the pdf file for a readable image – click the link below

The Dynamics of Emotional Mind – DBT-CBT Conference Handout – 072411

This hand-out addresses the dynamics of Emotional Mind and its role in driving destructive emotion-driven coping behaviors (e.g., substance abuse, aggression, eating disorders, etc.)

The “Cycle of Suffering”- when we respond to emotional pain and life problems in destructive, emotion-driven ways, we end up with new problems and increasingly severe old problems…and we feel worse than before.  If we respond to this new level of pain and problems in destructive ways, our pain and problems will continue to intensify and multiply.  Because we’re not working through our pain or resolving our problems, our emotional baggage piles up.  The trauma from the past weighs us down in the present and intensifies present misery.  What could have been temporary pain and problems has turned into long-term pain and suffering.  The only way to get the cycle of suffering to stop…is to stop it.  We can stop our suffering by stopping our destructive coping behavior.  We must turn on Rational Mind to “think through before we do” and we must “follow through” with Wise Mind problem-solving and life-enhancing coping behaviors.

Based on:  “Out-of-Control:  A Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook for Getting Control of Our Emotions and Emotion-Driven Behavior” copyright © 2010 by Melanie Gordon Sheets, Ph.D.   (www.dbt-cbt-workbook.com)

Radical Acceptance: Accepting the Unacceptable – Coming to Terms With Our Destructive Behavior to Heal the Emotional Pain of Shame, Guilt, and Regret

I recently responded to a LinkedIn discussion regarding the negative consequences of an individual being found “Not Guilty by Reason of Insanity.”  It was spurred by a Wall Street Journal article entitled, “The Trouble With the Insanity Defense” written by D. J. Jaffe, a co-founder of the Treatment Advocacy Center.  It was printed in the 3-26-10 edition.

http://online.wsj.com/article/SB20001424052748704896104575139801575696436.html

The writer notes, “Not guilty by reason of insanity is an inadequate remedy to violence by individuals with mental illness.” He raised some valid points.

As I work for a state mental health institution which provides treatment for NGRI patients, I responded with the following comment.

Pros and cons. Time in a psychiatric hospital is generally “easier” time than in prison – so that is a definite benefit to the NGRI population. Further, many of our NGRI patients have stabilized to a degree that they are among the highest functioning patients in the hospital and have the highest level of privileges. Those are benefits.

In terms of cons, in general the NGRI population spends more time in a psychiatric facility than they would if they served Guilty sentences in prison. Also, like the article notes, they are often held in a psychiatric hospital long after stabilization and likely safe release to the community. In Texas, the superintendent (CEO) of the hospital has to approve the potential release before petitioning the court for placing the patient on an outpatient commitment. Both the judge and the hospital CEO are risking their careers and reputation if the released patient recommits a significantly violent crime.

The headline test – ‘Judge ordered release of criminally insane man who kills again

In addition, the community mental health officials also have to ‘sign off’ on the release and attest that they can ensure adequate monitoring and treatment to prevent reoffending. It’s a risky business. However, many of the NGRI individuals are truly honorable, caring, competent individuals who regret their actions and strive for a productive life. It is a great shame for patients and victims. Our facility works very hard on behalf of these patients, the courts, and the community to carefully evaluate individuals who appear ready for an outpatient commitment and to ensure a sound outpatient treatment program / support plan is in place for these individuals. It is a risky situation however as a state psychiatric facility, we are charged with providing this service and level of care.”

Marilyn Miller, MS., LPC., a psychotherapist in private practice in San Antonio, Texas, comments in this discussion that she works with individuals with bipolar disorder to help them “resolve enormous shame for their actions during manic phases (pre-medication and -treatment).”  She notes that even though their acts did not involve violence against others, their behavior was so “devastatingly self-destructive” and “so counter to their own ‘real’ values that the hurdle of getting over that shame is quite high.”  She states that she “can not imagine the further horror” for NGRI individuals “knowing that they have taken lives (or attempted to do so).http://www.marilynmillerpsychotherapy.com/

My follow-up response using the vernacular and understandings of the DBT-CBT “Out-of-Control” Workbook I wrote…includes,

As you say Marilyn, it is horribly sad to work with the NGRI’s (or other patients) who are non-psychopathic…and in a period of being out of touch with reality or otherwise ‘Big Time in Emotional Mind’…enacted state dependent destructive behavior…and when they ‘come to’ reality (Rational Mind) and recognize what they have done and the impact on others and their lives…they are in great emotional pain and are devastated by their behavior.  Just this week in group at the state hospital, this came up as we were discussing the consequences of ‘Emotion-Driven Behavior.’  A cloud of great remorse and sadness came over the group in that moment of insight and understanding relating to why things are the way they are in their lives…why their people are so upset with them….and why they have lost so many of the things that they value and cherish.

I teach them that it’s not WHAT happened (like a relationship break-up, conflict on the job, abuse, etc) that has led to such life losses…that it is HOW they responded to the life situation (drugs, alcohol, suicide attempts, physical violence, saying ugly things to people, etc) that has led to the deterioration of their life and the widespread losses of all the people, things, and activities they love and cherish.  This is a painful truth that leads to a major moment of reckoning.  From there, we talk about what we can do to prevent getting ‘Big-Time in Emotional Mind’…and learning ways to respond through Wise Mind when we do experience out-of-control emotional moments.

This past week, this moment in group was so heavy in sadness that I told them that this is exactly why I wrote the workbook and why I am so passionate about helping them in group…that it pains me greatly to be among such neat, wonderful individuals who truly care about their lives and their people…and how it is so sad to live, eat, breathe Emotional Mind…and to be stuck in a ‘Cycle of Suffering’…a cycle of being upset, enacting destructive Emotion-Driven Coping Mechanisms, suffering more losses, feeling worse, continuing destructive copings, consequences worsen, feeling even worse….and on and on and on.

The depth of their pain is what drives me to work so hard to help them to understand Emotional Mind dynamics and to find new ways to respond to life stressors, problems, situations, losses, etc., to STOP the cycle of suffering, and to live a recovery lifestyle so they can reap all the rewards of doing so…to end their pain and suffering and to live a life that provides meaning and satisfaction.

For many, this involves understanding why they have done the things they’ve done, self-acceptance and forgiveness, being committed to change the way they respond to life, developing a Game Plan for recovery, and FOLLOWING THROUGH with their recovery plan.  This process also involves understanding why others have acted in certain ways towards them, acceptance and forgiveness of others, etc.

Another major point I teach them is that their destructive behavior is not a product of WHO THEY ARE as a person…not their character, personality, or true self…but a product of HOW THEY ARE (or were) when they are ‘Big Time in Emotional Mind’…as a result of psychosis, mania, intoxication, great anger or upset, the result of an altered state of consciousness, the one in which they are Big Time in Emotional Mind without any significant levels of Rational Mind going on.  It is not WHO THEY ARE….because most of these individuals are good-hearted people who care about others…and truly care about living a productive life and being kind, loving, and helpful to others.”

For this blog, I’d like to add the following text from Chapter 12:  “ACCEPTANCE” from the DBT-CBT Workbook.  This is an example of applying “Radical Acceptance” to our lives.  Radical Acceptance is about “accepting the unacceptable”….and boy, when we’re in recovery…we’re going to have to do a lot of that!

ACCEPTANCE OF THE BAD, HORRIBLE, ROTTEN THINGS WE’VE DONE

We’re human.  We ALL make mistakes.  When we’ve LIVED IN Emotional Mind, we’ve made MANY mistakes.  We’ve acted impulsively and have made MANY regrettable decisions.  We’re NOT bad, horrible, rotten people.  We’ve just done some bad, horrible, rotten things.  These things happen when people are drinking, drugging, in a manic or psychotic state, or are desperately overwhelmed with painful emotion.  When we’re CLEAN N’ SOBER, on our MEDS, making HEALTHY LIFESTYLE CHOICES, and ACTING IN WAYS to Mindfully Protect Our Peace and Stability, we’re GOOD-HEARTED PEOPLE with good morals and values…and WE CARE ABOUT PEOPLE.

Think of the REALLY NEAT people we’ve met in rehabs, AA, support groups, and hospitals.  They’ve lived a past JUST LIKE US.  They’ve done hurtful things to the people they love WHEN they were in the middle of their addictions and Destructive Coping Behavior.  They’re NOT bad people.  They’re the WALKING WOUNDED and IN THEIR DAYS of PAIN and IMPULSIVITY, they did some painful and impulsive things.  TAKE AWAY the drugs, alcohol, mania, depression, pain, anger, and bitterness…and what’s left are some PRETTY NEAT PEOPLE!

We’re the walking wounded.
We’ve experienced a lot of pain.
Being desperate for relief,
we’ve done a lot of painful things
that have hurt ourselves and others.

Think of two people YOU KNOW that fit that description.  What sort of bad things did they do when they were in the middle of their addictions and destructive coping behavior?  Also describe their character when they’re living a Recovery Lifestyle.  _________________________________________________ _________________________________________________

Our Recovery Task is to ACCEPT whatever we’ve done.  Then, we must WISELY decide which things we CAN DO SOMETHING ABOUT and which ones we CAN’T.  We need to focus our efforts on the things we CAN do something about that are a PRIORITY in our life.  We need to DO WHATEVER WE NEED TO DO to improve these things.  The things we can change that AREN’T A PRIORITY…
we need to LET THOSE GO… FOR NOW.

The things we CAN’T CHANGE…
we MUST let them go.
Letting go is a CHOICE.
It’s a choice for FREEDOM from burden
and a choice for PEACE and SERENITY.
Remember, “God grant me the serenity
to ACCEPT the things I cannot change.”
ACCEPTANCE is what gives us serenity
EVEN WHEN our lives are in turmoil.
It’s how we CHOOSE to THINK about things
and RESPOND to things
that ultimately affects HOW WE FEEL about things.
We can CHOOSE to be AT PEACE with our situations
or we can CHOOSE to be in turmoil.
We CANNOT LIVE NEW LIFE if we live in the PAST.
CHOOSE to let some things go
so you can GO ON with life…
and LIVE NEW LIFE!

Extra margin text from this section of Chapter 12:

We weren’t born this way.
We became this way
because of an Out-of-Control lifestyle.

Our people want us ALIVE and WELL,
so we need to bury the guilt and pain that’s killing us.
We cannot be the person we were meant to be
or live the life we were meant to live
if we are carrying around what makes us wish we were dead.

The only way to start over
is to START OVER.
We do that by accepting

what needs to be acceptedand by moving on down the Recovery Path.

This text was adapted from the DBT-CBT Therapy Workbook – “Out-of-Control: A Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook for Getting Control of Our Emotions and Emotion-Driven Behavior” by Melanie Gordon Sheets, Ph.D. – copyright 2009 – Recovery Works Publications –

Working Through Verbal and Emotional Abuse: Challenging the Lies We’ve Come to Believe Using DBT-CBT Therapy Techniques

The following is an amended excerpt from the DBT-CBT Workbook. It is from Chapter 8, “Challenging Extreme Judgments,” which focuses on the negative things we say to ourselves (and believe) and the negative things others have said of us that we come to believe as truths about us.

When we’re mad or hurt, we sometimes say very hurtful things to ourselves and others. This is Emotion-Driven Behavior. Our hurtful words are based on how we’re thinking and feeling in the Heat-of-the-Moment! They’re ANGRY WORDS. We’re not in Rational Mind and we’re not speaking truth. We’re expressing HOW WE FEEL about people and things WHEN WE’RE MAD OR HURT! Words driven by a heated Emotional Mind SHOULD NOT BE TRUSTED!

The purpose of this chapter is to recognize that these statements are borne from Emotional Mind…an angry, depressed, or discouraged state of mind. They are Emotion-Driven Lies…not Rational Mind truths. The worksheet for this chapter, “The Challenging Negative Judgments of Me Worksheet” leads us through the process of challenging these lies through Rational Mind. We identify a particularly hurtful statement that has negatively impacted our self-esteem and self-concept and we identify characteristics of ourselves that prove that we are not that way. Then, we are challenged to answer the question…”What is rational to believe…that statement that came out of the mouth of someone who was upset and irrational in the emotional moment…or all these facts about ourselves that prove otherwise and the hundreds of people that agree we really are this kind of person?”

THESE TRUTHS SHOW HOW MUCH OF A LIE the negative judgment is…and has been. The judgment was NOT based on truth. It was an EMOTION-DRIVEN LIE MADE UP about us…and WE HAVE LIVED SO MUCH OF OUR LIFE BASED ON THIS LIE. We have believed the lie. We have NOTICED EVERYTHING that supported the lie, and discounted, overlooked, and IGNORED ALL THE THINGS that challenged the lie…all the things that prove we’re NOT stupid, worthless, or undesirable. LET THAT SINK IN. What was said about you is A BOLD-FACED LIE. IT IS NOT TRUTH. We know that now because THE FACTS PROVE IT! Anytime those old feelings come up, be ever so Mindful of the facts and the TRUTH. TAKE A STAND and RATIONALLY CHALLENGE THE LIE…right then and there. Don’t EVER let yourself get away with believing that lie again. RATIONALLY CONFRONT IT and DEFEND YOURSELF!

The following is the text that follows this worksheet and discussion directly about it.

APPLICATION: The Origin of the Judgmental Lies

Most of the negative judgments made about us…were first said to us when we were young. They were NOT based on anything about us…not a character trait or a personality feature.

When someone tells a 3 or 4 year old child that they’re worthless, stupid, or will never amount to anything…or they’re too much of this or too little of that…or no one will ever love them…IT’S AN EMOTION-DRIVEN LIE. How in the world can someone know something like that about a very young child? This type of meanness, ugliness, and hurtfulness SPEAKS VOLUMES about the person making the statements…AND SAYS NOTHING ABOUT THE CHARACTER OF THE CHILD.

We know that when WE make ugly and insulting comments to others, we’re being verbally abusive. Oftentimes, we’re mad and we say these things in anger. Likewise, THE PERSON saying ugly things to us is UPSET, too. Often, THEY FEEL stupid, irresponsible, or worthless and THEY TAKE IT OUT ON US. Most of them were emotionally abused…and are just MINDLESSLY PASSING IT ON to the next generation. Also, they may suffer the moodiness and impulsivity that goes with drugs and alcohol, Bipolar Disorder, Borderline Personality Disorder, etc. For whatever reason, they’re BIG-TIME IN EMOTIONAL MIND and they’re being verbally and emotionally ABUSIVE to us. When we’re YOUNG or VULNERABLE, (22) WE TRUST THEIR OPINIONS and come to BELIEVE what they’re saying. However, WE’RE BELIEVING AN EMOTION-DRIVEN LIE.

When we did “The Challenging Negative Judgments About Me Worksheet,” we CHALLENGED the EMOTION-DRIVEN LIE by looking at the Big Picture of Our Life THROUGH THE EYES AND TRUTH OF RATIONAL MIND. When we review this worksheet and consider all the things about us that support we’re capable people with worth and value, we’re functioning in Rational Mind. When we make a DECISION that WE’LL NO LONGER JUDGE OURSELVES in a FALSE and HURTFUL manner, we’re functioning in WISE MIND. When we’re DETERMINED that ANY TIME those old thoughts or labels COME TO MIND, we’ll CHALLENGE THEM and REMIND OURSELVES of all the things about us that PROVE otherwise, then, we’ll be USING WISE MIND TO MINDFULLY PROTECT OUR PEACE AND STABILITY.

ANY TIME, ANY ONE of those NASTY JUDGMENTS comes into our thoughts and begins to hurt us, WE NEED TO CHALLENGE THEM…right then n’ there. (23) We need to STOMP THEM OUT and REFUSE to allow them to CONTROL US any longer. They are lies. WE HAVE BEEN LIVING A LIE. We have perceived ourselves based on a lie. DO NOT ALLOW THESE LIES TO CONTROL YOUR LIFE ANY LONGER! DO NOT ALLOW THEM TO TAKE AWAY your peace and stability! They’re things Coming At Us that have NO PLACE in our Inner Circle.  TAKE A STAND against these lies…and FIGHT FOR YOUR RECOVERY!

APPLICATION: Stupid Is as Stupid Does?

At this point, some folks say, “When they said that, I had done something stupid or irresponsible.” Remember, we’re human. We’re not perfect. Things WILL happen.  That’s our humanity! One stupid behavior or 10 or 12 of them means we did one stupid behavior or 10 or 12 of them. Those things describe our behavior in-the-moment or the month. They DO NOT define WHO WE ARE as a person or WHAT WE’RE CAPABLE OF. They DO NOT define our character or our make-up. THEY DEFINE AN event, action, or a behavior…NOT our WHOLE person. Just because the 8th grade educated shift team leader made a mistake, that doesn’t mean he’s stupid. That means HE MADE A MISTAKE…THAT DAY. That mistake and an 8th grade education DOESN’T describe what he’s capable of. Those things DO NOT define his character or describe everything he has ever accomplished in life. HE IS NOT STUPID. He simply made AN ERROR.(24) Stupid ISN’T as stupid does!

There may be times in our life when we make many errors…even when we totally mess things up for a year or two by making one bad decision after another. DOES THAT MEAN WE’RE STUPID? NOOOOOO. It means we’re DYSREGULATED (25) and LIVING Big-Time in Emotional Mind. It means we’re making a lot of Emotion-Driven decisions which ARE STUPID. That DOESN’T MEAN WE ARE STUPID…you know why?    Explain. _________________________________________________________________________
_________________________________________________________________________

We’re NOT stupid or clueless. In our gut, we usually know our behavior is going to cause problems BEFORE we do it! We have Wise Mind going on, but we’re NOT PAYING ATTENTION TO IT. We’re NOT Following Through With What We Know is in our best interests…because WE’RE BIG-TIME in Emotional Mind! WE’RE  DYSREGULATED… we’re LIVING IN-THE-MOMENT. We’re uncomfortable…we hurt…we’re not worrying about tomorrow. We’re living for TODAY…and if it feels good…we’re going to do it!

Are we STUPID because we do it?  Explain. ___________________________________
____________________________________________________________________

No, we’re NOT STUPID. We’re ACTING in poor judgment. We KNOW better.  We know right from wrong…and good from bad. We DO stupid things because EMOTIONAL MIND IS DRIVING. That’s why we SPIN-OUT and LOSE CONTROL.  That’s why we wreck-out and our life becomes a total wreck.

So, does that mean we have poor judgment?  Explain. __________________________________

____________________________________________________________________________

NO…because WE HAVE GOOD JUDGMENT! We KNEW it was stupid or of poor judgment…but we did it anyway! We KNEW it was going to end poorly, but we DIDN’T CARE AT THE TIME. We just did what we WANTED to do…
and no one or nothing was going to stop us. We were being VERY WILLFUL.

What we did was EMOTION-DRIVEN Behavior. We do all types of MINDLESS and IMPULSIVE things when we’re acting on Emotional Mind…ESPECIALLY WHEN WE’RE IN A DESPERATE STATE, like desperate for relief, desperate for comfort, or desperate to be held and loved on. It’s NOT STUPIDITY. It’s DESPERATION. You’ve heard the saying, “Desperate times call for desperate measures.” Well, desperate measures often involve risky things that are likely to have a bad outcome. So, BECAUSE WE’VE DONE SOMETHING STUPID or two years or ten years worth, that DOESN’T MEAN WE ARE STUPID. That’s because WE KNOW BETTER.

WE JUST DO IT ANYWAY! Gladly, this workbook is about GETTING CONTROL of our BEHAVIOR and our LIFE! And, we do that by Turning On RATIONAL MIND and WISE MIND to REGULATE and CONTROL our dysregulated and Out-of-Control emotions and Emotion-Driven Behavior.

Footnotes:

22- If we’re older when these lies were spoken, they usually came from an abusive spouse or romantic partner.  Over time, we’ll realize these people were angry, mean, harsh, moody, and unfair.  We KNOW their words were Emotion-Driven.  We KNOW they’re abusive, mean, and critical people, but for some reason, we believe their ugly opinions.  We believe they’re right and other people are wrong.  Go figure.  The truth, we were vulnerable and they took advantage of it.  Often, they were mean to “keep us in our place”…in a “downed position” with low self-esteem.  They wanted us to believe we ARE stupid, unworthy, and not capable…so we would never have the strength to leave them.

23- Whenever a negative judgment begins to bother you, either complete “The Challenging Negative Judgments of Me Worksheet” in your mind or on paper.  Use this RECOVERY TOOL to challenge those lies!

24- I’m pretty smart with a Ph.D…that just gives me a license to be  Piled Higher and Deeper in errors!  Lord knows if it’s 10AM and I haven’t made an error yet, I must still be asleep!

25- Dysregulated – (dis-reg-you-lated) – not in control of ourselves… we’re not able to regulate or control our behavior.

Extra margin text below:

No matter how smart we are or how much psychological stuff we know, we can get side-swiped and wrecked-out by a hurtful comment.

When we believe these lies and base our sense of self and identity on these lies, we’re viewing ourselves through Emotional Mind.  We’re not dealing with the facts and the truth.  We’re overlooking, ignoring, and denying all the things which tell us we aren’t that way…and we’re focusing on ALL the things which suggest we may be that way.  We’re ignoring what Rational Mind is telling us and we’re viewing ourselves through the distorted lenses of Emotional Mind.

We have thought poorly of ourselves and have treated ourselves poorly because of a lie.

We ARE going to do some stupid and thoughtless things now and then, but that doesn’t mean we’re a stupid and thoughtless person.  It means we DID SOMETHING that was stupid or thoughtless.

We ACTED in poor judgment.  We went against our good judgment.

“Then how do we describe this stupid, poor judgment behavior?!”   We describe it as DESPERATE behavior.  It’s not an issue of smarts.  It’s an issue of being desperate and dysregulated!  It’s an issue of being OUT-OF-CONTROL! We know better, but we do desperate, self-defeating things anyway.

This text was adapted from the DBT-CBT Therapy Workbook – “Out-of-Control:  A Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook for Getting Control of Our Emotions and Emotion-Driven Behavior”  by Melanie Gordon Sheets, Ph.D.  – copyright 2009 – Recovery Works Publications

How Could Someone Try to Kill Themselves: Suicide Attempts and Doing the Unthinkable – from a DBT-CBT Therapy Perspective

When Emotional Mind drives and Rational Mind is left on the side of the road…

When folks are moderately, even severely depressed (say up to an 8 or an 8.5 on a scale of 1-10), they are “Big-Time in Emotional Mind” but they still have some Rational Mind going on (say 85% Emotional Mind and 15% Rational Mind).  Through the small degree of Rational Mind, they maintain some contact with reality and have some mindfulness of the big picture of their life. For instance, they still recognize they have something to live for…they still have some holds on life…and although their grip is loosening and they may be barely holding on…with at least some Rational Mind going on, they recognize the basics…like they have kids to live for…or pets…or their dying parent (examples).  However, as the depression worsens, Emotional Mind intensifies, and Rational Mind further fades…and they lose awareness of these reasons to live.

Patients in various ways have explained how this happens.  They relate that when they made that final decision to kill themselves…to enact that near fatal behavior…they weren’t  thinking…that previously they thought about their kids, their spouse, or other holds on life and they struggled to stay alive…but then, something happened and they no longer thought about these things.

One patient so well described this to me, I haven’t forgotten it.  She said that as her depression deepened, it was like she was going further and further down a well…and the deeper she went, the less she could see out.  She related that she got so far down, she was surrounded by darkness…she could no longer see nor feel…and she lost touch with the love she had for her kids and concern about what would happen to them.  She cried intensely and said that when she did what she did, thoughts of her kids did not cross her mind.  It was utterly heartbreaking, and yes, as a therapist and despite trying to hold my tears back, they rolled out of my eyes.  I stood up and hugged her as she wept and gently rocked her to help soothe her through the pain. It was one of those heart-wrenching therapy moments when I had no words to comfort her and could only pray for her self-forgiveness and healing.  She so loved her babies and could not understand how she could have tried to end her life.  With Rational Mind going on, she realized she did the unthinkable.

I believe that she became 100% (or near 100%) Emotional Mind…and Rational Mind was essentially turned off.   Without Rational Mind, she was not connected or in contact with the reality of her life and what really mattered to her.  It was like a Rational Mind black-out.   She was no longer mindful of the big picture of her life and the reasons to continue the fight.  And we always ask, “God, how could she have done that, she has kids” or “How could he have done that knowing his family would find him.”  They weren’t thinking…that part of their brain was turned off.

Based on the recovery workbook by Melanie Gordon Sheets, Ph.D. -<span
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The DBT-CBT Recovery Workbook Focuses On Self-Destructive Behaviors

DBT-CBT is a life-changing recovery program that inspires people
to make the life changes that will change their lives.
This program has turned many defeated hearts into empowered spirits
that are psychologically prepared to take on the challenges of
GETTING ON  and STAYING ON the Recovery Path.

Come join us in our journey.

This is a workbook for recovery from a variety of Self-Destructive Coping Behaviors. The philosophy of DBT-CBT is that “Many of our “abnormal” behaviors are normal given our experiences. They once served as survival skills.  However, their period of usefulness is long over.  We’ve overused these coping behaviors…and now, they’re causing us great pain and they’re destroying our lives.”

This workbook explains why we do the things we do…and why we keep doing these things even though they cause us more pain and problems.  It’s about what we do in the heat-of-the-moment…the emotional moment.  It’s about what happens when EMOTIONAL MIND drives and RATIONAL MIND takes a backseat…and WISE MIND is left on the side of the road.

When we’re filled with upsetting emotions, we often do things for quick relief…like drugs and alcohol; suicide attempts; cutting and other forms of self-mutilation; aggression; temper tantrums; walking off and leaving the situation; withdrawal; overeating or not eating enough; overshopping; “sleeping around”; rebound relationships; gambling; and other risky and reckless behaviors. The Nature of the Problem is…the things we do to feel better end up multiplying and intensifying our problems. Our Destructive Coping Behaviors help us to cope in the Heat-of-the-Moment…but, they have many negative consequences. They make our current problems more severe…and they CREATE many new problems for us to struggle with.   Over time, our lives spiral OUT-OF-CONTROL and into a CYCLE OF SUFFERING.

This workbook provides useful tools, attitudes, and plans for changing how we respond to life.  Our goal is to GET CONTROL of our OUT-OF-CONTROL emotions, behaviors, and thinking. We do this by PARTICIPATING EFFECTIVELY in our lives and by using LIFE-ENHANCING COPING MECHANISMS to deal with our pain and problems.  Our goal is to MINDFULLY PROTECT OUR PEACE AND STABILITY and the BIG PICTURE OF OUR LIFE.  Our goal is to STOP the CYCLE OF SUFFERING.

Six Major Problem Areas Addressed by the DBT-CBT Recovery Program

DBT-CBT Addresses Six Major Problem Areas

These six areas are listed below.  Examples of the types of problems
we might have in each area are also noted.

This workbook is designed to meet the needs of people who suffer
from problems in SOME or ALL of the six areas.


1. RELATIONSHIP PROBLEMS

Conflict-Filled or Stormy Relationships   •   Abusive Relationships
Relationship Disappointments or Frequent Ups and Downs
Unfulfilling Relationships   •   Short-Term Relations
Love – Hate Relationships   •   Few or No Close Relations
Fear of Rejection  /  Actual Rejection  /  People Have Pulled Away
Co-Dependency  /  Dependency   •   Attention-Seeking Behavior
Fear of Abandonment  /  Actual Abandonment   •   Mistrust
Mad at Everyone   •   Loneliness  /  Can’t Tolerate Being Alone
Shyness  /  Fear  /   Major Discomfort in Social Situations

2. MOOD SWINGS – DEPRESSION – ANXIETY – ANGER

Moodiness  /  Major Mood Swings   •   Easily Angered   •   Rage
Guilt / Shame   •   Being a “High Drama” Person
Unbearable  /  Intense Emotions   •   Anxiety  /  Panic
Depression  /  Helplessness  /  Hopelessness  /  Worthlessness
Believe Things Won’t Get Better  /  Want to Give Up
Feel Out-of-Control  /  Overwhelmed  /  Suicidal

3. UNHEALTHY THINKING

Worrying  /  Overthinking  /  “Stewing” over Things
Dwelling on the Past   •   Preoccupied with Revenge
Pessimistic Thinking  /  Negative Expectations   •   Irrational Beliefs
Catastrophizing  /  Blowing Things Out of Proportion
Black and White  /  All-or-None Thinking
Putting Ourselves Down  /  Focusing on Our Worst Qualities

4. UNHEALTHY COPING BEHAVIORS

Please see the “List of Common Self-Destructive Coping Behaviors” above.

5. OTHER IMPULSIVE BEHAVIORS – BAD CHOICES

Doing Things on a Whim  /  Making “Snap Judgments”
Not Thinking Things Through and Having Negative Consequences as a Result

6. QUALITY OF LIFE PROBLEMS

Burnt-Out  /  Life Is a Chore   •   Nothing to Live For
Emptiness  /  Meaninglessness  /  Boredom
More Problems Than I Can Bear   •   Must Start Over
Financial Problems  /  Bankruptcy
Job Loss  /  Can’t Keep a Job Loss of Career or Professional License
Demotion  /  Probation at Work
Loss of Relationships   •    Family Pulled Away   •   Can’t See Children
Loss of Trust From Others   •   Reputation Damaged
Loss of Self-Respect and Integrity   •   Loss of Self-Confidence
Problems Getting an Education  /  Not Completing Semesters
Underachievement • Loss of Housing   •   Loss of Transportation
Loss of Possessions • Loss of Pets   •   Loss of Freedom
Legal Problems  /  Probation or Imprisonment
Health Problems  /  New Medical Diagnosis

This list is an excerpt from the DBT-CBT Therapy Workbook – “Out-of-Control:  A Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook for Getting Control of Our Emotions and Emotion-Driven Behavior”  by Melanie Gordon Sheets, Ph.D.  – 2009 – Recovery Works Publications