"What keeps us stuck?" Emotion Mind and Homework

In DBT, clients and skills trainers have homework assignments from week to week.  "Repetition is the mother of understanding."  The intentional practice prompts the client to develop and hone her skills.  The interpersonal effectiveness skills really require practice with others because they involve interactions with others, so it can be difficult to practice by yourself; DEAR MAN, GIVE, and FAST are the main interpersonal effectiveness skills.

In skills groups, there is a designated time for a review of the homework.  This is usually after the mindfulness activity and before the skill lesson. 
Sometimes the homework isn't completed when the clients arrive for group, so there might be clients writing quickly as the other clients talk about their homework.  If skills trainer asks about the unfinished homework, she may ask the client to complete the work and bring it next week and/or to write a chain analysis about what kept her from completing her homework.  

The chain analysis may elucidate the emotional factors and cognitive factors that influenced the outcome.  Sometimes emotional responses hinder the likelihood of completing tasks. It's a difficult process to figure out "what happened when."  

Chain analyses are not punishments and should not be punitive.  They are tools for helping the client identify the behavior(s), what led up to it (emotional vulnerabilities), the prompting event, and what happened as a result of the behavior(s).  It can be dysregulating and difficult to write the chain analysis alone, so it may be helpful to work through a chain analysis with the individual therapist.  She or he can help the client self-soothe and regulate her emotions when filling out the chain.

Looking at factors that keep us from working effectively, procrastination is an application of Emotion Mind.  Fear and anxiety can create a hostile environment for effective task completion.  Randy Pausch described procrastination as one of the hindrances to completing tasks in his lecture, "Time Management;" click here to watch the YouTube video of "Time Management." 

"If you are procrastinating, you've got to find some way to get back into your comfort zone.  Identify why you are not enthusiastic. Whenever I procrastinate on something, there's always a deep psychological reason. Usually it's, I'm afraid of being embarrassed because I don't think I'll do it well, or I'm afraid I'm going to fail at it."

Let's look at homework experiences to see the effects of the anxiety and fear that can come with being in Emotion Mind. 

I don’t want to be avoidant today.

I want to look at the theories book,

pick up it up and say,

I am not going to live in fear.

I will read this

one section at a time.

I can do this.

I may need help

along the way.

You will not define me.

I will not label myself as a

bad, ignorant, or avoidant

student.

I can do this.

In looking at the poem, there is a consistent cheerleading statement: I can do this.  It also has components of goal setting: reading the book one section at a time.  There are also elements of Wise Mind and non-judgmental stance in not wanting to add labels that could increase avoidance, diminish motivation to finish the work, increase the likelihood of living in fear, and keep us from reaching our potential.

Mindfulness 101: Mindful Worrying

This is the time for the kick-start to charge into the summer, fueled by caffeine and adrenaline.  Deadlines and pressure to meet them seem to come at us from every side, leaving us stressed out, irritable and utterly sleep deprived.  

While a triple shot of espresso might be a short term solution to increasing mental stamina, researchers Marsha Linehan and Jon Kabat-Zinn offer a modern twist to focus the mind and body, yielding constructive, balanced reactions to the stress of school, through mindfulness.  

“Mindfulness means paying attention in a particular way: on purpose, in the present moment, and non-judgmentally,” wrote Kabat-Zinn in his 1994 book Wherever You Go, There You Are. Practically, mindfulness is a mechanism “to be more in touch with the fullness of your being through a systematic process of self-observation, self-inquiry, and mindful action,” wrote Kabat-Zinn.   

Another way to think about it is “putting your mind where your feet are” (Hall, 2009), meaning your mind is focused only on the information directly in front of you- not the outcomes.   Thoughts of impending doom of taking the exam and your expectations of the grade you receive get in the way of your attention and focus on the reading assignment or problem set.

Mindful worrying can be a great way to begin a study session or group work.  It may seem counterintuitive to write a list of the issues you’re worried about concerning your work, but in doing so you identify and label your fears to develop a way to approach them.  The exercise is to select one of the fears or worries and think, talk, or scream about it for a specific period of time, typically 3 to 5 minutes. 

If the fear comes back as you work, acknowledge that it exists, and then consciously say to yourself, “Yes, it scares me that I don’t know the difference between a beta-blocker and a meta-analysis, but I’m going to keep working and I am not going to give any more attention to my fear.”   

You’ve acknowledged that the fear exists, validated your emotional experience, and given yourself the steps you need to succeed. 

Validation has several levels, and they are better discussed by Karyn Hall and Melissa Cook, The Power of Validation: Arming Your Child Against Bullying, Peer Pressure, Addiction, Self-Harm, and Out-of-Control Emotions.  Click here to learn more about The Power of Validation" by Karyn Hall and Melissa Cook.



One last thought about mindfulness and the nature of worry when troubles and stress surround us.  This is an example of a DBT skill called Vacation.  It is a part of IMPROVE the Moment. 

DBT Core Mindfulness Skills: States of Mind

The DBT Training starts on Thursday.  I could not be more excited.  I will be meeting people who are as fascinated by the DBT skills and illness as I am.  

So the four structural posts of DBT are Core Mindfulness Skills, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance.  In the next three days, we will have an overview of these modules and questions for consideration.
 It can be hard for individuals with borderline personality disorder to trust their perceptions, in part because the emotional reactions can be so strong and pervasive invalidation can be detrimental in trusting your perspective.  In working with individuals with borderline personality disorder, remember that there is not a single "right way" to look at a situation.  There are often dialectics that can be explored. To explore these different perspectives, turn to the source.

So let's look at the States of Mind.  No one can live exclusively in one mind, so expect to see a mixture of Minds.  

Marsha Linehan defines Reasonable Mind as "your rational, thinking, logical mind.  It is the part of you that plans and evaluates things logically.  It is the cool part" (Linehan's Little Red Book, p. 65)

She also describes being in Emotion Mind as: ". . . your emotions are in control- when they influence and control your thinking and behavior" (Linehan's Little Red Book, p. 65).

So DBT emphasizes the synthesis of opposites.  Wise Mind is the synthesis of logical thinking and passion.  It takes the most effective aspects of the Emotion Mind and Reasonable Mind and integrates them into the processing of situations, moods, emotional reactions, and time for contemplative thought.

Marsha Linehan describes Wise Mind as "that part of each person that can know and experience truth" (Linehan's Little Red Book, p. 66).  

I like to call Wise Mind truths the things we know in our bones.  Like a skeleton, these thoughts help us to have structure and mobility to act on what we know to be true.

I found this poem recently.  It is true for me and the battles that we face in the realization of dwelling in the poles of Reasonable Mind and Emotion Mind, but also in Fixed Mind.

Found myself here in this place again
caught up in this moment
seeing that slavery brings security,
but in what, for what, and by what means?
It is moving from the known-
the constants and forces of what works within me-
to the uncertainty of hope and the freedom it brings.