"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: The What and How Skills

As Eastern practices infuse into Western medicine, mindfulness is becoming popular and is widely utilized in dialectical behavior therapy (DBT).  Mindfulness is an ideal skill set that supports active listening and enhances the clarity of thoughts, potentially yielding more authentic and precise questions and feedback. 

               

At its core, Linehan’s mindfulness is the fusion of Zen meditation and “Western contemplative thought” (Linehan, 1993, p. 144).  It integrates attention and heightened awareness techniques with emotion regulation and distress tolerance by involving the “what” and “how” skills of mindfulness.    

The activities of mindfulness, the “what” skills, are to observe, describe and participate.  Observation is the back seat perception of one’s immediate environment without labels or judgments.  Description is the verbal acknowledgment of what is observed internally and externally and equally cognitively and behaviorally.  Participation is akin to Csíkszentmihályi’s positive psychology concept of flow and is “entering completely into the activities of the current moment, without separating oneself from ongoing events and interactions” (Linehan, 1993, p. 146). 

The ways to practice them are the “how” skills: taking a nonjudgmental stance, focusing your thoughts on the here and now, and “using skillful means,” also termed “being effective,” to respond to one’s internal and external environments.  These concepts are the foundation for urge surfing (Linehan, 1993). 

               

Mindfulness 101: Urge Surfing

The goal for using mindfulness is to bring oneself back to focus on the here and now, which then aids in the fading of the urge (Linehan, 1993).  Urge surfing is an aspect of mindfulness that guides people through the cognitive reactions, emotional waves and drives that come with everyday life.  Urge surfing allows people to ride the waves of intense emotions and urges, or drives, to act. 

The basic procedure is:

1) To notice, or observe, the thought, urge, or emotion;

2) To describe it;

3) To self-validate, which looks for the reasonable aspects of one’s response to confirm that something is valid and makes sense under the circumstances and in the appropriate context (Fruzzetti, 2006); and

4) To let it pass. 

Do not be surprised if the urge does not cease immediately; generally urges last for approximately twenty-one minutes with varying levels of intensity (Honig, 2009).  Urge surfing works well when it is accompanied with other skills, such as distracting by writing in a journal.  Another option for distraction is playing a game of solitaire with actual playing cards.  This engages your body and your mind to focus on the present moment and not on the distressing situation.

Remember, things come and go in waves, so hang ten and ride the waves of life as they come.