OVERVIEW

Emotion Regulation is the module in which we learn to understand how our

emotions work, and the skills we need to manage our emotions instead of being
managed by them, to reduce how vulnerable we are to negative emotions, and to
build positive emotional experiences.

Perhaps more than in the other three modules, the skills in Emotion Regulation
build on each other. As we learn each little piece, and practice it, we are putting
another building block in the structure of our own Emotion Regulation, learning
little by little how to handle negative emotions and how to build positive ones.

As you learn each new skill or awareness in your life, congratulate yourself. You
are doing probably the hardest work you will ever do, and the outcome of all the
struggle and practice will be worth it. Things will get very much easier, and your
emotional life will be more comfortable.

The first thing to realize is that no one is telling us that our negative emotions are
bad, or not important, or to get rid of them. Everyone has negative emotions. It is
part of life. Those of us who have been through painful or traumatizing
experiences may have very intense negative emotions. We want to validate these
emotions, have them recognized and believed, accept them as real and meaningful.

What the module on Emotion Regulation intends to teach us is how to understand
our emotions and how they get that way, how we are or become more vulnerable to
those emotions and what we can do about it, and some techniques for building
positive emotions into our lives.


What is Emotion Regulation?

I am going to talk a little about what we mean by Emotion Regulation and the
goals of Emotion Regulation training in DBT, and then we will begin to talk about
a model for understanding our emotions.

Our emotions can frequently be very intense and labile, which means they change
often. Our emotions often drive our behavior. A lot of our behavior focuses around
finding ways to get our emotions validated or to get rid of the pain in some way.

Because of this, learning to regulate emotions is a central part of DBT. This does
not mean that the emotions are invalid, and it does not mean that we are trying to
get rid of them. They are valid and important. But because our emotions cause us
so much pain and often keep us feeling out of control, we are going to first learn
some things about our emotions and where they come from, and then we will learn
some techniques about managing our emotions, reducing our vulnerability to
negative emotions, learning to experience some positive emotions, and learning to
reduce our emotional suffering.



Primary and Secondary Emotions

There are primary and secondary emotions. The secondary emotion is the one that
follows the primary or first emotion, for example, feeling shame because you got
angry. Anger is the primary emotion, and shame is the secondary emotion. A
person can get angry for being angry, or depressed for being depressed, or angry
for feeling fear. In these three cases, anger, depression and anger are the secondary
emotions.

It's really important to be able to tell which emotions are the primary emotions and
which are the secondary emotions.

Neither the primary nor the secondary emotions are good or bad, but to get back to
the original problem and work on solving it, it is necessary usually to deal with the
primary emotions.

Try to think of a situation where you experienced a primary and then a secondary
emotion. For example: A close relative died. I first feel grief. That is my primary
emotion. Then I feel ashamed because I feel so sad. Shame is the secondary
emotion.

This can be hard, because the switch often happens very fast. If you feel an
emotion, look at your emotion and see if there is a primary emotion behind it. We
will come back to this later.



Exercises

There are two Kinds of emotional experiences

(being criticized, having a loved one call on the phone, losing a game, etc.)
oughts
(guilt about feeling angry, shame about not doing well at something, fear
about something anticipated or thought about)

How have emotions acted in your lives? Helpful? Hurtful?































Myths about emotions
There are a lot of myths about emotions. This is true not just for those of us with
borderline symptoms, but in our whole society.

For example, "Emotions are really stupid."
Do you think this is true? Of course not. It may feel that way sometimes, but
emotions are there for a reason.

What challenging statement could you write for "Emotions are really stupid."
Maybe "Emotions help us to deal with our lives," or "Emotions are there for a
reason," "or "Everyone has emotions."
There is a theory about emotions:
guilt/shame, interest. All of the others are learned, and are usually some
combination of the basic emotions.

re self-perpetuating. Once an emotions starts, it keeps restarting
itself. I once heard a DBT moderator say, Emotions like themselves. They want to
live on forever.

Exercise
In invite you to work through this writing challenge by writing a more realistic
view or an opposite statement. Of the examples listed below, write a myth and a
challenge.

Examples: "Emotions are for babies."
"If I had the right feelings, I wouldn't have so much trouble."
"If I had no feelings, I wouldn't have so much trouble."
"Only good feelings are okay."





DESCRIBING EMOTION
Emotions involve what we call action urges. An important function of emotions is to
prompt behaviors. For example if we feel angry, we may be prompted to fight. Or if
we feel fear, we may be prompted to run or flee.

The action itself, the fighting, or running, or hugging is not part of the emotion, but
the urge to do the action, the feeling that prompts you to do the action, is considered
part of the feeling.

If we feel angry at someone, we may feel an urge to start yelling at them. That urge is
part of the angry feeling. But the fighting is not part of the feeling.
1. Prompting event
Emotions can be either reactions to events in the environment or to things
inside a person. These events and things are called PROMPTING EVENTS.
They prompt, or call forth the emotion. A person's thoughts, behaviors and
physical reactions prompt emotions. (Recently someone put his hand on the
back of my neck, and I felt fear and anger.) You might have an automatic
feeling, without thinking about it, like "I feel love when I see my cat."

What triggers it or gets it going? Prompting events can be events happening in
the present (an interaction with someone, losing something, physical illness,
financial worries). A prompting event might also be a memory, a thought, or
even another feeling (we feel ashamed, and then feel angry about feeling
ashamed, for example). In managing our emotions, it is important to be able to
recognize prompting events.

Think of some examples of your own where there is an inside prompting for a
feeling you have
2. Interpretation of an event or experience
Most events outside ourselves don't prompt emotions. It is the interpretation of
the event that prompts the emotion.





Event


Interpretation


Emotion


Seeing my boyfriend with
my best friend


They must have been
talking about me


Anger


My car has a flat tire


Some neighborhood kid
did this


Anger


It starts to thunder and
lightning


I have heard of people
being killed by lightning


Fear


I see Mary at the concert
with Betty after she
promised to go with me


Mary doesn't care about
me


Sadness


I see Mary at the concert
with Betty after she
promised to go with me


Mary is trying to get back
at me


Anger



Can you see that the emotion comes after the interpretation is made, after you
have the thought about the reason something is happening?


Think of some examples of your own, and list the event, your interpretation of the
events (what you think about it) and your emotion.
3. Body Changes
Emotions involve body changes such as tensing and relaxing muscles, changes in
heart rate, breathing rate, skin temperature, rises and falls in blood pressure, etc. The
most important of these changes for you to be aware of are the facial changes -
clenched jaw, tightened cheek and forehead muscles, tightening the muscles around
the eyes so that they open wider or shut more, grinding or clenching teeth, loosening
and tightening around the mouth.

Researchers now believe that changes in the face muscles play an important part in
causing emotions. I noticed years ago, for example, that stretching out my cheek
muscles like in a lion's roar made me cry - still does.
Be aware of the changes in your facial muscles when you are experiencing emotions.
4. Body Response to Emotions
When we experience emotions, there are changes in our bodies. Sometimes people
have trouble sensing their body changes. To regulate our emotions we have to be
pretty good at sensing what is going on in our bodies. If we have practiced shutting
off our body sensations, this can be difficult. However it is a learned response and we
can unlearn it by practicing something else.

5. Action Urges
An important thing that emotions do is to prompt behaviors. An action urge may be to
fight or attack verbally in anger, or to flee or hide in fear, etc.

What are some action urges that you might have for these emotions?







6. Expression and Communication
One of the most important functions of emotions is to COMMUNICATE. To
communicate something, an emotion has to be expressed. Sometimes, if we have not
learned to express our emotions, we may think we are communicating but the other
person isn't getting it. This can cause misunderstanding.

Example: I am told that for most of my life I did not show any expression on my face,
and it still is not the easiest thing for me. I would feel angry, hurt and rejected
because people did not respond to my feelings, which I thought were very obvious.
Now I understand that people could not tell what I was feeling and so they did not
respond. I find that it works best for me to tell people what I am feeling, instead of
relying just on
my facial expression.

Emotions are expressed by facial expressions, words and actions. Expressing
emotions through behaviors can also cause problems, because different people
interpret behaviors in different ways.

Example: When I am so angry that I am afraid I am going to say something I will
regret, I leave the room. People have interpreted this as meaning that I am chickening
out or I don't care or I am saying "in your face." I have learned to say that I am
leaving to cool down and I will be back, so people will understand what I am doing.

7. After Effects
Emotions have after effects on our thoughts, our physical function and our behavior.
Sometimes these effects can last quite a while. One after effect is that an emotion can
keep triggering the same emotion over and over.





Exercises
Try completing work on Homework Sheet 1. Select a current or recent emotional
reaction and fill out as much of the sheet as you can.
Tips for Describing Emotions

The Emotion Regulation Handout 4: Ways to Describe Emotions, are for you to use
for help indescribing your emotions. You don't need to read them all through unless
you want to. You can refer to them when you need some help in describing your
emotions. Probably you will find that not everything in these lists fits you. Emotions
are very individual, and you can choose things that fit, and add other things.

If you are having trouble, try describing the qualities of your emotions. There are no
right answers here. We are trying to get you to pay more close attention to your own
emotions.

Some things interfere with observing and describing emotions. One of these things is
secondary emotions. Secondary emotions are those that come after the original
emotions For example, you might feel angry, and then you might feel shame for
feeling angry. Or you might feel sad, and then feel angry about the sadness. This
makes it harder to figure out what was your original emotion and to work on dealing
with that. Ask yourself, "Was that my first feeling?

Some people also often feel ambivalence, or more than one emotion at the same time,
like both anger and sadness when someone dies or goes away.

You will become more skilled at describing emotions as you practice. I suggest that
you do this exercise several times (make some photocopies of the page) over the next
couple of weeks. The more you practice, the better you will get at describing and
observing your emotions. Don't feel discouraged if it doesn't come easily at first.
Looking at emotions this way is changing patterns that a lot of us have been using
most of our lives. There are no right answers. The idea is for you to get practice in
observing and describing your emotions.







THE FUNCTION OF EMOTION
What good are emotions? Why do we have emotions? Until we begin to
understand the functions of emotions, why we have them, what their effect is on
others, we cannot expect ourselves to change them.

DBT looks at three major functions of emotions:
1. Emotions Communicate to and Influence Others.
2. Emotions Organize and Motivate Action
3. Emotions Can be Self-Validating

Part 1: Emotions Communicate to and Influence Others.

We communicate our emotions to other with verbal and nonverbal (facial
expressions, body gestures or postures) language. Some expressions of emotion
have an automatic effect on others. When there is a difference in what a person
communicates non-verbally versus verbally, the other person will usually respond
to the nonverbal expression.

For many years I showed little or no expression on my face while feeling very
intense feelings, and I got little response from others. Other people have talked
about showing very strong emotions on their face, while expressing less strong
emotions with their voice. People responded to the facial expressions.

DBT teaches that one of the main problems experienced by people with Borderline
Personality Disorder is that their nonverbal emotional expressions do not match
their inside feelings. So we are often misread. People misunderstand what we are
feeling.
Exercises
you give some examples of situations where your expressions of emotion
were misread?
else? Maybe their face looked one way, while they meant to express something
else.
ome examples of how your emotions have influenced others.


I will give an example of my own. When I walked into my class after hearing that
my father was critically ill, I felt very sad and my face looked sad. People asked
me what was wrong, and when I told them, they offered sympathy and comfort.

One of the people I teach with is often very depressed, and it shows in her body
posture and facial expression. I try to reassure her and encourage her.

Sometimes this strategy has backfired, and my expression of emotions gave me
something I didn't want. A friend suggested an outing, and I got very excited and
kept telling her how happy I was to go. In the end, she did not go. I was very
disappointed. After thinking for awhile, I realize it was not my fault that she
decided not to go. I can't make things like that happen. I can only be responsible
for myself.
.
What does expression of these emotions do for you? How do they influence
others? What do they communicate?










Part 2: Emotions Organize and Motivate Action

Emotions prepare for and motivate action. There is an action urge connected to
specific emotions that is hard-wired. (See the diagram on Emotion Regulation
Handout 3) "Hard-wired" means it is an automatic, built-in part of our behavior.
For example, if you see your two-year old child in the middle of the street and a
car coming, you will feel an emotion, fear, and this emotion will prompt you to run
to save your child. You don't stop to think about it. You just do it. Your emotion
has motivated your behavior without you having to take the time to think.

Emotions can also help us overcome obstacles in our environment. An example
given in the book is the anxiety someone feels when they are about to take a test.
This anxiety, though it's uncomfortable, helps to motivate you to study so you will
do well on the test.

Anger may motivate and help people who are protesting injustices. The anger may
override the fear they might feel in a demonstration or protest.

Guilt may keep someone who is dieting stick to her diet. (This is not saying that
you should feel guilty, just that it is the emotion that prompts some people to carry
through with a diet or some other difficult project.)
Exercises
See if you can come up with a couple of examples where your emotion prompted
you to take action before you thought about it.

See if you can come up with a situation where an emotion helps you overcome an
obstacle in your environment (in the community, at home, at school), where it
makes it easier for you to get something done, for example. It may not be a
pleasant emotion (we have mentioned here guilt, anger, fear), but it does help you
get the job done.

During the week, notice when your emotions motivate your action, save you time,
or help you get something done.

Part 3: Emotions can be self-validating

Emotions can give us information about a situation or event. They can signal to us
that something is going on.

Sometimes signals about a situation will be picked up unconsciously, and then we
may have an emotional reaction, but not be sure what set off the reaction. Feeling
"something doesn't feel right about this" or "I had a feeling something was going to
happen and it did" are some of the signals we might get.

Think of some times when your feel for a situation turned out to be right. Is there
some time when you felt anxiety or apprehension that turned out to be justified? Or
that you had a good feeling about someone that turned out to be right?

When dealing with our feelings this way is carried to extremes, though, we may
think of the emotion as fact. "I love him, so he's a good person." If I feel stupid, I
am stupid." While our emotions are always valid, it doesn't necessarily make them
facts.

This is difficult for people with Borderline Personality Disorder and others,
because one of our biggest issues is that we have been in invalidating environments
-- so much that we don't trust our emotions.

If our emotions are minimized or invalidated, it's hard to get our needs taken
seriously. So we may increase the intensity of our emotions in order to get our
needs met. And then if we decrease the intensity of our emotions, we may find
again that we are not taken seriously.

Think of some times when emotions are self-validating. For example: I am going
to a party, but I feel uneasy about it, as if something is going to happen. At the
party, a friend and I have an argument and I leave. My feeling about something
happening is right.

I am at work, and there seems to be a lot of tension. I sense that something is up.
At lunch, my coworkers hold a surprise birthday party for me. Again my emotion
is validated.

I am home alone and feeling very lonely. I am getting more and more anxious and
angry. I call friends and try to get someone to come and stay with me. No one will
come. So this intense negative emotion also validates my feeling that I am lonely
and no one cares.

Think of some examples of your own. Remember that we are not evaluating or
judging anyone's feelings or behavior. We are just trying to look at how emotions
function.
Exercise: Emotion DiarY

Fill out an emotion diary for several days. For each day choose your strongest
emotion, or the one that lasted the longest, or was the most difficult or painful.
Describe the prompting event, the event that caused or triggered the emotion. And
describe the emotion's function:



And remember, DO NOT JUDGE YOURSELF!!



Reducing Vulnerability to Negative Emotions
This is a skills that we can use to keep ourselves less vulnerable to having negative
emotions, and less likely to get into a state of Emotion Mind, where emotions
control our thoughts and actions.

These skills are things that affect your physical and your mental well-being. As
you read through them, you may find that you are already doing some of these
things, or that you need especially to work on one or two.

Linehan uses this chart as a way of remembering these skills, with the phrase
"P L E A S E M A S T E R."

treat Physical illness
balance Eating
avoid mood-Altering drugs
balance Sleep
get Exercise
build M A S T E R y

If we are feeling sick, hungry, tired, under the influence of drugs, don't get much
exercise or aren't doing something in our day that gives us a sense of mastery or
accomplishment, we are more likely to be vulnerable to negative emotions, to
experience or see the negative than the positive, less able to handle situations and
interactions with our wise mind.

P &
L: Treat Physical illness
Do you have a physical illness that needs to be tended to? Do you have medication
or treatments prescribed for you that you aren't taking or doing? What things keep
you from treating your physical illness? Take some time to think about this, and
see what it would take for you to take care of your physical needs.
E: Balance Eating
How well do you eat? Do you eat too little? Too much? What kinds of food do you
eat? (Eating too little means that your body doesn't get the nourishment it needs.
Also, if you eat too little over a period of time, your body goes into starvation
mode, and burns the food more slowly, trying to protect itself from starving.)

What foods make you feel good? Calm? Energized? What foods make you feel
bad? How does eating a lot of sugar make you feel? Caffeine? The key here is to
eat foods that are healthy and that make you feel good.
A: Avoid Mood-Altering Drugs
Alcohol and drugs can lower resistance to certain negative emotions. For example,
I found that when I drank alcohol, I felt more depressed and sometimes more
frightened. If you use drugs or alcohol, notice how they make you feel. If they are
a problem in your life, can you get some help?
S: Balance Sleep
How much sleep makes you feel good? Some people do fine on 5-6 hours, others
need 9-10 hours. Some people need to nap during the day. Learn to plan your
schedule so that you get the sleep you need. Do you have trouble sleeping?

Sleep is a big one for me. If I do not get enough sleep on a regular basis, I get
irritable, short-tempered, my judgment is less good and I get upset much more
easily. I have to work on it all the time.
E: Get Exercise
Regular exercise, besides being good for your heart, lungs, muscles and bones,
stimulates chemicals in your brain called endorphins, which are natural
antidepressants. We are talking about aerobic exercise, the kind that makes you out
of breath.

Do you get regular exercise? What kind? If not, is there something you can do for
exercise, starting out with just a little?
MASTER: Build MASTERY

Do things every day that make you feel competent, confident, that you are good at
something or are learning something. What kinds of things are you good at doing?
Can you learn a new skill? What kinds of things give you a sense of mastery, of
being good at something or meeting a challenge? Sometimes these things will be a
little bit hard or challenging.





Discussion


If you are someone who has not yet incorporated some of these things into your
life, perhaps you could make a plan for doing so, perhaps trying just one thing at a
time.

If you want to keep track of how you are doing at sleep, for instance, you might
keep a little chart of what time you go to bed and how much sleep you get each
night. Sometimes we are not really aware of how much sleep we get or what
exactly we eat. You could use your diary card as a checkoff chart.

The purpose of this section is to get you to take a look at these parts of your life.
Notice what you do and how you feel. Once you are aware of which areas are
working well and which you would like to improve, you can choose something to
work on.























Paying Attention to Positives
This section is about practicing increasing our positive emotions. This is another
step in learning to deal with our difficult emotions. We need some positive
emotions to put in the place of the negative emotions, or to share their space. This,
like all of our DBT skills, may take some practice. If we are very used to dealing
with negative emotions a lot, it may take a while to make some space for positive
emotions and pleasant experiences.

This is not an effort to invalidate the negative emotions that we feel. It IS a way of
expanding our experiences, and of providing some alternatives to some of our
difficult times.

We can build positive emotional experiences in two ways:
Short Term Experiences
Long Term Experiences
Short Term Experiences

Short-term positive experiences could be something like a swim, a walk in the
park, going out for pizza, watching a favorite TV show, talking on the phone to a
friend. Most of us probably already do something like this in our lives. We are
asking you to INCREASE doing pleasant things that give you positive emotions.
Doing more of this makes us feel good, which we deserve, even in the midst of all
the turmoil, and it gets us in the habit of having positive feelings.

Take a look at the Adult Pleasant Events Schedule. For the next week, do ONE
THING every day from this list of 176 activities. It's helpful if you plan what you
are going to do early in the day, but you might want to do something
spontaneously. I would challenge you to do at least one thing on the list that you
have never tried before, maybe something you have been wanting to do. Enjoy
yourself.

Long Term Experiences

In addition to having short term pleasant experiences, we also want to do things
and make changes in our lives that will make positive events happen more often.
Marsha Linehan often speaks of having "a life worth living." This is part of what
makes life worth living.


GOALS
What are some things that you can do to make your life more worth living in the
long term?

If you are going to school, or planning to go to school, you have a plan, and are
working toward a goal. For some people, their job may be a goal in itself, or
preparation for a goal (another more challenging or interesting or better-paying
job). Perhaps you would like to move into your own apartment, or attend a
treatment program, or move into the city or live in the country. Maybe you may be
learning or want to learn a skill or a craft, or take art lessons or swimming lessons,
visit a friend or family member or travel in another country or buy a car. The
possibilities are endless

Think about what you would like to do to make your life more pleasant in the
future. Make a list. Now list some small steps you can take toward your goals.
Take a first step. How does this feel?
RELATIONSHIPS
Another important area to work on for a more positive future is relationships. This
is not an easy area for most of us. But we can do some things that will help.

1. Repair a Relationship
If you really care about a relationship that has gone bad or just lapsed, work on
repairing it. In my own life, I had a relationship that I had let go for 20 years. L.
was my best friend all through school. The last time I saw her, she was headed to
Europe, and the meeting wasn't totally comfortable. I let 20 years go by, feeling
hurt and abandoned. And then somehow it came to me that I did not have wait for
her to write. I could write myself. Maybe she would answer and maybe she
wouldn't. Well, she did and we have since gotten together, and that big knot I felt
because she didn't write to me is gone. (By the way, I learned that she is an
absolutely terrible letter writer! That's why the long silence.)

Perhaps you will be inspired to renew a relationship or to work to repair a
relationship. The rewards can be great.


2. Create a New Relationship
We can also reach out for new relationships. This is hard for a lot of us. One thing
I have found helpful is to choose a community activity, like a club, bowling,
singing, church, community gardening, etc. Go every week, and you will see the
same people over and over, and begin to chat and feel familiar. Invite someone you
like for coffee or a walk. Maybe you might try something like that for one of your
Pleasant Events for this week.


3. Work on a Current Relationship
This could include spouses, partners, children, parents, siblings, friends,
coworkers, any one who is close to you or with whom you spend a lot of time. If
you think that your positive feelings would improve by working on a present
relationship, then give it a try. Don't let all your happiness depend on one person.
Try to cultivate a variety of relationships.



Positive Mindfulness

These last two points are really important if you are going to have and keep
positive experiences in your life.
1. BE MINDFUL OF POSITIVE EXPERIENCES
Remember when we talked about and practiced mindfulness? To be mindful of
positive experiences means applying mindfulness to the things that give you
pleasure. Focus your attention on the positive things that happen or that you do - a
talk with a friend, a walk in the woods, an ice cream cone, a good night's sleep,
anything that you enjoy. Focus your attention on it, and if your attention wanders,
refocus as many times as necessary. This will help to get you into the habit of
experiencing pleasure.



2. BE UNMINDFUL OF WORRIES
Distract yourself from:
thinking about when the positive experience will end
thinking about whether you really deserve this positive experience
thinking about what might be expected of you now that you've had this
experience
For example, if you find yourself thinking, "Gee, I'm having fun at the circus, but I
am so messed-up, I don't deserve this," distract yourself. Focus on the experience.
Keep those worry thoughts away.
In a situation like this, I usually distract by describing to myself the experience, for
example, "It's a great day. It's fun seeing all these people. Look at that cute little
kid. I love eating cotton candy. The clowns are so funny, especially that one in the
striped suit."

PRACTICE

This lesson on focusing on positive experiences is a lot of material. You don't need
to do it all at once. Just work down the list, and remember that actually practicing
the skills is the most important thing, practicing them every day, until they become
second-nature to you. Because we are trying to change thought and behavior
patterns that have been with us for many years, you can expect that it's going to
take a while to change things. But stick with it, because you CAN change, and it is
SO worth it.

Discussion

What are you doing to put some more positive experiences in your life? Maybe
schedule something nice for what is usually a down time of day for you. Try
something you've never done before. Ask someone to do a pleasant events with
you. Anytime you are feeling really down or blah, check out the Adult Pleasant
Event Schedule and see what might appeal to you.

One of the most important ways to work on negative feelings is to provide yourself
with some positive experiences to take the place of the negative ones. It's much
easier to let go of negative feelings when you have something positive to put in
their place.
Letting go of painful emotions
This section provides some techniques for letting go of emotional suffering. The best
way to get rid of painful and negative emotions is to let them go. Learning to let go of
the emotions is extremely difficult.

Letting go of emotional suffering associated with negative emotions is not the same
thing as letting go of the emotions themselves. Letting go of the suffering is a process
that we can learn.

We do not mean pushing away or sitting on the emotions. The emotions are valid, and
represent experiences and interactions that were or are painful. What we are talking
about is dealing with these emotions in a new way that will relieve some of the
suffering that goes with them.

In learning to let go of our emotional suffering, we use the mindfulness skills that we
have practiced before, the observe and describe skills. We learn to get some distance
from our emotions, to stand back and observe them. If we can get distance, we can see
them more clearly.

Try getting some distance from a painful emotion that you have. Put it over there and
look at it, maybe as if it were on a screen or a stage. Describe in words what the
experience of that emotion is like. This also helps to give you distance and
perspective.

By looking at your emotions, you are exposing yourself to them, looking and
describing, not necessarily acting on them, and not being swallowed by or
overwhelmed by them.
Homework
As you practice observing your emotions, fill out Emotion Regulation Homework
Sheet 1. Make several copies of this sheet, and use them as you practice this skill.
Understanding Dialectics
In DBT, we talk about the dialectic (as in Dialectical...). This means looking at two
different ideas, principles, interpretations, points of view, and balancing and
measuring them against each other. Then you may choose one or the other, or decide
to live with both or some mixture of both.

Some examples of dialectics are:





Can you think of other examples?

When we learn to accept our negative emotions, we begin to let go of the hold they
have on us and the suffering that they cause us. Accepting our emotions, letting
ourselves realize that we have these emotions and that they are real and valid, is NOT
approving of our suffering, or approving of the events that preceded these emotions.
We DON'T have to approve of our negative emotions as we learn to accept them.

You can choose acceptance without choosing approval.
This was probably the hardest thing for me to learn in DBT. I felt that accepting that I
had these terrible, painful feelings meant that it was okay that I felt so much pain. That
made me angry and despairing.

But when I understood that I did NOT have to approve, that I only had to let the
feelings in and acknowledge that they were there, accepting them in that way, it was
not such an impossible process.

How do you think accepting your emotions might affect your suffering?

Steps for Letting Go of Painful Emotions
Sometimes accepting the painful emotions can reduce our suffering, because we are no
longer
running from them or pushing them away. At times this acceptance can reduce our
pain. Notice the difference between pain and suffering. Suffering is the pain plus
frantic efforts to push the pain away, and feelings about the injustice of our suffering
and the pain of having our pain.


Following are Marsha Linehan's steps for letting go of our suffering.

and get yourself unstuck from it.
helpful to concentrate on some part of the emotion, like how your body is feeling, or
some image about it.

I try to imagine an ocean wave flowing through me, but not so big that it knocks
me over.
Don't try to push the emotion away. This makes it bigger, and increases our
suffering. Don't reject the emotion.
Don't judge your emotion. It is not good or bad. It is just there. There are no bad
emotions, just emotions. Anger, fear, sadness are all painful emotions, but they
are not bad. Everyone has them, and they are just as valid as the happy emotions.
At the same time, do not hang onto your emotion. Don't rehearse it over and over
to yourself. Don't escalate it or make it bigger. Sometimes when we feel a very
painful emotion, like anger or a deep grief, we hold onto it, or we intensify it,
making it stronger or bigger, in our efforts to deal with it or to give it our
full attention. Try not to do this. Just let it be however it is. This can result in a
lessening of the pain.
You are not your emotion. Your emotion is part of you, but it is not all of you. You
are more than your emotion.

Do not necessarily act on the emotion. Having the emotion does not mean you
have to act. You may just need to sit with the emotion. Often acting can intensify
and prolong the emotion.
Practice LOVING your emotions. This can be a difficult concept. Why would we
want to love painful emotions?

We can learn to love our emotions just the way we can learn to love (accept) anything
else about ourselves or our experience that we cannot change - our age, our height,
freckles, the birds that sing early in the morning and wake us up, the weather, the size
of our feet, allergies, etc.
Remember that acceptance (love) and approval are two different things. You don't
have to like your freckles, but they are there and you can't change that, so if you just
accept or love them, you will feel a lot better than if you keep fighting the idea that
they are there.





EXAMPLES
I will give a couple of examples from my own experience. The first one has most to do
with not hanging on or intensifying my emotion, and with not acting on my emotion.
This situation happened several weeks ago. A close friend and I communicate only by
e-mail and telephone - don't have the chance to meet in person. We had a difficult
phone conversation, in which I felt I was being attacked and felt hurt and angry. And
then I got a long letter from her in which she expressed her hurt and anger at me for
some things I had not realized were bothering her. She asked what we should do,
should we talk on the phone and hash it all out. Or not talk for awhile. Or just move
ahead and leave it behind.

I am a person who usually likes to talk things out, and I wanted her to know my
feelings. But I decided to think on it for a few days, because I was afraid that because
we couldn't meet face to face, there would be more misunderstanding. I decided that
saving the relationship was more important than airing my feelings (not hanging onto
my feelings). I suggested to her that we both go on from where we were, instead of
talking about the anger and hurt feelings, and who did what when, and she agreed.
And that's what we did. We just had a conversation like all our other conversations
(not acting on feelings). I think that it saved our relationship, and the bonus is that the
anger and hurt went away. I think this may be the first time that I have just let go,
because the relationship mattered more to me than hanging on to my feelings.

The other example is about more ongoing anger. I often feel angry at my youngest
sister. She does and says hurtful things, not all the time, but just enough so that I feel a
little on my guard. Last year there was an angry exchange about Thanksgiving that left
me in tears. I thought about acting on my anger, saying something angry back. I tend
to hold on to anger, especially regarding someone I love. At that time, I decided that I
did not want to lose or damage that relationship, and that I would only write to her and
call her when I had positive things to say, because the other things left me feeling so
bad.

So I did not entirely let go of my anger and hurt, but I didn't feed it or act on it. The
same thing has happened a couple more times since. After planning what angry or hurt
thing I was going to do or say, I remembered my plan to only say positive things, and
I can say that although the anger and hurt don't go away right away, the suffering does
go away, and as in the other situation, I still have a relationship.

I am not saying that this is always the way to handle a problem relationship, but this
was what I have chosen in this particular situation, with this particular person (I should
maybe add that I don't think most of what she had said was deliberate), and it has
worked to lessen my suffering and eventually to allow me to let go of my painful
feelings.

It might be that you would choose to hash out a difficult situation with someone, or to
let them know your feelings, but you can still choose to not hang on to your anger, to
not make it bigger.



Exercises
This is difficult stuff. It takes time and lots of practice to get the hang of it, and more
practice to get it to be a natural response to pain for you. I suggest that you pick one
small thing to try, and try it in a simple situation (for example, how you feel when the
mail is late, or how you feel when you lose a favorite piece of jewelry or how you feel
if you get scared watching a horror movie).

These are skills that are going to make it easier for you to live with the feelings that
come up from day to day, and also the long-standing painful feelings that you have.

TRY THESE:



or bad






Remember that you are a courageous person for doing this work, and that you deserve
and will have success and move closer to a happier and more fulfilling life.



Opposite to Emotion Action
the last suggested technique for changing painful emotions. Like all of the
techniques we have been learning about, it takes a lot of practice to be able to use it
skillfully. The idea behind this technique is that it can help to deal with distressing
emotions by setting into motion an action that is helpful, not harmful. Doing this
counteracts the suffering you might otherwise feel because of the distressing
emotion.

For example, if we are angry, there are many actions that we might take to express
our angry feelings. But if the action that we take is one that is opposite to the
emotion we feel, like walking away from a situation when we are angry, or
distracting ourselves with something nice, then we have put our energy into
something that is eventually going to make us feel better. In this way, we not only
reversed our action (walked away instead of yelling at someone), but we also
began to make a change in our angry feelings. We didn't escalate or heighten our
feelings, but did something that made the feelings decrease, by putting something
positive in their place.

It's important to know that this skill is not about trying to suppress our emotions.
We are using that angry feeling to take a different action. The result of this will be
a gradual change in our emotions.

The kinds of situations in which it is appropriate to use this technique are ones in
which the emotions might not be realistic to the situation we are in, maybe out of
proportion, or escalating, or be emotions that we want to challenge or change.

For example, if we are feeling very depressed and low and like no one wants us
around and we might as well just stay in bed, a way to act opposite to the emotions
is to get ourselves up and do something (go for a walk, go to the grocery store, visit
a friend, go to therapy, etc.). We are not denying our emotion, but we are
challenging it by acting opposite to it. Instead of staying at home in bed, we are
getting up and going out. We may not see big changes, but little by little we will
notice changes in the way we feel.

Several years ago, I needed a major amount of dental work done. I had been a
dental phobic all my life. I had major panic if I even smelled a smell like a dentists
office. But I really wanted this work done - it was mostly cosmetic work, and my
brother had agreed to pay the whole amount, enough, as the dentists said, to buy a
new car at the time. I was so scared that I could not sleep for days before my first
appointment. But I went. And when they called me to come in to the office, I
picked myself up and went in. I was screaming no, I can't, inside, but I did anyway.
This process lasted five months. I did not lose my fear right away, but I made
myself keep going, and as the time went on, I had less and less fear, and now I
think nothing of a trip to the dentist. I had to act opposite to my fear in the
beginning, to eventually reach a place where that fear had turned into acceptance.

Sometimes this is NOT the best thing to do. If you are afraid because you are in an
unsafe situation, pay attention to that fear. Do not go into that unsafe situation.

If you are ashamed about something, and that shame really does not belong to you
(i.e. it is from your past or from when someone told you you should be ashamed),
you might try to do what you feel ashamed about over and over and over (like
buying a new dress, or getting medical treatment, or eating a hearty lunch), do
these things over and over, until you are desensitized from the shame.

But if you feel shame because you have done something that is contrary to your
sense of right or your own ethics, then do your best to repair the situation and to
apologize, and then move on. This is not a situation where you would want to act
opposite to your emotion, because your emotion fits the situation.

Exercises

Can some of you give examples of how you have acted opposite to your current
emotion? Can you describe a situation in which it was not appropriate to act
opposite to your present emotion?

What do you do when you are angry?
depressed?
sad?
guilty?
ashamed?
afraid?
disappointed?

What are some opposite actions you could take when you have these emotions?

Look at Emotion Regulation Handout 10, "Changing Emotions by Acting Opposite
to the Present Emotion." There are suggestions for dealing with fear, guilt and
shame, sadness or depression and anger. Pick a situation in your life, and use these
suggestions to come up with a plan of action. Keep practicing your action, and
watch to see what happens with Your emotions

































Emotion Regulation Review
As you work through this module of DBT, try to answer the questions. Notice what
things about your own handling of your emotions might have changed or improved
in the last few months. In a Nutshell, the lessons of Emotion Regulation follow:
Our emotions come from:
1. REACTIONS to things and people in our ENVIRONMENT
What examples can you think of? (Losing a baseball game, seeing a friend you
like, failing a test, getting a good grade, being
criticized. What else?)

2. REACTIONS to things going on INSIDE OURSELVES
Examples of what happens to you. Feeling shame or guilt about not doing well at
something. Feeling afraid about something you are thinking about. Give some
examples of your own.
We have PRIMARY and SECONDARY emotions.


The PRIMARY emotion is the one we feel first -
like anger at being stood up by a friend, grief at someone we love who is dying

The SECONDARY emotion comes after the first.
First I feel anger at being stood up by a friend. Then I feel ashamed for feeling so
angry. In this case, shame is the SECONDARY emotion.

It is important to know which feeling is the PRIMARY feeling and which is
SECONDARY. The PRIMARY emotion is usually the one we need to work on.
When you have an emotion, look to see whether there was another emotion that
came first. Sometimes the switch from one to the other happens pretty fast.
How to Describe Emotions:

1. Describe the PROMPTING EVENT for the emotion.
What happened that set off your emotion? A friend stood you up? You feel you got
an unfair grade on a test? Your beloved dog died?

2. INTERPRETATION of an event - what you think about it.
For Example, EVENT = The cashier closes the line just as I get to
it. INTERPRETATION = He doesn't want to bother waiting on me
FEELING = Anger and Hurt
Here the feeling comes after an interpretation is made.

Can you think of other possible interpretations? What feelings do those other
interpretations give you?

3. BODY CHANGES
Do you feel changes in heart rate, breathing rate, skin temperature or moisture,
your facial expressions, your hands (clenched?)? Does your face get red? Notice
these changes.

4. ACTION URGES
Does the emotion prompt you to take action or to feel like taking action?
Fighting, crying, yelling, running away, hugging, throwing something? What else?

5. EXPRESSION AND COMMUNICATION
A very important function of emotions is to communicate. We need to express our
emotions to communicate.
We express with our words, our facial expressions, and our actions.
A PROBLEM WITH EXPRESSING OUR EMOTION THROUGH BEHAVIOR
IS THAT DIFFERENT PEOPLE INTERPRET BEHAVIOR DIFFERENTLY.
Can you think of a time when the emotion you expressed by your behavior was
misunderstood?

It is often difficult to express our feelings in words, but we can practice, a little at a
time. The more clear and direct we can be with the other person about our
emotions, the better chance we have of being understood.