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kaberett[I am using The Dialectical Behaviour Therapy Skills Workbook. Content notes as implied by the subject.]
The way I'm currently working through the book seems to be to go about half a chapter to a chapter ahead, to the point where I can't easily fill in blanks, and then head back to where I started to do a more thorough work-through and set of practice, followed by writing up. The book is divided into nine skills sections and one synthesis chapter; there are three pairs and one triplet of chapters, addressing four areas: distress tolerance, mindfulness, emotion regulation, and interpersonal effectiveness.
I think that when it comes to writing up I'm actually going to be subdividing chapters further: Basic Distress Tolerance Skills, f'rex, splits sorta-kinda neatly into (i) the subject of this post, (ii) distraction, and (iii) relaxation.
One of the things this chapter is leaning on quite heavily is a distinction between pain and suffering:
Coping strategies they describe as "self-destructive", they argue,
Use the Cost of Self-Destructive Coping Strategies worksheet to see how, they say, and list twelve of them in a two-column table; the second column is "possible costs", with some suggestions filled in and a blank space for you to write more. Relevant, at this point, isvass's comment on my previous post (CN self-injury methods and also suicide mention): everywhere else, the book asks you to list positives as well as negatives, so that you can work out how to get those needs/desires/drives met, or compensated for, without falling back on behaviours you would rather reduce.
Which is a very good point, so in the gaps in the first column -- there's enough space for my tiny handwriting -- I thought about it and then wrote down positives for basically all of them (and should perhaps write down positives for the couple I didn't). I also crossed out several Possible Costs I consider irrelevant or scare-mongering (like "infection" and "possible death" -- no, not with my methods of self-harm) or a problem of society and the social model, rather than an inherent problem of the strategy (like: "shame" is not actually a necessary outcome of "self-injury", and I'm much more into being compassionate to myself on this one, thanks).
(The strategies in question are: spending a great deal of time thinking about past pain, mistakes, and problems; getting anxious worrying about possible future pain, mistakes, and problems; isolating yourself to avoid possible pain; using alcohol and drugs to numb yourself; taking painful feelings out on others; engaging in dangerous behaviours, like cutting, pulling out hair, and self-mutilation; engaging in unsafe sexual activity; avoiding dealing with the causes of your problems; disordered eating; reckless behaviour and suicide attempts; avoiding pleasant activities; and surrendering to your pain and living an unfulfilling life. To these I have added "sleep deprivation", which is great when used in moderation while under-medicated for depression but is really shitty beyond about 48 hours and does actually make everything except for the emotional experience of existence significantly worse.)
Whiiich was the first exercise.
The second exercise introduces radical acceptance: "acknowledg[ing] your present situation, whatever it is, without judging the events or criticising yourself." I do not fundamentally have a problem with this; it's something I've been putting into practice for... Some Time Now, in various forms.
... oh my goodness the suggested Radical Acceptance Coping Statements exercise is a pile of platitudinous meaningless bullshit full of value judgements, by and large, with the occasional kernel of something useful. "This is the way it has to be"? Oh, fuck off. (I want to note explicitly, at this point, that something not working for me does not mean I think it's inherently bad or wrong, just that I am being prickly and spiky and slightly defensive in my own space about how to make this book work for me.)
"This is the way it is": yes. "It doesn't have to be this way" is, in fact, an important statement for me for managing other things -- you don't HAVE to resign yourself to living in this much pain in perpetuity, you don't HAVE to resign yourself to tolerating abuse, etc. "This is the way it is" has its own pitfalls, of course, cf that time I convinced myselfme_and had de facto broken up with me and just hadn't bothered to tell me yet on the basis that, basically, Google was lying about which messages he'd seen, and he was in a field with poor reception for three days, but -- it's rather less This Was Fated And There Is No Such Thing As Free Will, which works better for me.
As suggestions I'm willing to tolerate go, "I can't change what's already happened" is one; "this moment is the result of many other decisions", yep; "the present is the only moment I have control over" no no NO (i) you don't have absolute control over it and are still dependent on other people and (ii) you can exert influence on the future by doing things in the present: like, making it easier for me to do horn practice by unpacking my horn at a point when I'm not about to play, or moving things through to the room they're supposed to be in to make it easier to eventually put them away, or not being massively douchey to somebody now so that the future etc etc etc.
And obviously that isn't control of the future but I'd argue you don't meaningfully have control of the present either, so.
Statements I've added, which are of rather more use to me, in addition to the above: "here is temporarily who I am"; "do the job in front of you"; "you don't have to play wall". (I don't have any ready reference for that last one but it's Vorkosiverse.)
We are then encouraged to use these statements to Practise Radical Acceptance with things other than our own Very Painful Events.
The suggestions (you see where this is going) are "read a controversial story in the newspaper without being judgmental about what has occurred", "the next time you get caught in heavy traffic, wait without being critical", "watch the world news on television without being critical of what's happening", "listen to a news story or a political commentary on the radio without being judgmental", and "review a nonupsetting event that happened in your life many years ago, and use radical acceptance to remember that event without judging it".
... I really do think "wait in heavy traffic" is fundamentally different from "expose yourself to news stories about atrocities that are being filtered through a subjective and non-neutral point of view and quite possibly directly affect you in terrifying ways". I think this book was very obviously written by three white guys. I furthermore think that I actively find it a great deal easier to be accepting of how unpleasant and distressing shit is playing out in my life, and getting on with the job in front of me, than to be asked to turn off critical analysis of how information is being disseminated in an increasingly fascist (have you not been keeping up with the Tory party conference? YEAH.) political climate.
Which does, of course, probably mean that this is a valuable exercise for me to attempt -- but I think also means that for me this exercise doesn't belong under "basic distress tolerance". (I can already do traffic. I think I did a pretty good job, eventually, of getting to "okay, but this is how it IS, so what am I going to do about it next" after first flush of towering rage/panic over the first half of this year. I definitely did it without getting overwhelmed with respect to work last week, more than once.)
The other point being that I found Ozy's example -- part of a sequence of posts flagged up to me bywildeabandon, specifically the rate at which people die -- much more usable, in the first instance, than the Listen To The News variant, despite (I think) aiming at a fairly similar thing. I am going to try to think of other exercises, but honestly I think Get Better At Doing This One Rapidly When Shit Goes Down is highest up my priority list.
The way I'm currently working through the book seems to be to go about half a chapter to a chapter ahead, to the point where I can't easily fill in blanks, and then head back to where I started to do a more thorough work-through and set of practice, followed by writing up. The book is divided into nine skills sections and one synthesis chapter; there are three pairs and one triplet of chapters, addressing four areas: distress tolerance, mindfulness, emotion regulation, and interpersonal effectiveness.
I think that when it comes to writing up I'm actually going to be subdividing chapters further: Basic Distress Tolerance Skills, f'rex, splits sorta-kinda neatly into (i) the subject of this post, (ii) distraction, and (iii) relaxation.
One of the things this chapter is leaning on quite heavily is a distinction between pain and suffering:
The costs of these self-destructive coping strategies are clear. All of them lead to your pain being prolonged into long-term suffering. Remember, sometimes pain can't be avoided, but many times suffering can.
Coping strategies they describe as "self-destructive", they argue,
are paths to even deeper emotional pain, because even the strategies that offer temporary relief will only cause you more suffering in the future.
Use the Cost of Self-Destructive Coping Strategies worksheet to see how, they say, and list twelve of them in a two-column table; the second column is "possible costs", with some suggestions filled in and a blank space for you to write more. Relevant, at this point, is
vass's comment on my previous post (CN self-injury methods and also suicide mention): everywhere else, the book asks you to list positives as well as negatives, so that you can work out how to get those needs/desires/drives met, or compensated for, without falling back on behaviours you would rather reduce.Which is a very good point, so in the gaps in the first column -- there's enough space for my tiny handwriting -- I thought about it and then wrote down positives for basically all of them (and should perhaps write down positives for the couple I didn't). I also crossed out several Possible Costs I consider irrelevant or scare-mongering (like "infection" and "possible death" -- no, not with my methods of self-harm) or a problem of society and the social model, rather than an inherent problem of the strategy (like: "shame" is not actually a necessary outcome of "self-injury", and I'm much more into being compassionate to myself on this one, thanks).
(The strategies in question are: spending a great deal of time thinking about past pain, mistakes, and problems; getting anxious worrying about possible future pain, mistakes, and problems; isolating yourself to avoid possible pain; using alcohol and drugs to numb yourself; taking painful feelings out on others; engaging in dangerous behaviours, like cutting, pulling out hair, and self-mutilation; engaging in unsafe sexual activity; avoiding dealing with the causes of your problems; disordered eating; reckless behaviour and suicide attempts; avoiding pleasant activities; and surrendering to your pain and living an unfulfilling life. To these I have added "sleep deprivation", which is great when used in moderation while under-medicated for depression but is really shitty beyond about 48 hours and does actually make everything except for the emotional experience of existence significantly worse.)
Whiiich was the first exercise.
The second exercise introduces radical acceptance: "acknowledg[ing] your present situation, whatever it is, without judging the events or criticising yourself." I do not fundamentally have a problem with this; it's something I've been putting into practice for... Some Time Now, in various forms.
... oh my goodness the suggested Radical Acceptance Coping Statements exercise is a pile of platitudinous meaningless bullshit full of value judgements, by and large, with the occasional kernel of something useful. "This is the way it has to be"? Oh, fuck off. (I want to note explicitly, at this point, that something not working for me does not mean I think it's inherently bad or wrong, just that I am being prickly and spiky and slightly defensive in my own space about how to make this book work for me.)
"This is the way it is": yes. "It doesn't have to be this way" is, in fact, an important statement for me for managing other things -- you don't HAVE to resign yourself to living in this much pain in perpetuity, you don't HAVE to resign yourself to tolerating abuse, etc. "This is the way it is" has its own pitfalls, of course, cf that time I convinced myself
me_and had de facto broken up with me and just hadn't bothered to tell me yet on the basis that, basically, Google was lying about which messages he'd seen, and he was in a field with poor reception for three days, but -- it's rather less This Was Fated And There Is No Such Thing As Free Will, which works better for me.As suggestions I'm willing to tolerate go, "I can't change what's already happened" is one; "this moment is the result of many other decisions", yep; "the present is the only moment I have control over" no no NO (i) you don't have absolute control over it and are still dependent on other people and (ii) you can exert influence on the future by doing things in the present: like, making it easier for me to do horn practice by unpacking my horn at a point when I'm not about to play, or moving things through to the room they're supposed to be in to make it easier to eventually put them away, or not being massively douchey to somebody now so that the future etc etc etc.
And obviously that isn't control of the future but I'd argue you don't meaningfully have control of the present either, so.
Statements I've added, which are of rather more use to me, in addition to the above: "here is temporarily who I am"; "do the job in front of you"; "you don't have to play wall". (I don't have any ready reference for that last one but it's Vorkosiverse.)
We are then encouraged to use these statements to Practise Radical Acceptance with things other than our own Very Painful Events.
The suggestions (you see where this is going) are "read a controversial story in the newspaper without being judgmental about what has occurred", "the next time you get caught in heavy traffic, wait without being critical", "watch the world news on television without being critical of what's happening", "listen to a news story or a political commentary on the radio without being judgmental", and "review a nonupsetting event that happened in your life many years ago, and use radical acceptance to remember that event without judging it".
... I really do think "wait in heavy traffic" is fundamentally different from "expose yourself to news stories about atrocities that are being filtered through a subjective and non-neutral point of view and quite possibly directly affect you in terrifying ways". I think this book was very obviously written by three white guys. I furthermore think that I actively find it a great deal easier to be accepting of how unpleasant and distressing shit is playing out in my life, and getting on with the job in front of me, than to be asked to turn off critical analysis of how information is being disseminated in an increasingly fascist (have you not been keeping up with the Tory party conference? YEAH.) political climate.
Which does, of course, probably mean that this is a valuable exercise for me to attempt -- but I think also means that for me this exercise doesn't belong under "basic distress tolerance". (I can already do traffic. I think I did a pretty good job, eventually, of getting to "okay, but this is how it IS, so what am I going to do about it next" after first flush of towering rage/panic over the first half of this year. I definitely did it without getting overwhelmed with respect to work last week, more than once.)
The other point being that I found Ozy's example -- part of a sequence of posts flagged up to me by
wildeabandon, specifically the rate at which people die -- much more usable, in the first instance, than the Listen To The News variant, despite (I think) aiming at a fairly similar thing. I am going to try to think of other exercises, but honestly I think Get Better At Doing This One Rapidly When Shit Goes Down is highest up my priority list.