{"id":150173,"date":"2022-11-17T10:32:36","date_gmt":"2022-11-17T15:32:36","guid":{"rendered":"https:\/\/effectsofanxiety.net\/?p=150173"},"modified":"2022-11-16T17:41:50","modified_gmt":"2022-11-16T22:41:50","slug":"dbt-skills-emotion-regulation-counselor-toolbox-podcast-with-dr-dawn-elise-snipes","status":"publish","type":"post","link":"https:\/\/effectsofanxiety.net\/archives\/150173","title":{"rendered":"DBT Skills Emotion Regulation | Counselor Toolbox Podcast with Dr. Dawn-Elise Snipes"},"content":{"rendered":"<div class=\"jetpack-video-wrapper\"><iframe loading=\"lazy\" title=\"DBT Skills Emotion Regulation | Counselor Toolbox Podcast with Dr. Dawn-Elise Snipes\" width=\"660\" height=\"371\" src=\"https:\/\/www.youtube.com\/embed\/nTPsEHHA_g8?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/div>\r\n\r\n&nbsp;\r\n\r\nCEUs are available at AllCEUs.com this episode was pre-recorded\r\nas part of a live continuing\u00a0\u00a0education webinar on-demand, CEUs are still available for this presentation\u00a0\u00a0 at <a href=\"http:\/\/AllCEUs.com\/counselortoolbox\">AllCEUs.com\/counselortoolbox<\/a> I’d like to welcome everybody to today’s\r\npresentation of dialectical behavior therapy\u00a0\u00a0 techniques emotion regulation we are going to\r\nstart by reviewing the basic premises of\u00a0\u00a0 DBT and the reason we’re doing that we’re only\r\ngoing to do it in this one because emotion regulation we’re starting kind of at\r\nthe beginning but we want to go over what is\u00a0\u00a0 the theory underlying a lot of what we’re going\r\nto talk about we’ll learn about the HPA axis and\u00a0\u00a0 this isn’t something that Linehan talks about\r\nin DBT but it is important for understanding\u00a0\u00a0 our physiological stress reactions will define\r\nemotion regulation identify why emotion regulation\u00a0\u00a0 is important and how it can help clients ourselves\r\nstaff yay and we will finally explore some\u00a0\u00a0 emotion regulation techniques there are things\r\nbesides just preventing vulnerabilities that\u00a0\u00a0 we can provide to clients to help them regulate\r\ntheir emotions before moving into that distress\u00a0\u00a0 tolerance realm of skills and activities so basic\r\nDBT premises everything is interconnected when you\u00a0\u00a0 get up in the morning if you’re having a bad\r\nthe day you know you didn’t sleep well your back\u00a0\u00a0 hurts you’re cranky you got a lot of stuff to do\r\nit’s raining outside you know yay\u00a0 \u00a0you’re noticing all the negatives your thoughts\r\nmaybe more negative you may be more likely to\u00a0\u00a0 notice the negative you may be more likely to have\r\nwhat we call commonly call a bad attitude if you\u00a0\u00a0 start to have a better attitude what happens to\r\nwhat you observe and we’ll talk about that in a\u00a0\u00a0 little while the reality is not static what is true\r\nright now in the present may not be true which is you know was the future from what\r\nthe present was half a second ago so reality\u00a0\u00a0 changes when we look at a situation when we look\r\nat an event, we’re looking at how am i reacting and\u00a0\u00a0 what is my feeling about the situation right now\r\nyou know we can learn to change where we’re at but\u00a0\u00a0 with the information, I have right now what’s\r\ngoing on and a constantly evolving truth can\u00a0\u00a0 be found by synthesizing different points of view\r\nbecause most of the time as humans it’s just kind\u00a0\u00a0 of part and parcel of being humans we don’t have\r\nthe whole picture and I did the best I could with\u00a0\u00a0 these little graphics here think back if you will\r\nto some of PJ’s experiments when he was trying to\u00a0\u00a0 demonstrate egocentrism when we’re looking at\r\nthis yin and yang sort of model the girl’s stick\u00a0\u00a0 figure what does she see if you ask her what\r\ncolor is this orb she would probably say black\u00a0\u00a0 because we’re assuming she sees the black side\r\nif we ask this little thick figure model over\u00a0\u00a0 here what color is the orb she’s seeing the white\r\nside so he’d say white now if we asked a little\u00a0\u00a0 confused guy who is standing kind of on the third\r\nside or the south side he sees both of them so he\u00a0\u00a0 hears the stick figure girl say it’s black he\r\nsees a stick figure boy say it’s white and he’s\u00a0\u00a0 going well it’s kind of both you can synthesize\r\nboth perspectives and figure out that this is\u00a0\u00a0 an orb that has multiple colors even though she\r\ncan’t necessarily see those colors and he can’t\u00a0\u00a0 necessarily see those colors so BBT says let’s try\r\nto take a look and see if there are blind spots\u00a0\u00a0 see if there are things we’re not seeing or things\r\nwe didn’t observe the basic assumptions of DBT\u00a0\u00a0 and well people do their best if we didn’t think\r\nthat we probably wouldn’t be in this profession so\u00a0\u00a0 people are doing their best with the tools they\r\nhave and the knowledge they have at any given\u00a0\u00a0 time and I added that extra part people\r\nwant to get better and be happy most people don’t\u00a0\u00a0 want to be miserable if it seems like they don’t\r\nwant to get better then we need to ask ourselves\u00a0\u00a0 what is the benefit to staying miserable why is\r\nit is scarier more threatening more awful to look at\u00a0\u00a0 getting better or being happy and that’s one of\r\nthose motivational things we’re not going to go\u00a0\u00a0 there today but in general people are going to\r\nchoose the most rewarding option when prevents\u00a0\u00a0 presented with multiple options okay now this\r\none area in that I kind of diverge from the official\u00a0\u00a0 statement is clients need to work harder and be\r\nmore motivated to make changes in their lives I’ve\u00a0\u00a0 had a lot of clients who have been working their\r\nbutt off but they may not have the right tools\u00a0\u00a0 it’s like trying to unscrew something that is\r\nPhillips head with a butter knife they’re working hard but it’s not going anywhere because\r\nthey can’t get any traction so I crossed out the\u00a0\u00a0 work harder and I tend to replace it with work\r\nsmarter clients need to work smarter they need to\u00a0\u00a0 have more tools they need to have more effective\r\ntools and some of the tools they have may be awesome if we just tuned them up a little\r\nbit sharpen their oil and grease them whatever you\u00a0\u00a0 need to do and be more motivated to make changes\r\nin their life and you’re saying well they’re in\u00a0\u00a0 therapy they’re coming here for whatever reason\r\nthere why aren’t they motivated to make changes\u00a0\u00a0 well again let’s look back at motivation and what’s\r\nthe most rewarding choice is if they tried to make\u00a0\u00a0 changes before and it hasn’t worked out and\r\nthey’ve been told that it was their fault they\u00a0\u00a0 were being resistant or you know they were blamed\r\nin some way or they just felt disempowered what’s\u00a0\u00a0 going to make them motivated to try to do that\r\nagain please let me run the gauntlet most\u00a0\u00a0 people don’t want to do that so we need to help\r\nclients work smarter and understand that they are\u00a0\u00a0 working hard and they need to continue to do so\r\nand we’re going to help them get more effective\u00a0\u00a0 tools and we need to help them get more motivated\r\nwe need to help them see that this time it’s going\u00a0\u00a0 to be different maybe a little bit different\r\nbut this time we’re trying something new it may\u00a0\u00a0 be different even if people didn’t create their\r\nproblems they still must solve yep you know\u00a0\u00a0 if you grew up in a dysfunctional household you\r\ndidn’t create that problem but it is negatively\u00a0\u00a0 impacting you today so you’re going to have to fix\r\nit if you want to be happy which is the\u00a0\u00a0 whole goal of the lives of suicidal or addicted\r\npeople are unbearable and when we’re talking\u00a0\u00a0 about DBT we’re generally talking about people\r\nwho are highly emotionally reactive and suicidal self-harm those behaviors are away at this point\r\nthat they’re trying to figure out how to tolerate\u00a0\u00a0 what seems like an unbearable situation in their\r\nhead addiction is much the same way it provides\u00a0\u00a0 some relief from something they feel they have no\r\ncontrol over people need to learn how to skillful\u00a0\u00a0 live skillfully in all areas of their life well\r\nyeah because every area is interconnected if\u00a0\u00a0 you’re stressed out at work do you just\r\nleave work go home and you have not stressed out\u00a0\u00a0 anymore no that’s not the way it works it would\r\nbe great if it did but it’s just not even if you\u00a0\u00a0 don’t take all your stresses of work home with you\r\nit has taken a toll on your energy level so when\u00a0\u00a0 you get home you’re more vulnerable to emotional\r\nupset or just fallen asleep on the couch at 6:00\u00a0\u00a0 p.m.\r\n\r\n&nbsp;\r\n\r\nWhatever it is so we need to help people\r\nlearn how to live skillfully in each area so\u00a0\u00a0 the exhaustion or negativity or whatever it is\r\nfrom one area doesn’t bleed over into the other\u00a0\u00a0 area so we need to learn how to juggle stresses\r\nin all of our areas to prevent vulnerabilities\u00a0\u00a0 and people cannot fail in treatment when someone\r\nrelapses when someone you know backslides whatever\u00a0\u00a0 word you want to use I look at it as a learning\r\nthe opportunity I say okay you made a different choice\u00a0\u00a0 than we wanted you to make a different choice than\r\nyou were hoping you would make so let’s learn from\u00a0\u00a0 and figure out why that was the most rewarding\r\nchoice than what was on your treatment plan\u00a0\u00a0 the goal that you’re working toward why what\r\nhappened what were you more vulnerable so you\u00a0\u00a0 didn’t choose the newer behaviors because they\r\nweren’t as readily available let’s use this as\u00a0\u00a0 a learning opportunity to figure out what’s going\r\non it’s not a failure it’s a learning moment or a\u00a0\u00a0 teachable moment so what is emotion regulation\r\nemotional dysregulation will start there\u00a0\u00a0 results from a combination of high emotional\r\nvulnerability so you’ve got somebody who is\u00a0\u00a0 kind of reactive and extended time needed to return to\r\nbaseline so that when they get upset it takes them\u00a0\u00a0 longer to de-escalate and get back to baseline\r\nand an inability to regulate or modulate one’s\u00a0\u00a0 own emotions so I want you to think about some\r\nthe time that you’ve been driving on the interstate\u00a0\u00a0 and you’re just driving along cruising along and\r\nheaven forbid if this has happened I hope not\u00a0\u00a0 but if it did you’re probably just late a semi comes\r\nalong and runs you off the road onto the shoulder\u00a0\u00a0 and oh my gosh you get onto the shoulder your legs\r\njust to go in like this you can’t even press the\u00a0\u00a0 gas pedal because you are so stressed out you’re\r\ngripping your knuckles are white from gripping the\u00a0\u00a0 steering wheel so tight your heart racing you’re\r\nbreathing fast you’re in full-out fight-or-flight\u00a0\u00a0 mode so you went from a1 on the stress meter\r\nyou know kind of cruising along aware of the\u00a0\u00a0 fact that you need to be cognizant of dangers to\r\na5 of oh crap that could have been bad alright so you take a couple of deep breaths you\r\nyour breathing goes down a little bit you get to\u00a0\u00a0 the point where you can press the gas\r\npedal and you pull back out onto the highway now\u00a0\u00a0 are you returning to baseline and just like\r\nla-dee-da cutting around like you were before most\u00a0\u00a0 likely not you’re a little bit more\r\non edge and you’re checking your bat rearview\u00a0\u00a0 mirror more often you’re looking back making\r\nsure nothing’s in your blood spot more awesome\u00a0\u00a0 so you’re not returning to that same level of less\r\nstress Tunis if you will you stay a little bit\u00a0\u00a0 elevated because your brain is gone you know I\r\nthought it was kind of a safe situation but I’m\u00a0\u00a0 realizing now that not so much so I’m going to\r\nkeep you on higher alert and it’s going to take\u00a0\u00a0 longer for you to return to baseline because\r\nyou’re looking for those threats now you’re\u00a0\u00a0 much more aware that it could happen to people who\r\ncome from invalidating environment people who are\u00a0\u00a0 regularly chronically stressed they’re constantly\r\nlooking around for anything else that is going to\u00a0\u00a0 threaten them anything else that’s going to stress\r\nthem out so they’re not going from a 1 to a 5 back\u00a0\u00a0 down to a 1 again they’re going from a 1 to a 5\r\nback down to a 2 and then back up to a 5 and then\u00a0\u00a0 now we’re only going down to a 3 it’s that\r\nstress is ramping up so we need to figure out how\u00a0\u00a0 to help people deescalate get back down to that\r\none and realize okay I got this that was an unpleasant situation but I got this now emotional\r\nvulnerability refers to the situation in which\u00a0\u00a0 an individual is more emotionally sensitive or\r\nreactive than others or then they normally would\u00a0\u00a0 be you know some people this is kind of and when\r\nwe’re talking about personality disorders this is\u00a0\u00a0 pervasive when we’re talking about someone who\r\nhas been under a bunch of stress for six months\u00a0\u00a0 this may be a situational sort of thing that we\r\nneed to help them figure out how to get out of\u00a0\u00a0 but it may not be something that is completely\r\nand utterly pervasive in any event when you are\u00a0\u00a0 stressed you know you’re already kind of on edge\r\nand something happens do you react the normal way\u00a0\u00a0 that you normally would if you were just like\r\nsitting there and going off oh well okay let’s\u00a0\u00a0 figure out how to handle this or does it throw\r\nyou up sort of into the stratosphere and for a\u00a0\u00a0 lot of people with emotional dysregulation when\r\nthey’re their relaxation is on the brink\u00a0\u00a0 of chaos so they’re standing there teetering\r\nand they’re going okay I cannot take one more\u00a0\u00a0 wind or it’s going to push me over and then they\r\ncall them damp they get upset and they’re kind\u00a0\u00a0 of on freefall for a while they get their balance\r\nagain but then they’re still right there on that\u00a0\u00a0 precipice they never come down so what\r\nwe want to look at is what’s going on with these\u00a0\u00a0 people that’s making them more reactive that’s\r\nmaking them more alert and more hyper-vigilant to stresses and stressors some of these may be\r\nbecause of differences in the HPA axis which\u00a0\u00a0 play a role in making people more vulnerable or\r\nreactive and we’re going to talk about the HPA\u00a0\u00a0 axis in a minute environment of people who are\r\nmore emotionally reactive or often invalidating\u00a0\u00a0 and what does that mean well pick Jane Jane\r\nhas had a heck of two years you know\u00a0\u00a0 there’s just been death after death a job loss\r\nshe lost her home she’s living in an apartment\u00a0\u00a0 right now but she’s not happy and you know yeah\r\nyou can just pile stuff on okay so James struggling right now she’s holding on and really\r\ntrying to do the next right thing she’s trying\u00a0\u00a0 to make ends meet trying to do what’s right\r\nby our kids just feeling stressed out and\u00a0\u00a0 then something happens something that most of us\r\nwould react with it to you know it’s annoying but\u00a0\u00a0 it wouldn’t throw us into utter chaos well James\r\non that precipice Jane’s already at a four maybe\u00a0\u00a0 a four and a half depending on the day so when\r\nthis happened just that too puts her on a scale of one to five puts her at a\r\nsix-and-a-half which is in freefall but people\u00a0\u00a0 may not understand that they may not understand\r\nwhat’s going on in Jane’s life and they’re like\u00a0\u00a0 this is not that big of a deal why are you just\r\noverreacting which makes Jane feel guilty\u00a0\u00a0 Phil is self-conscious and feels misunderstood so\r\nthen she feels isolated and rejected and we’ve\u00a0\u00a0 talked about basic fears being rejection isolation\r\nfailure loss of control and the unknown well James\u00a0\u00a0 kind of experiencing all of those right now and\r\nthe people around her instead of being validating\u00a0\u00a0 and going okay you were already stressed out I\r\ncan see how this was just the straw that broke\u00a0\u00a0 the camel’s back they’re going what is your\r\nthe problem so she doesn’t feel like she’s got\u00a0\u00a0 social support she’s out there on an island unto\r\nherself so we want to help Jane with emotional\u00a0\u00a0 regulation because we know she’s up here and we\r\nknow she doesn’t like going into that freefall\u00a0\u00a0 but how do we help her emotional regulation is the\r\nability to control or influence which emotions you\u00a0\u00a0 have when you have them and how you experience or\r\nexpress them and that’s a quote straight out of\u00a0\u00a0 Linda hands book so emotion regulation prevents\r\nunwanted emotions by reducing vulnerabilities\u00a0\u00a0 so you can go through life you can go through\r\nthe day you can experience stress but instead\u00a0\u00a0 of feeling overwhelmed or enraged you might feel\r\nmildly irritated for a second and then choose to\u00a0\u00a0 move on emotion regulation helps people learn how\r\nto change painful emotions once they start so you\u00a0\u00a0 don’t get stuck nurturing that emotion or feeding\r\ninto it and being angry with yourself because you\u00a0\u00a0 got angry about something you have no control over\r\nit teaches that emotions in and of themselves are\u00a0\u00a0 not good or bad they just are it’s your brains\r\nhardwired way of responding based on waiting for\u00a0\u00a0 it the information that it has at this particular\r\npoint in time spiders if you’re afraid of spiders that is your brain’s way you see a spider and you\r\nfeel fear it’s your brain’s way of going threat\u00a0\u00a0 spiders can be a poisonous big threat so you want\r\nto get away from it that’s your body’s way your brain’s way of going let’s survive we want to do\r\nthis now you can figure out you can learn more\u00a0\u00a0 about spiders so in the future when you encounter\r\nthen you realize that they’re not you know 99% of\u00a0\u00a0 them are not threatening to humans but right now\r\nat this moment your brain is saying warning getaway you probably want to do that so it teaches\r\nthat emotions internet themselves are just\u00a0\u00a0 prompting us to do something they are survival\r\nresponses and suppressing them makes things worse\u00a0\u00a0 telling yourself I shouldn’t feel afraid does that\r\ndo any good if your kid comes to you and tells you\u00a0\u00a0 that you know I’m having a crappy day or I\r\nhate this does it usually do any good to tell them\u00a0\u00a0 well you shouldn’t feel that way feel better you\r\nknow just be happy does that work I’ve never had\u00a0\u00a0 an experience where that worked now it may work\r\nfor some people but so we want to help people\u00a0\u00a0 identify their emotions and not get consumed\r\nby the emotions are effective when acting on\u00a0\u00a0 the emotion is in your best interest so sometimes\r\nit’s in your best interest expressing your emotion\u00a0\u00a0 gets you closer to your ultimate goals sometimes\r\nexpressing your emotion gets you closer to your\u00a0\u00a0 short-term goals like making the pain stop\r\nand true pain is unpleasant however in the\u00a0\u00a0 big scheme of things 15 minutes from now 3 hours\r\nfrom now is that getting you closer to the goals\u00a0\u00a0 that you want to achieve or was it just a\r\nstopgap expressing your emotions will influence\u00a0\u00a0 others in ways that will help you so if you want\r\nto influence others in ways that are positive and\u00a0\u00a0 will help you then emotions can be very kinder\r\nthat can be very helpful emotions are sending you\u00a0\u00a0 an important message and we already talked about\r\nthat so I’m thinking the devil’s advocate amigos\u00a0\u00a0 well I can think of a client that goes you rage\r\nis a great emotion to express is it in my best\u00a0\u00a0 interest yeah gets people to leave me the heck\r\nalone does it get me closer to my ultimate goals\u00a0\u00a0 yeah it reduces my stress by getting people to\r\nleave me the heck alone will it influence others\u00a0\u00a0 in ways that will help you, yeah it make them\r\ngo away and are these emotions sending you an\u00a0\u00a0 important message yet rage is telling me that\r\nthese people like everybody are a threat to me\u00a0\u00a0 so in the short term when you look at it that\r\nway it can be tricky to see but we want to help\u00a0\u00a0 people get outside of this immediate threat and\r\nsay where you want to be what happiness looks like to you or however you want to define\r\nthat ultimate goal and then once you get into\u00a0\u00a0 distress tolerance was your Thursday talk about\r\nhow do you endure unpleasant emotions so you don’t\u00a0\u00a0 take the stopgap route now on to our favorite\r\nHPA axis the hypothalamic-pituitary-adrenal axis\u00a0\u00a0 is our central stress response system and doesn’t\r\nget too caught up and all the psychobiology of\u00a0\u00a0 this I think it’s good to be cognizant of but\r\nwe’re not prescribing hypothalamus\u00a0\u00a0 place in the brain release is a compound\r\ncalled corticotropin-releasing factor or CRF\u00a0\u00a0 which triggers the release of adrenocorticotropic\r\nhormone from the pituitary gland which triggers\u00a0\u00a0 the adrenal glands to release stress hormones\r\nparticularly cortisol and adrenaline now your adrenal glands are actually on your\r\nkidneys and why is that important what I want you\u00a0\u00a0 to see or understand is there are a lot of systems\r\ninvolved there are a lot of hormones involved\u00a0\u00a0 there’s a lot of stuff involved it’s not just box\r\nyou know you’re releasing a bunch of chemicals in\u00a0\u00a0 your body that are altering the neurochemicals\r\nand the other hormones to prepare you for spiders\u00a0\u00a0 the adrenals control chemical reactions over large\r\nparts of your body including the fight-or-flight\u00a0\u00a0 response and produce even more hormones than\r\nthe pituitary gland so you’ve got these adrenals\u00a0\u00a0 this is kind of your stress area if you will it\r\nproduces steroid hormones like cortisol which\u00a0\u00a0 is a gluteal corticoid which means it makes your\r\nbody release glucose what we know is that glucose is blood sugar energy all right so it increases the\r\navailability of glucose and fats for the long-term\u00a0\u00a0 fight-or-flight reaction it also produces sex\r\nhormones like DHEA and estrogen okay why is that\u00a0\u00a0 important because we know that when estrogen\r\ngoes up serotonin availability goes up so if there are the adrenals are busy doing something\r\nelse it may cause other hormonal imbalances and\u00a0\u00a0 it also produces stress hormones like adrenaline\r\nthat is going to ramp you up they’re going to\u00a0\u00a0 increase your respiration increase your heart rate\r\nall that kind of stuff so once you have that whole\u00a0\u00a0 reaction we talked about and the perceived threat\r\npasses cortisol levels return to normal great this\u00a0\u00a0 is what happens in the ideal situation but what if\r\nthe threat never passes what if we’re working with\u00a0\u00a0 a client who is constantly fearing rejection\r\nand isolation they need external validation\u00a0\u00a0 because they don’t feel good enough as they are\r\nthey don’t have social support because their\u00a0\u00a0 emotional reactivity kind of pushes everybody\r\naway so they’re constantly feeling this threat\u00a0\u00a0 of rejection isolation failures loss of control\r\nand the unknown they’re holding on just like you\u00a0\u00a0 were holding on to the steering wheel after you\r\nran off the road and you got back on you know\u00a0\u00a0 you kept chugging because you wanted to get to\r\nyour destination but you were scared witless okay so you’re chugging along what’s going\r\non what’s going on in that body the amygdala\u00a0\u00a0 and the hippocampus are intertwined with the\r\nstress response the amygdala modulates anger\u00a0\u00a0 fear or fighter flight and the hippocampus helps\r\nto develop and store memories when you’re under\u00a0\u00a0 stress and think about a time when you are under\r\na lot of stress were you effective at learning and\u00a0\u00a0 paying attention to the good things and the bad\r\nthings or were you just trying to make the pain\u00a0\u00a0 stop and make the threat go away from the brain of the\r\nchild or adolescent is particularly vulnerable\u00a0\u00a0 because of its high state of plasticity which is\r\nwhy do we see people who tend to have personality\u00a0\u00a0 disorders much of their trauma and stuff really\r\nstarted early in their development and which is\u00a0\u00a0 why it’s pervasive in every area or many areas\r\nof their life, bad things are learned emotional\u00a0\u00a0 upset prevent learning new positive things to\r\ncounterbalance it if you’re in a bad mood if\u00a0\u00a0 you’re scared if you’re threatened you know if\r\nyou’re hungry homeless put whatever stuff is\u00a0\u00a0 there are you paying attention to the\r\nbluebirds that are flying around and singing\u00a0\u00a0 pretty songs or are you paying attention\r\nto the fact that you got an a on a test maybe\u00a0\u00a0 not so, we need to understand this person who lives\r\nin a chronically stressful environment may also\u00a0\u00a0 have an overactive HPA axis so they’re already\r\nthey’ve already got some adrenaline and\u00a0\u00a0 cortisol going on they live kind of in this state\r\nof hyper-vigilance and then something happens and\u00a0\u00a0 they’re just like through the roof kind of like\r\nwhen you scare a cat what happens to the brain\u00a0\u00a0 one is a chronic threat to its safety and a constant\r\nthe underlay of anxiety is constant undercurrent as\u00a0\u00a0 it learns your brain forces synaptic connections\r\nfrom experience and pruned away connections that\u00a0\u00a0 aren’t utilized by people who feel a lack of control\r\nover their environment are particularly vulnerable\u00a0\u00a0 to excessive stimulation of the stress response\r\nnow it’s not just children abuse and neglected\u00a0\u00a0 children pop right up there but abuse and\r\nneglected adults think about a client you’ve\u00a0\u00a0 worked with who’s been in an abusive relationship\r\nfor years does she have all the happy connections\u00a0\u00a0 or is she pretty much terrified exhausted and\r\nstressed out most of the time adults with\u00a0\u00a0 anxiety or depressive disorders it doesn’t even\r\nhave to be an abusive or neglectful situation if\u00a0\u00a0 you have someone that forever whatever reason has\r\nclinical anxiety or depressive symptoms they are\u00a0\u00a0 in this state of constant threat and constant of\r\npeople if you will so they’re not seeing they’re\u00a0\u00a0 not able to learn and take in as much of the\r\ngood stuff so there’s more bad stuff coming in\u00a0\u00a0 they’re paying attention to more of the bad stuff\r\nor unpleasant stuff the synaptic connections\u00a0\u00a0 that form the foundation of people’s schema of\r\nthemselves in the world become skewed towards\u00a0\u00a0 the traumatic event at the expense of a synaptic\r\nNetwork-based on positive experiences and healthy\u00a0\u00a0 relationships so we had this client here and these\r\nare her negative experiences she has a lot of them\u00a0\u00a0 and she’s got these going through her head a lot\r\nand it’s not they don’t just go away whenever she\u00a0\u00a0 meets somebody and she’s like well they’re going\r\nto leave me whenever something happened she feels\u00a0\u00a0 isolated and alone she may fear so she’s got\r\nreally strong connections to those memories\u00a0\u00a0 and past experiences and when you’re in the midst\r\nof all this, there’s not a lot of happy stuff and\u00a0\u00a0 even when she appears happy a lot of times she’s\r\nfaking it she’s not seeing and remembering all\u00a0\u00a0 the happy stuff she just wants to avoid the pain\r\nanother example I could give you is thinking about\u00a0\u00a0 a city planner now a city planner only has a\r\nthe certain budget just like we only have a certain\u00a0\u00a0 amount of energy the city planner looks and says\r\nwhat roads and what connections between cities get\u00a0\u00a0 the most traffic and let’s devote our resources\r\nand strengthen those connections because we know\u00a0\u00a0 we’ve got all kinds of traffic going over there\r\nand those roads that don’t travel those\u00a0\u00a0 back roads we don’t need to pay much attention to\r\nthem right now because we need to make sure that\u00a0\u00a0 those roads that are used the most are strong\r\nbut that’s the best analogy I can give without\u00a0\u00a0 putting out strings and everything else but so\r\nthe hyper-vigilant state active IDEs activated\u00a0\u00a0 by the stress response that disrupts our ability\r\nto focus and learn you know we’re just trying to\u00a0\u00a0 not die we’re trying to not be consumed by pain\r\nit impairs the ability to form new memories and\u00a0\u00a0 recall information due to the physiologic changes\r\nin the hippocampus, it’s not time to learn and\u00a0\u00a0 process and do all that kind of stuff have you\r\never tried to study for a test when you had 16\u00a0\u00a0 other things going on that you are stressed about\r\nhow well did you remember this stuff over here sometimes people relate things to prior experience\r\nwell most of the time so maybe they’ve had a lot\u00a0\u00a0 of dysfunctional relationships and they start to\r\nget in a relationship which side is going to be\u00a0\u00a0 triggered the negative memories are the positive\r\nmemories and then you have somebody who may be\u00a0\u00a0 attached to some positive relationships they start to\r\nget into a relationship and they remember some of\u00a0\u00a0 the positives because there have been some really\r\ngood relationships but you know they may remember\u00a0\u00a0 the negative too but most likely they’re going\r\nto remember more strongly the positive so what’s\u00a0\u00a0 their reaction going to be if we’re trying to help\r\nour clients develop a healthy support system we\u00a0\u00a0 need to help them address some of those highways\r\nthat are going towards the negative memories emotion regulation is transdiagnostic or useful\r\nwith many disorders it helps people increase their\u00a0\u00a0 present focused emotion awareness it says right\r\nnow right here right now what are your feelings\u00a0\u00a0 what are your physical sensations what are your\r\nthoughts and what are your urges it helps people\u00a0\u00a0 increase cognitive flexibility because it helps\r\nthe kind of step back and take a look and say\u00a0\u00a0 okay what are my options let me step back from\r\nbeing intertwined with this feeling and go okay\u00a0\u00a0 I feel angry got it what are my options here what\r\ndo I usually do what I want to do when I’m on\u00a0\u00a0 autopilot what are some other options I could\r\ndo that might help me move toward where I want to\u00a0\u00a0 go identifying and preventing patterns of emotion\r\navoidance and emotion-driven behaviors we don’t\u00a0\u00a0 want to get into the situation of constantly trying\r\nto avoid unpleasant emotions by lashing out by\u00a0\u00a0 hurting ourselves or by doing things reactively\r\nwhen I feel this way I must smoke a cigarette I\u00a0\u00a0 must cut myself I must fill in the blank we want\r\nto help people find alternate ways and be able\u00a0\u00a0 to step back and say that is an option is it the\r\noption I want to choose today increasing awareness\u00a0\u00a0 and tolerance of emotion-related physical\r\nsensations sometimes these physical sensations\u00a0\u00a0 are just so powerful and so overwhelming and\r\nsometimes the rush of adrenaline and that foggy wibbly-wobbly feeling you get in your head when\r\nyou have just adrenaline coursing through your\u00a0\u00a0 veins is so overwhelming that people don’t know\r\nwhat to do with it and are afraid it won’t stop\u00a0\u00a0 so let’s help them increase their awareness and\r\ntolerance of this helped them understand that it\u00a0\u00a0 passes and use emotion-focused exposure procedures\r\nwhen they get upset help them think about things\u00a0\u00a0 in the group sessions that get them a little bit\r\nrevved up you know we don’t want to precipitate\u00a0\u00a0 a full-scale crisis or talk about something that\r\nhappened last week that got them upset and let’s\u00a0\u00a0 apply these procedures emotional behavior is\r\nfunctional to change the behavior it’s necessary\u00a0\u00a0 to identify the functions and reinforcers of the\r\nbehavior so when they did it you know let’s talk\u00a0\u00a0 about cutting because you know that is one of\r\nthose behaviors that we see are self-injury it’s what is the function of that behavior cutting\r\nor self-injury is a way of inflicting physical\u00a0\u00a0 pain where the person has control and they focus\r\non that and they feel a sense of mastery when the\u00a0\u00a0 stuff going on in their head feels completely\r\nuncontrollable and intolerable it diverts their\u00a0\u00a0 attention and it also is something that they\r\nthey can control how much pain they’re in so\u00a0\u00a0 that’s how it’s functioning now is the best\r\nthe response we want no but we can see why somebody\u00a0\u00a0 might engage in that behavior and what reinforces that\r\nbehavior well when they do that not only do they\u00a0\u00a0 get a reprieve from this emotional turmoil that\r\nthey don’t feel like they can touch or control\u00a0\u00a0 or do anything with but their body also releases\r\nendorphins release natural painkillers to kill\u00a0\u00a0 that physical pain which makes them feel a little\r\na bit better so they’ve got kind of a double whammy\u00a0\u00a0 on reinforcers there so we understand that\r\nnow we need to find something else that they\u00a0\u00a0 can do and help them figure out how to tolerate\r\nthe turmoil emotions function to communicate to\u00a0\u00a0 others and influence and control their behaviors\r\nand serve as an alert or an alarm to motivate\u00a0\u00a0 one’s behaviors so let’s talk about the first\r\none communicate to others so I’m communicating to\u00a0\u00a0 a rat around me the people around me through my\r\nemotions what’s going on if I’m angry I’m lashing\u00a0\u00a0 out I’m going to influence people’s behavior and\r\nthey’re probably going to back off if I am sad\u00a0\u00a0 or crying or scared that might bring them closer\r\nand in a more supportive sort of thing you know\u00a0\u00a0 again you’ve got to look at some of the behavior\r\nself-injury can elicit a caretaking response but\u00a0\u00a0 these emotions before somebody start\r\nacting out the behaviors the emotions serve as\u00a0\u00a0 a cue that okay Sally is getting ready to go in\r\nfree fall so they can start reacting sooner and\u00a0\u00a0 it serves as an alert or an alarm to the person to\r\nmotivate their behaviors if they know you’re\u00a0\u00a0 on the precipice if you know you’re right on the\r\nedge of being vulnerable cranky being irritable that day can motivate your own\r\nbehaviors to figure out how to reduce some\u00a0\u00a0 of your vulnerabilities and identify obstacles to\r\nchanging emotions now we can’t just say be\u00a0\u00a0 happy and all of a sudden somebody’s like oh I\r\ndon’t know why I didn’t think of that I’m just\u00a0\u00a0 going to go ahead and be happy that’s just not\r\nhow it works we want to look at organic factors\u00a0\u00a0 do they have an organic long-standing chemical\r\nimbalance of some sort and it may not be neurochemical it may be hormonal they may have too\r\nmuch estrogen too much testosterone too little\u00a0\u00a0 estrogen too little testosterone whatever let’s\r\nfigure out you know have them go see their doctor\u00a0\u00a0 and figure out if there is something fibroids\r\nor moans whatever that might be affecting their\u00a0\u00a0 mood okay once we identify anything that we can\r\ntweak there we can’t measure neurotransmitters\u00a0\u00a0 we’re out of luck there because they’re found\r\nin so many places in the body that there’s no\u00a0\u00a0 way to isolate how much serotonin is actually\r\nin the brain can’t do it yes we want to look at\u00a0\u00a0 other factors that are biological imbalances\r\nneurochemical imbalances that are caused by\u00a0\u00a0 chronic stress that cause addiction to sleep\r\ndeprivation and nutritional problems so what sort\u00a0\u00a0 of chemical imbalances are we precipitating\r\nby keeping the stress going and keeping the\u00a0\u00a0 adrenaline going keeping your body revved up\r\nall the time we want to look at obstacles well\u00a0\u00a0 let me stay with biological factors here real\r\nquick the organic things if we can refer to the\u00a0\u00a0 physician and we can figure out ways to address\r\nthose that give the person one step forward so\u00a0\u00a0 they’re not feeling as depressed or they’re not\r\nfeeling as reactive people with hyperthyroid you\u00a0\u00a0 know when their thyroid is overactive may have\r\nsome anxiety issues or some other mood issues\u00a0\u00a0 that can be addressed with medication then we\r\nLooking at situationally caused things is the ways we can help them reduce their chronic stress\r\nsometimes there are some easy right-now sort of\u00a0\u00a0 solutions other times but chronic stress comes\r\nfrom issues that are so long-standing it’s going\u00a0\u00a0 to take a while it’s not that we can’t do it but\r\nit’s going to be a process so we move on and we\u00a0\u00a0 say okay addiction we know that when people use\r\nstimulants rev them up and then they crash and\u00a0\u00a0 it makes them more than emotional yo-yo caused\r\nby the substances or the addictive behaviors\u00a0\u00a0 also makes them more vulnerable to emotional\r\nreactivity sleep deprivation is all kinds of\u00a0\u00a0 hormones out of whack and tends to make people more\r\nirritable that’s one almost everybody can look at\u00a0\u00a0 addressing right now and nutritional problems\r\nif they’re not eating well not eating at all encourage them to see a nutritionist to\r\nmake sure they’re getting something balanced that\u00a0\u00a0 they will adhere to not something that\r\nthey look at and go yeah that looks great but no\u00a0\u00a0 way I’m eating nuts skill factors what can we help\r\nthey with we can identify cognitive responses that\u00a0\u00a0 are obstacles which as I can’t do that\r\nI won’t do that resistance in some way my response\u00a0\u00a0 to that obstacle is set to look at it and weigh\r\nthe positives and the negatives do a decisional\u00a0\u00a0 balance exercise to address the cognitive\r\nresponses and figure out why is the dysfunctional\u00a0\u00a0 or unhelpful reaction more rewarding why is it\r\nmore rewarding to be angry or scared than to look\u00a0\u00a0 at doing things and thinking of things that will\r\nhelp you feel happier what’s the disconnect generally, it comes back to prior failures and fear of\r\nfailure because they’ve been down that road before\u00a0\u00a0 and it’s such a letdown when they’re feeling\r\ngood for like three weeks and then they\u00a0\u00a0 crash behavioral responses that are obstacles to\r\nchanging emotions if somebody lashes out when they\u00a0\u00a0 get upset they lash out and throw things\r\nand then they feel guilty so this behavioral\u00a0\u00a0 response may lead to having more difficulty\r\nchanging emotions because we’ve got to help\u00a0\u00a0 them figure out how to pause before the behavioral\r\nthe response so they don’t compound the situation with\u00a0\u00a0 more negative emotions and environmental factors\r\npeople places and things being in environments\u00a0\u00a0 where you’re surrounded by people who either agon\r\nnegativity or who bring out you know they’re there\u00a0\u00a0 with you they’re talking about conspiracy theories\r\nthey’re just negative about everything or they’re\u00a0\u00a0 critical of you or remind you of situations where\r\nyou’ve been criticized before so first, we want to\u00a0\u00a0 help people identify and label emotions a lot\r\nof our clients are relatively Alex Simon you\u00a0\u00a0 know they have a small repertoire if any of\r\nnoting their emotions they just generally go\u00a0\u00a0 from situation to reaction and label what they\r\nfelt is kind of a mystery so we want to help them\u00a0\u00a0 and doing it retrospectively is fine at first\r\nbecause that’s probably all you’re going to be\u00a0\u00a0 able to get the event profiting the emotion what\r\nwere your thoughts your physical sensations and\u00a0\u00a0 your urges help me describe this in enough detail\r\nthat if we were going to give it to an actor or an\u00a0\u00a0 actress they could recreate the situation what\r\nexpressive behaviors were associated with that\u00a0\u00a0 emotion you know did you cry did you throw\r\nthings did you hit the wall what were your\u00a0\u00a0 interpretations of that event at the moment not\r\nretrospectively but at the moment what\u00a0\u00a0 were your interpretations of what was going on\r\nwhat history before the event increases your\u00a0\u00a0 vulnerability to emotional dysregulation lots\r\nof big words what happened before that that\u00a0\u00a0 already stressed you out or had you on edge\r\nand you know we go through a whole bunch of\u00a0\u00a0 different things and this is you know behavior\r\nchaining we’re looking at kind of what led up to\u00a0\u00a0 the event what made you more vulnerable and what\r\nwere you feeling at that time and then what were\u00a0\u00a0 the after-effects of the emotion or the reaction\r\non your other types of functioning so after this\u00a0\u00a0 event and you went into freefall and you got angry\r\nand you lashed out and you screamed and you threw\u00a0\u00a0 things how did that affect your work how did that\r\naffect your relationships with your family how\u00a0\u00a0 did that affect your mood and just generally your\r\nsense of being in yourself for the rest of the day changing unwanted emotions okay so we started\r\nlabeling them we figure out what we’re feeling\u00a0\u00a0 we figure out that yeah when we feel that way\r\nwe act in ways that you know make us feel worse afterward what do we do about it let’s change\r\nAll alright we already talked about the obstacles\u00a0\u00a0 and we’re trying to address those but in a moment\r\ncheck for facts ask yourself what are the facts\u00a0\u00a0 for and against your belief if you believe that\r\nsomeone did something to be antagonistic towards\u00a0\u00a0 you okay what was their motivation what is the\r\nfacts for and against that also ask yourself is\u00a0\u00a0 this emotional or factual reasoning am I making\r\na decision based on how I felt I felt attacked\u00a0\u00a0 therefore I must have been being attacked or\r\nfacts you know I felt attacked yes but that was\u00a0\u00a0 because this person said ABCDE and all of those\r\nwere very attacking and I felt like I needed to\u00a0\u00a0 defend myself so those are to check the facts sort\r\nof steps or you can go with problem-solving so\u00a0\u00a0 let’s change the situation that’s called cause\r\nany unpleasant emotion like I said with spiders at the moment you may not have enough information\r\nto not feel scared but maybe your spouse loves hiking and camping and you want to go but\r\nyou’re afraid of those aren’t spiders so how\u00a0\u00a0 can you change the situation so spiders don’t\r\ntrigger that same reaction increase knowledge\u00a0\u00a0 increase exposure there are a lot of different\r\nways but problem-solving says ok what can I do\u00a0\u00a0 so my reaction my correct reaction is not one of\r\nthreat or anger but it is one of at least mild\u00a0\u00a0 acceptance prevent vulnerabilities which helps\r\nreduce reactivity if you are a hundred percent\u00a0\u00a0 you know you get up and you’re like this is going\r\nto be a good day to day things that come your way\u00a0\u00a0 are probably going to roll more like water off a\r\nduck’s back then smack you upside the face like a\u00a0\u00a0 mud pie so we want to prevent vulnerabilities from the turn\r\ndown the stress response because when you’re not\u00a0\u00a0 when you’re not up here already then you know\r\nyou can fluctuate a little bit more and they\u00a0\u00a0 help the person be aware of and able to learn and\r\nremember positive experiences so if you turn down\u00a0\u00a0 that vulnerability and somebody’s in a good place\r\nor a better place than they were at least they’re\u00a0\u00a0 going to be able to notice and we’re going to\r\nwant to encourage them to notice the positive\u00a0\u00a0 experiences you know instead of thinking that all\r\npeople are threatening all people are going to\u00a0\u00a0 hurt me all people are going to leave they might\r\nnotice that you know there’s Sally over here who’s\u00a0\u00a0 worked here for 15 years with me and you know\r\nshe’s there she sometimes calls in sick but then\u00a0\u00a0 she comes back she’s generally in a good mood\r\nyou know she’s not such a bad person and\u00a0\u00a0 you start noticing some of the things that are\r\nnot self-fulfilling processes building mastery\u00a0\u00a0 through activities that build self-efficacy\r\nself-control and competence smuggle we don’t\u00a0\u00a0 want to say you don’t want to set a goal\r\nwhere somebody needs to go an entire week without\u00a0\u00a0 having an emotionally reactive response let’s\r\nsay go for hours or maybe even a whole day that\u00a0\u00a0 would be wonderful but first, we’ve got to talk\r\nabout how to reduce those vulnerabilities so we\u00a0\u00a0 set the person up for success what things can you\r\ndo and well and we’re going to get down here in a\u00a0\u00a0 minute what can you do if you wake up and you’re\r\nfeeling vulnerable you know the creepy crowds\u00a0\u00a0 are going around they cancel school\r\nfor the entire week for school the county\u00a0\u00a0 school system kids are off for an entire week\r\nbecause of illness right now but you wake up in\u00a0\u00a0 the morning and you’ve got a fever and a sore\r\nthe throat you’re like I don’t want to go\u00a0\u00a0 to work and get out of bed today what can you do\r\nto prevent being grumpy and overly reactive\u00a0\u00a0 throughout the day’s mental rehearsal and this can\r\ngo for if you’re getting ready to do something\u00a0\u00a0 scary or threatening seeing yourself do that and\r\ndo it successfully and this can even be during the\u00a0\u00a0 day just envisioning yourself getting up and eating\r\nyour breakfast driving to work going through your\u00a0\u00a0 day seeing that one person at the office that\r\nalways has some sort of snarky comment to say or\u00a0\u00a0 whatever irritates you laughing at it or dealing\r\nwith it just fine going through everything in your\u00a0\u00a0 day as you would like to see it happen envision it\r\nsee see what you can do rehearse it rehearse how\u00a0\u00a0 to handle negativity you know if you know you’re\r\ngoing to have to go in for your annual evaluation\u00a0\u00a0 with your boss okay so mentally rehearse how it’s\r\ngoing to go how are you going to react what’s\u00a0\u00a0 going to happen so you’re prepared for it you have\r\nyour responses and it takes some of the unknown\u00a0\u00a0 out of the situation physical body mind care pain\r\nand illness treatment and the acronym for this is\u00a0\u00a0 please I changed one of them to laughter\r\nit used to be physical illness and that was both\u00a0\u00a0 PNL but I like laughter anyway we’ll get there\r\nwhen you’re in pain or when you’re sick you’re\u00a0\u00a0 vulnerable to being a little bit cranky you know\r\nthat’s just because your body is already saying you are\u00a0\u00a0 weak you know back in the day when you had to\r\ndefend yourself against predators the sick ones\u00a0\u00a0 and the ones that were in pain were the ones\r\nthat usually got taken out first as a part of\u00a0\u00a0 our brain that still remembers that for whatever\r\nthe reason so when we’re in pain or when we’re sick\u00a0\u00a0 our body keeps that cortisol keeps our cortisol\r\nlevels higher and the stress response a little bit\u00a0\u00a0 higher so we want to deal with those things but\r\nknow if we wake up and we’re in that situation\u00a0 moment that was a little bit more vulnerable\r\nso we need to handle it with care and laughter you can’t\u00a0\u00a0 be miserable and happy at the same time laughter\r\nreleases endorphins laughter helps people feel\u00a0\u00a0 a little bit better and find something to laugh at\r\nand have on my phone I keep comedy skits every\u00a0\u00a0 once in a while I’ll just pop one in even if\r\nI’m not having a bad day pop it in because I\u00a0\u00a0 like to laugh eat two-sport mental and physical\r\nhealth avoid addictive or mood-altering drugs\u00a0\u00a0 or behaviors that are going to put you on that\r\nthe up-and-down roller coaster that goes up and it\u00a0\u00a0 goes even further down than you were when you\r\nstarted to get adequate quality sleep and exercise also helps increase serotonin and release\r\nendorphins which help people be in a better mood mindfulness is a judgemental observation and\r\ndescription of the current emotions we’re not\u00a0\u00a0 going to go deep into this right now\r\nanother class on mindfulness and you can also\u00a0\u00a0 google it remembering that primary emotions\r\nare often adaptive and appropriate I know I\u00a0\u00a0 said that like six times much emotional distress\r\nis a result of your secondary responses shame over\u00a0\u00a0 having it I shouldn’t feel this way anxiety\r\nabout being wrong you know maybe this\u00a0\u00a0 is the wrong way to respond or you know what if\r\nI’m wrong about this or rage doing due to feeling\u00a0\u00a0 judged for feeling that way I feel this way\r\nand you’re telling me I shouldn’t how dare you\u00a0\u00a0 so mindfulness is kind of an exposure technique\r\nbecause it helps people identify that yes I feel\u00a0\u00a0 that way but it helps them learn to step back and\r\nfigure out how to not judge that and just go okay\u00a0\u00a0 I feel that way better or worse whatever that’s how I\r\nfeel exposure to intense emotions without negative\u00a0\u00a0 consequences that non-judgmental acceptance just\r\ngoing all right is what extinguishes the\u00a0\u00a0 secondary emotional responses of feeling guilty\r\nabout it or feeling ashamed or angry at yourself\u00a0\u00a0 for being angry so think of it this way if you\r\ncan’t see this one’s the best Bruce Lee picture I\u00a0\u00a0 could come up with scenario one is an unpleasant\r\nexperience the person has an unpleasant emotion and then feels guilt shame or anger for feeling that\r\nan emotion so instead of having to deal with one\u00a0\u00a0 emotion one-on-one now you’re having to fight for\r\ndifferent unpleasant emotions and you start acting\u00a0\u00a0 to try to stop the avalanche of negativity in the\r\nabsence of adequate skills now Bruce Lee he was\u00a0\u00a0 able to take out four or five at a time but most\r\nof us you know we would be beaten because all of\u00a0\u00a0 these adversaries would be coming at us and\r\nwe would be building on them in scenario two and\u00a0\u00a0 this is where we want people to get they have an\r\nunpleasant experience which is part of life they\u00a0\u00a0 identify unpleasant emotions again part of\r\nlife is sucky but part but they can deal with one emotion they’re like okay I’m\r\nangry what do I do about it instead of I’m angry\u00a0\u00a0 what do I do about it and I’m guilty and you\r\nsee how you know she’s got this she can take that\u00a0\u00a0 one emotion so what we’re helping people do is\r\nuncomplicated this regulation is common to many\u00a0\u00a0 disorders people with dysregulated emotions\r\nhave a stronger and longer-lasting response\u00a0\u00a0 to stimuli yes they’re already kind of stressed\r\nout they’re already hyper-vigilant if you want\u00a0\u00a0 to say they’re already wound up a little bit and\r\nthen something happens and it amps for months now\u00a0\u00a0 we have a scale of 1 to 5 if they’re already on\r\na 4 and it amps them up 2 points they’ve fallen\u00a0\u00a0 off the scale they’re in freefall so we need to\r\nunderstand that what we perceive as an excessive\u00a0\u00a0 emotional reaction they may not have been starting\r\nfrom the same place that we were, we’re starting\u00a0\u00a0 from a 1 if they’re starting from a 4 you know\r\nthen their reaction to the same thing you seemed\u00a0\u00a0 pretty reasonable emotional dysregulation is often\r\npunished or invalidated and increases hopelessness\u00a0\u00a0 and isolation emotional regulation means we help\r\npeople use mindfulness to be aware of and reduce\u00a0\u00a0 their vulnerabilities so we help them take it so\r\nthey’re not at a 4 there may be a 2 you know\u00a0\u00a0 they’re in therapy for a reason we’re going to\r\nhelp them work on the other stuff and get them\u00a0\u00a0 down to a 1 but right now let’s help them figure\r\nout ways, they can take down their stress response\u00a0\u00a0 take down their just underlying anxiety, and stuff\r\nidentify the function and reinforcers for current\u00a0\u00a0 emotions when they happen was understand where\r\nthey came from because they’re functional do that\u00a0\u00a0 chaining worksheet check for facts ok now that\r\nI know how I feel I know what my reactions are\u00a0\u00a0 I know what my thoughts are I know what my urges\r\nare let’s check the facts in the situation for\u00a0\u00a0 and against that forces people to kind of step\r\nback which lets the urge sail out some and then problem-solves what can I do right now to improve\r\nthe situation and what can I do in the future\u00a0\u00a0 so I don’t necessarily experience this exact\r\nthe same situation again how can I break that mold okay so emotion regulation doesn’t provide us\r\nwith a whole lot of distress tolerance skills, emotion regulation is really about preventing\r\nvulnerabilities and helping people figure out\u00a0\u00a0 okay here’s where I’m at how do I pause so then\r\nI can choose from my disgust distress tolerance\u00a0\u00a0 problem-solving or interpersonal effectiveness\r\nskills but it’s a big step how awesome would\u00a0\u00a0 it be if you could eliminate some of your\r\nvulnerabilities and think about it just for\u00a0\u00a0 a minute or two what vulnerabilities you’ve\r\ngot going on in you right now and how many\u00a0\u00a0 of those you know could you potentially over\r\nthe next week or two kinds of address sleeping and eating maybe you have 16 things going on\r\nand you could pare it down to eight there\u00a0\u00a0 are a lot of different things that you might\r\nbe able to kind of pull out of the rabbit hat\u00a0\u00a0 if you will and what kind of a difference\r\nwould it make if you’re talking to your staff and looked around at your organizational environment\r\nwhat vulnerabilities are there environmental\u00a0\u00a0 vulnerabilities physical vulnerabilities my best\r\nfriend’s working somewhere right now where pretty\u00a0\u00a0 much everybody is required to work doubles because\r\nthey are so short-staffed they’re going to start\u00a0\u00a0 getting vulnerable pretty soon so look around\r\nwhat can you do to moderate that so they can\u00a0\u00a0 model effective emotional regulation but they\r\ncan also not be emotionally dysregulated by a\u00a0\u00a0 client who has emotional dysregulation issues all\r\nright so that concludes our discussion today if\u00a0\u00a0 you have any questions I would love to hear them\r\nif you want to discuss that’s awesome if you want\u00a0\u00a0 to get on to your next client you know I totally\r\nunderstand that I want to wish everybody a happy\u00a0\u00a0 Valentine’s Day for me I don’t particularly pay\r\na lot of attention to Valentine’s Day but it is\u00a0\u00a0 the eve before half-price chocolates\r\nand that is my kind of my kind a day you you you you if you enjoyed this podcast please like and\r\nsubscribe either in your podcast player or\u00a0\u00a0 on YouTube you can attend and participate\r\nin our live webinars with dr.\r\n\r\n<a href=\"https:\/\/ralphleaman.business.site\/?m=true\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/i.ibb.co\/Dp8sWx4\/R-4.png\" alt=\"\" width=\"365\" height=\"282\" \/><\/a>\r\n\r\n&nbsp;\r\n\r\nSchneider I\u00a0\u00a0 subscribing at all CEUs comm slash counselor\r\ntoolbox this episode has been brought to you\u00a0\u00a0 in part by all CEUs calm providing 24\/7\r\nmultimedia continuing education and pre-certification training for counselors\r\ntherapists and nurses since 2006 have used coupon code consular toolbox to get a\r\n20% discount on your order this month.\r\n\r\n<a href=\"https:\/\/www.youtube.com\/watch?v=nTPsEHHA_g8\" target=\"_blank\" rel=\"noopener\">As found on YouTube<\/a>\r\n\r\n<a href=\"http:\/\/flywait.depress1on.hop.clickbank.net\/\">Hi, My name is James Gordon 👻🗯 I\u2019m going to share with you the system I used to permanently cure the depression that I struggled with for over 20 years. My approach is going to teach you how to get to the root of your struggle with depression, with NO drugs and NO expensive and endless therapy sessions. If you\u2019re ready to get on the path to finally overcome your depression, I invite you to keep reading\u2026<\/a>","protected":false},"excerpt":{"rendered":"<p>&nbsp; CEUs are available at AllCEUs.com this episode was pre-recorded as part of a live continuing\u00a0\u00a0education webinar on-demand, CEUs are still available for this presentation\u00a0\u00a0 at AllCEUs.com\/counselortoolbox I’d like to welcome everybody to today’s presentation of dialectical behavior therapy\u00a0\u00a0 techniques emotion regulation we are going to start by reviewing the basic premises of\u00a0\u00a0 DBT and &hellip; <a href=\"https:\/\/effectsofanxiety.net\/archives\/150173\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">DBT Skills Emotion Regulation | Counselor Toolbox Podcast with Dr. Dawn-Elise Snipes<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":150172,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false},"version":2}},"categories":[2331,137,3328,122,72,305],"tags":[38507,34232,40276,35950,696,37897,37895,38513,38514,59801,38515,37905,38531,38505,36289,38519,40130,37878,38508,38509,59837,953,59840,59809,59836,59842,1629,42326,38520,37893,37894,38517,42329,36776,38522,37877,38523,38524,37876,34002,38525,38526,42327,38527,37906,38528,38506,35665],"class_list":["post-150173","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-american-football","category-animals","category-golf","category-lgbt","category-style","category-unrest-conflicts-war","tag-adacb","tag-addiction","tag-addiction-recovery","tag-anger","tag-anxiety","tag-cadc","tag-cap","tag-ccapp","tag-ccdc","tag-ccmc","tag-ce","tag-ce4less","tag-cebynet","tag-cheap-ce","tag-coaching","tag-continuing-education","tag-coping-skills","tag-counseling","tag-counselling","tag-counsellor","tag-dbt","tag-depression","tag-dialectical-behavior-therapy","tag-donnelly-snipes","tag-emotion-regulation","tag-emotional-regulation","tag-florida","tag-hpcsa","tag-ladac","tag-ladc","tag-lcdc","tag-lcsw","tag-lcsw-ceus","tag-lmft","tag-lmhc","tag-lmhc-ceus","tag-lpc","tag-lpc-ce","tag-lpc-ceus","tag-mindfulness","tag-naadac","tag-nbcc","tag-nctrc","tag-online-training","tag-quantum-units","tag-relapse-prevention","tag-unlimited-ce","tag-ytccon"],"jetpack_publicize_connections":[],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"https:\/\/effectsofanxiety.net\/wp-content\/uploads\/2022\/11\/htmlF_IMG_63753c4d6a7ae.jpg","_links":{"self":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts\/150173"}],"collection":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/comments?post=150173"}],"version-history":[{"count":3,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts\/150173\/revisions"}],"predecessor-version":[{"id":150199,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts\/150173\/revisions\/150199"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/media\/150172"}],"wp:attachment":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/media?parent=150173"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/categories?post=150173"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/tags?post=150173"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}