The Dialectical Behavior Therapy Skills Workbook for Anxiety

Basic Emotion Regulation Skills 143

Physical Tension and Stress

If you experience physical tension on a regular basis, you also probably feel emotionally
stressed-out, anxious, drained, or irritated. Muscle tension, like an illness, directly affects your
emotions. Similarly, if you feel anxious, your emotions can often lead to muscle tension, especially
in the neck and shoulders, as well as stomach ailments and skin problems.
There are many situations in modern life that can make you feel physically tensed and
stressed: long working hours, a job you don’t like, commuting to work, difficult relationships, a
demanding family schedule, what’s happening in the world news, politics, and so on. As a result,
it’s very important that you find healthy ways to cope with tension and stress so that they don’t
lead to further illness.
Many good coping skills are found in this book in the mindfulness and distress tolerance chap-
ters. The mindful breathing exercise is very effective for helping you relax, as are many of the self-
soothing exercises. Go back to those chapters, if you need to, to find exercises that work for you.
In the space below, record any thoughts you have about how your physical tension and stress
affect how you feel, and then write at least two ways you can cope with your stress and tension in
order to feel better.

My tension and stress affect how I feel because

I can treat my tension and stress by

1)

2)

Exercise: Recognizing Your Self-Destructive Behaviors

Now that you’ve learned about different forms of self-destructive behaviors and physical vulnerabili-
ties, make photocopies of the following Recognizing Your Self-Destructive Behaviors Worksheet
to observe your own self-harming actions for the next two weeks. This worksheet is very similar
to the Recognizing Your Emotions Worksheet found earlier in this chapter. However, this exercise
asks you to observe your self-destructive behaviors and then to identify what the emotional rewards
were for your behavior and why those rewards were only temporary. Use the following example
worksheet to help you.