The Dialectical Behavior Therapy Skills Workbook for Anxiety

(avery) #1
Advanced Emotion Regulation Skills 173

Notice that the external event—the mother-in-law’s visit—is only one step in a series. And
most of the steps leading to the rage are internal—both thoughts and other painful feelings. If Sam
is going to better regulate his anger, he may need to identify which steps in the triggering process
he wants to change and then use problem solving to plan a different response.
The point here is that you can change or soften overwhelming emotions by changing what
you do before the emotion sweeps you away. The first step, after completing your behavior analysis,
is to decide which of the precipitating or secondary events you want to alter. This must be (1) an
event you have control over (for example, your own thoughts or behavior) and (2) an event, if
altered, that’s likely to reduce your problematic emotion.
In Sam’s case, he decided to do something about his shame-generating thoughts and the
verbal attack. Sam realized that all too often over the years, this same pattern had repeated itself
prior to his getting angry. He’d start with self-shaming thoughts, which would soon feel intolerably
painful. Then he’d try to mask the shame by finding fault with others, which would trigger anger
and eventually an attack.
Once you’ve identified the precipitating or secondary event(s) you want to change using your
own Behavior Analysis Worksheet, the next step is to use the ABC Problem Solving technique.

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