6 The Dialectical Behavior Therapy Skills Workbook
You make yourself feel numb with alcohol or drugs.You take your feelings out on other people by getting excessively angry at them or
trying to control them.You engage in dangerous behaviors, such as cutting, hitting, picking at, or burning
yourself or pulling out your own hair.You engage in unsafe sexual activities, such as having sex with strangers or having
frequent unprotected sex.You avoid dealing with the causes of your problems, such as an abusive or
dysfunctional relationship.You use food to punish or control yourself by eating too much, not eating at all, or
by throwing up what you do eat.You attempt suicide or engage in high-risk activities, like reckless driving or taking
dangerous amounts of alcohol and drugs.You avoid pleasant activities, such as social events and exercise, maybe because you
don’t think that you deserve to feel better.You surrender to your pain and resign yourself to living a miserable and unfulfilling
life.All of these strategies are paths to even deeper emotional pain, because even the strate-
gies 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. Note the strategies that you use as well
as their costs, and then include any additional costs that you can think of. At the end of the
worksheet, feel free to add any of your own strategies that aren’t included as well as their costs.