Thursday, December 13, 2012

My Personal DBT Diary Card

I was thinking today while on Twitter that although I do talk about some personal items (mostly my mischievous dog and cooking skills) and I have shared Why I become a Therapist, I have not shared how DBT has helped me.  I currently do not meet any criteria for any DSMIV-r diagnosis, but learning about and teaching DBT has helped me immensely in my life.  Here is a list of the most (and least) common used skills:

Mindfulness: I use this almost daily, so much so during stressful times at work, sometimes while in group that clients have "caught" me suddenly re-positioning myself to do some grounding/square breathing.  This most often happens when someone shares their autobiography or I am dealing with my own personal issue and need to re-focus on the task at hand.  I also use mindfulness when doing paperwork, the dreaded part of counseling.  After 4 hours of Utilization Reviews, "square breathing" and "observe and describe," helps me focus on the task.

HOW Skills: I use these when I come in every Monday to a stack of sheets to file, a slew of notes from clients stating "I need to talk to you ASAP," as well as an occasional bombardment of someone in my office at 7:30am with an urgent issue, that needs to be solved fast.  The HOW skills allow me to non-judgmentally (instead of yelling, freaking out or catastrophizing,) one-mindfully and effectively assess the situation.  In short it helps me to remain calm and prioritize: pick group sheets off floor, quick organize, turn on computer while I read the client notes to me, prioritize highlighting and placing anything urgent on top of pile in front of computer, check e-mails, respond quickly if necessary or it is something short that I don't want on my to-do list, continue working on paperwork to do first (I create a to-do list on Saturdays for Monday.)

Distress Tolerance- Sensations:  All the time in group or one-on-ones I use this skill in very basic ways, sometimes it's as simple as fiddling with a Styrofoam cup I randomly keep in my office, rolling the toilet paper (we don't have the luxury of tissues in prison) into small balls or noticing the heat from the computer on my left leg.

Improve the Moment: Mints, I keep a larger round container in my office and although they are great for some breath refreshing post-lunch I often use it to Improve the Moment.  Simply popping a spearmint piece in my mouth for a few seconds vastly improves whatever I am doing and it also gives me a reason to get out of the chair and look away from the computer for a bit.

Wise Mind: In the prison, we refer to it as "I over E" (intellect over emotion) and use it as a cognitive skill.  I use this all the time, and encourage my clients to do the same.  For example I am now able to notice my ears getting hot, my heart racing before the feelings of anger or panic.  I am able to think very concrete and remind myself almost instantly "this too shall pass."  A close friend/counselor told me she spoke to her anxiety, and for me that seems a little odd, I do talk to my feelings saying things like "This is anger right now, you feel betrayed, upset, sad and disrespected  and this will stop.  Is it valid? What DBT skill can I do to Improve the Moment? What is my best option for being most effective right now. This too shall pass."
Can you tell what days are more stressful and which days I have off?

I am going to stop here, as I could probably list 20 instances in he last 5 days I used DBT skills.  There are some I struggle on still as well:

PLEASE: I try to sleep 8 hours, but stress and the late night anxiety ("I need to remember to pack a lunch tomorrow? Where are my brown shoes? Can I wait until Saturday to wash the dog? Do we have enough OJ for breakfast?") often keeps me up and I find myself staying up to do fun things only to regret it in the morning.

DEAR MAN: I am good with this one up until the end, negotiate is what trips me up.  I do think part of it is due to the power dynamic working in a prison where my word is the final word most of the time.  I am very assertive, but when it comes to moving an inch, I sometimes personalize and I often get stubborn.

So that's my best/worst list.  What skills do you utilize most often? Which ones are you struggling/still working on?

No comments:

Post a Comment