Trauma Informed Treatment and Education DBT Emotion Regulation

Trauma Informed Treatment and Education: DBT: Emotion Regulation Skills PRESENTED BY, KEITH MADER, LCSW DIRECTOR THERAPY SERVICES C-V RANCH WILSON, WYOMING

Nuts and Bolts The Presentation will be an Hour in length, from 4: 00 to 5: 00 pm Questions and Comments are Welcome by typing and sending them in during the presentation or by unmuting the mic and speaking. Handouts Including a Copy of this Power Point should have been Emailed to you.

Goals of Presentation Be introduced to a brief overview of Dialectical Behavior Therapy (DBT). Learn the rationale and purpose for Emotion Regulation Skills. Be Introduced to DBT Model of Emotion Learn a number of Emotion Regulation Skills that can be utilized with students. Be provided with some further resources on Distress Tolerance.

Emotion Dysregulation Defined

Emotional dysregulation (ED) is a term used in the mental health community that refers to emotional responses that are poorly modulated and do not lie within the accepted range of emotive response.

What is Affect/Emotion Dysregulation? Emotion Dysregulation may be thought of as the inability to manage the intensity and duration of negative emotions such as fear, sadness, or anger. If you are struggling with emotion regulation, an upsetting situation will bring about strongly felt emotions that are difficult to recover from. The effects of a prolonged negative emotion may be physically, emotionally, and behaviorally intense.

For example, an argument with a friend or family member may cause an over-reaction that significantly impacts your life. You can’t stop thinking about it or you may lose sleep over it. Even though on a rational level you feel it’s time to let it go, you are powerless to control how you feel. You may escalate a conflict to the point it is difficult to repair, or you may indulge in substances to help yourself feel better, thus creating further stress for yourself and others.

Causes Emotional Dysregulation can be associated with an experience of early psychological trauma, brain injury, or chronic maltreatment (such as child abuse, child neglect, or institutional neglect/abuse), and associated disorders such as reactive attachment disorder

Treatment

What is DBT?

Basic Assumptions of DBT People are Doing the Best They Can. People Want to Improve. People Must Learn New Behaviors both in Therapy and in the Context of Their Day to Day Lives. People Cannot Fail in DBT. People May Not Have Caused All of Their Problems, but They Have to Solve Them Anyway. People Need to do Better, Try Harder and be More Motivated to Change The Lives of Dysregulated People are Unbearable.

Bio Social Theory: DBT Theory that the Problem Behaviors of Emotionally Dysregulated Individuals Stem from a Combination of Biological and Environmental Factors. Specifically, these Factors are a Biological Vulnerability to Emotional Dysregulation and an Invalidating Social Environment (an Environment where Coaching in Emotion Regulation is Inadequate and Dysfunctional Learning Takes Place) (Linehan, 1993)

Dialectics: DBT ACCEPTANCE…. . Vs. …. . CHANGE STUDENTS ARE DOING THE BEST THEY CAN…. AND…. THEY NEED TO DO BETTER

Non-Judgmental View of Behavior “Effective” Behavior: Does Not Make Problems Worse. Causes No Harm to Self, Others, Property. Keeps Us on Track Toward Achieving Life Goals. Versus…. . Ineffective Behavior…. That Served a Purpose in Face of True Threat of Traumatic Situation, and has outlived it’s usefulness.

Validation is……. . Communicating to Another Person that His or Her Feelings, Thoughts, and Actions Make Sense and are Understandable to You in a Particular Situation… It Does Not Necessarily Mean that you Like or Agree with what the Other Person is Doing, Saying or Feeling… It Means that you Understand Where They are Coming From.

Things That Interfere with Capacity Lack of Skill; Not Knowing What To Do or How To Do It High Emotional Dysregulation Failure to Generalize Across Contexts (ex. More Skillful at Home than School) Willfulness Thoughts

DBT Skill Modules: Mindfulness

Goals of Emotion Regulation Skills Goal 1 Understand the emotions that you experience • Identify (observe/describe/name) emotions • Know what emotions do for you (are your emotions working for or against you in this moment? )

Emotion Regulation Skills Goal 2 Reduce emotional vulnerability and stop unwanted emotions from starting in the first place. • Increase positive emotions • Decrease vulnerability to Emotion Mind

Emotion Regulation Goal 3 Decrease the frequency of unwanted emotions.

Emotion Regulation Goal 4 Decrease emotional suffering; stop or reduce unwanted emotions once they start. • Let go of painful emotions using mindfulness • Change emotions through opposite action

Emotional Vulnerability: DBT Hungry Tired Illness Injury/Physical Pain and Discomfort High Levels of General Distress

DBT Model of Emotions

Model of Emotions Model of emotions The Prompting event Thoughts about the event Vulnerability factors Internal body reactions Urges to act Expressions of emotions-facial, body language, words, actions The emotion name(s) Aftereffects (including secondary emotions) A second prompting event