Emotion Regulation Worksheet 1a: Intense Anxiety Episode

One of the reasons that I am able to write so openly and vividly about the experience of the intense emotion of anxiety is because I, too, experience it. Perhaps not as often as in years past, but that doesn't seem to matter in the heat of the moment when it strikes. It feels just as intense and real as ever. A very recognizable group of sensations and thoughts. Can you relate?

This morning, I woke up feeling anxious. We've recently been prompted by our DBT group therapist to pull out and fill out the DBT Emotion Regulation Worksheet 1a when we experience an intense emotion.   Early on in my journey with DBT, these worksheets were a life saver for me. (If you put "Emotion Regulation Worksheet 1a" in the search box at the upper right of my blog, several posts will come up - one of which includes a blank sheet so you can fill one out, too. Click here to go directly to the blank worksheet.) Taking the time to fill this sheet out helped me on many occasions to slow down my experience and prevent myself from behaving in ways that would only cause me more distress by making the situation worse (allowing the sheet to serve two purposes: emotion regulation and distress tolerance.)

It's been months since I've felt the need to fill out one of these sheets. I've had intense episodes but have processed through them without the sheet.  I don't see the choice to use one today as regression. In fact, I think this sheet will be in my toolbox as a resource for many years to come.  I think I just happened to have been  nudged by the reminder that this sheet is the homework for group this week, so it made sense to use it. Plus, it may help some readers if I share it...so here goes.

Note: I fill out these sheets in the heat of the intense emotion, except for the last question on After Effects, which I fill out as I begin to feel calmer. Also, I try to be blatantly honest and real with myself about my experience, sometimes revealing behaviors I've engaged in that evoke shame, which I then need to deal with separately.  I find that the only way to really get anything out of therapy, DBT, doing these worksheets, etc., is to take the risk to be very honest with ourselves about our experiences -- even if uncomfortable emotions come up in response. Then, we just deal with those and further heal, grow, and move forward on our healing journey.

Emotion Name: Anxiety
Intensity (0-100):  78

Prompting Event for my emotion (who, what, when, where) What triggered the emotion?: 
Woke up with some physical pain, nausea, and muscle tension. Received a mean comment online. Hurt feelings of family member with passive aggressive Facebook post rather than reaching out in compassion, for which I feel guilty and like a jerk and hypocrite. MRI scheduled for today.

Vulnerability Factors - What happened before that made me vulnerable to the prompting event?
Anticipation of loneliness/boredom during the day to come. Had neurological exam yesterday (was fine, but anxiety provoking. Dr. asked upsetting, triggering questions.)  Had MRI scheduled for today but was too anxious to go. Weather, though cozy, is gloomy, and driving would likely be dangerous, so I feel stuck isolated at the house.

Interpretation (beliefs, assumptions, appraisals) of the situation:  
This is anxiety or I could be sick. Another annoying anxiety episode. This could ruin my day. This could pass quickly. I know how to get through this.  I shouldn't have to deal with this again!

Face and Body Changes and Sensing(what am I feeling in my face and body?):
Tension in jaw and face. Hands cold. Stomach making noises, having to go to bathroom. Breathing faster. Muscles really tense.

Action Urges - What do I feel like doing? What do I want to say?:
Freaking out: screaming, running, crying.

Body Language - What is my facial expression? posture? gestures?:
Despair face (eyebrows up, frowning, eyes look scared), rubbing belly. Head in hands.

What I said in the situation (be specific):
This sucks. Not again. Enough already. I know what to do.

What I DID in the situation (be specific):
Tweeted. Told sister how I was feeling (on phone). Rescheduled MRI appointment instead of just being a no-show, sat down to do this worksheet. Started planning for self- care, including a guided meditation and muscle tension and relaxation exercise. Took Tylenol for pain. Rescheduled MRI appointment instead of just doing a no-show.

What AFTER EFFECTS does the emotion have on me (my state of mind, other emotions, behavior, thoughts, memory, body, etc.)?:
So far I've noticed tension. A little bit of sadness. Thinking more clearly about what footwork I need to do to get out of the house more (i.e. part-time job, gym).

Here's the actual sheet I filled out: 

Was this helpful to you in any way? Might you fill out this sheet the next time you are feeling an intense emotion and bring it to DBT group/share it with your therapist?

Thank you for reading.
More Soon.


  1. Do you know of any blank DBT, etc worksheets than can be printed out via an online source (preferably free)? These things really can help, as your post states...I think the trouble for most is s-l-o-w-i-n-g down enough to do them.

    1. Hi Laura -- I wish! I know that Alicia Paz, M.A. is working on something like this (her logo is up at top of page if you wish to check out her blog.) I do have some worksheets randomly posted on the site. I agree with you -- slowing down is the challenge, but it's so worth it! ♥

  2. This is an awesome idea! I may have to try this sometime!

    I agree that slowing down would be tough. I get pretty shaky when I get really anxious so writing is not ideal, but if I could get to a computer or have this on my phone or ipad that would be great!

    1. Awesome idea to save this form electronically for easy convenience, Aaron! ♥ Debbie



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