911 Dialectical Behavior Therapy Skills for When You’re Triggered

When things get so intense that you begin to go into crisis, it’s time to pull out your 911 Dialectical Behavior Therapy Skills.

In this post, I will briefly go into a situation that triggered me today (it’s about an abusive alcoholic… if that might be a trigger for you, you can skip the italicized section to avoid…) and then what I did to cope. I will then add some ideas for a DBT Crisis Toolbox that you may find helpful to put together for when things get really difficult to handle.  If you have additional ideas on what could go in such a self-care kit, please let me know your thoughts.


The situation that set me off, as I Facebooked and Tweeted this morning:

I facilitated staff meeting at the office. A colleague showed up drunk and belligerent and became very verbally abusive and physically intimidating with a number of employees. I’ll have to blog about it later. 

Right now, it’s 911 on the DBT skills, because his drunken cruelty has triggered me. 

Also, another colleague suggested I move out of my office to a desk space upstairs so that they can store boxes in my space. That would suck, but I could live with it and make the best of it.

Doing the best I can. Breathing. Just this moment. All is well.


The great thing about all of this work in Dialectical Behavior Therapy is that when you apply it outside of the clinical group/class setting, it works. I’ll keep you updated with how it goes and some ideas on dealing with being triggered.

Although I did not have an Emotion Regulation Worksheet 1a handy from my DBT Binder, I mentally ran through some of the questions in my mind. Here, without judgment, is what I noticed:

Physical:

  • jaw clenching
  • shoulders and neck tensing
  • trembling
  • the impulse or desire to run from the situation

Emotional:
  • Tearful
  • Anxious
  • Afraid
  • Angry
  • Triggered
  • The impulse to be Mother Hen and take care of all of my coworkers
  • Impulse to cause a scene/get out of control emotionally
I managed to get into Wise Mind and acknowledge that while these physical and emotional symptoms were manifesting, they were purely a reaction to an old emotional wound. Hearing a drunk man be verbally abusive is something I hoped I would never again experience, and I least of all expected to experience it at the workplace – a place many think of as “safe” and as an escape from such things. (And it should be! Our boss is out of town but was contacted, so this WILL be dealt with.)
In order to keep from escalating, I had to get into my skills. Fast.
I started by going to my office and closing the door.
I took some long, deep, calming breaths…slowly.
I used self talk, “All is well. This is upsetting, but I have the skills to manage this. I don’t have to make it any worse than it is.”
Fast forward a few minutes: I get a call from the clinic that my group was canceled today (ironic timing, I know). Perhaps it’s more “interesting” timing, because a main goal of therapy, I’m told, is for us to become more integrated in all ways and to not be dependent solely on outside sources for support. We want to learn to tap into the power and strength within, and all of the hard work we’ve put into learning and practicing DBT skills.
So, that’s what I intend to do. 
In the past, before Dialectical Behavior Therapy, if this incident had happened, I know I would have spiraled out of control.  I would have made things worse and possibly have sabotaged my job, my relationships with my coworkers, and so much more.
But this time, I kept it together, and I am proud.
Here are my 911 DBT Skills that I pulled out:
  • Taking space to myself to regroup
  • Deep breathing
  • Noticing my body’s reaction
  • Noticing my thoughts
  • Using Wise Mind to do self-talk that encouraged  me through the clutter of emotional reactions and emotional, intense (and somewhat hysterical) thoughts
  • Thinking of my long term goals of maintaining my job, self-respect, respect of my coworkers, and the relationships with my coworkers
  • I checked in with a co-worker who was also visibly upset, and we supported each other. He suggested that I go home if I need to or get online and do something that would take my mind off of it. He doesn’t know my diagnosis, but he, in a sense, gave me permission to “distract,” which I did.
  • Decided to self-soothe with some comfort food. I’m not one for feeding emotions through food, but I do make exceptions
  • Referred to my Pinterest boards, specifically the Self-Soothing Board. The images and music are ones that I collect when I am not in crisis so that I have them to refer to when I am. 
  • As a result of DBT group being cancelled, I used the time to blog and to create a video for you
  • I decided that I can keep it together, not add more drama to the situation, and get through…and you know what? I am.
Here is a sheet that contains a reader’s digest of the DBT skills. It’s helpful to have this handy. You can keep it in your purse, wallet, etc.:

DBT digest/cheat sheet. Click to enlarge.

And here’s that video for you:

Thank you for reading.
More Soon.


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