Crisis Averted using DBT PLEASE Skills

I’m proud of myself. Today I experienced a medical issue that, when I last experienced it about a year and a half a go, landed me in the ER in a state of panic. It’s a good thing I did go the first time. Doing so lead to a test the next day that showed I can sometimes be sensitive to sugar (or a lack thereof). I don’t have a diagnosis around this. It just tends to happen if there are certain vulnerability factors, namingly stress, the weather is very hot, and if I haven’t eaten enough.
Today all of the elements were there to brew the perfect storm.
As I was driving home from a fun day out in the warm California sun, my calves began to feel very heavy. It was a very familiar feeling – the first thing I noticed when I had the episode over a year ago. I then had a sudden onset of extreme hunger (again, same as before), and finally, just as in the first episode, my hands began to visibly tremble.
Initially, my nervous system reacted in panic. I decided to pull over and use my skills to avoid a medical and mental health crisis.
Once pulled over, I took out one of my energy bars, which I now carry in my purse at all times. This is the type I had with me today.

I ate it, quickly but calmly. I also drank some water. I knew that my body needed more sugar, fast. Fortunately, there was a frozen yogurt place on the same street. I waited until I felt a little bit more calm, then I went in, got a small serving of frozen yogurt in a cone, and returned to my car, AC blasting, to eat it.
Anxious thoughts that I should go to the ER popped up. I countered with Wise Mind and assured myself that this was something I’d been through before, that I knew how to take care of myself, and that I needed to slow down my mind. I thought about my day — how it was hot, I’d been running around, and I hadn’t eaten enough. It all added up. I needed to eat, and my body would find equilibrium. I felt more calm. I trusted that if I could stay in control of my emotions, I could rationally monitor my health and make reasonable decisions.It took about 20 minutes, but the trembling subsided.
I’m proud that I was able to use the skills in such a scary situation! I was all alone, and part of wanting to go to the hospital was to have people around me taking care of me. The little girl inside of me was frightened, and I managed to use my DBT PLEASE skills to take care of “us.”
The DBT PLEASE skills are on Emotion Regulation Handout 14 of Dr. Marsha Linehan’s Skills Training Manual for Disordered Emotion Regulation. I am also showing you Handout 9, which talks about Reducing Vulnerability to Negative Emotions: How to Stay Out of Emotion Mind (including PLEASE).

Specifically, paying attention to number 2 on the list would have prevented my Emotional Mind episode and the ensuing feeling of panic and anxiety.

Nonetheless, Wise Mind skills worked to help avoid a crisis. DBT works!

Which PLEASE skills have you been implementing? Which do you need to work on?
If you find these worksheets helpful, I strongly recommend Marsha Linehan’s book, Skills Training Manual for Disordered Emotion Regulation. It is an essential part of DBT practice, a therapy that Dr. Linehan founded to treat Borderline Personality Disorder, and it is effective at helping people with many other conditions as well.
Thanks for reading.More Soon.

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