PLEASE Prevent Emotional Vulnerability (DBT)

In DBT, one of the skill sets that we learn to help regulate our emotions is known as “PLEASE.” These skills are so very important because if we neglect our physical health, we open ourselves up to being very vulnerable emotionally.
Just think of the last time you got very hungry but couldn’t immediately eat (i.e., in a traffic jam with no food available). In my experience, low blood sugar is a trigger. I quickly become irritable and anxious. I now try my best to make sure I have a snack in my purse at all times so that I don’t make irrational, impulsive decisions based on an emotional reaction to the low blood sugar. Making sure we keep our blood sugar balanced is just one of the things we need to do to maintain equilibrium in our bodies.
PLEASE breaks down as the following. The acronym is a bit of a stretch, but stay with me:
PL: Treat PhysicaL illness (take care of your physical body by taking medication as prescribed, seeing a doctor when you need to, etc.)
E: Balance Eating (It’s important not to skip meals and to be mindful of when we are over or under eating and to adjust to create balance in this area. On Emotion Regulation Handout 14 from Dr. Linehan’s Skills Training Manual for Disordered Emotion Regulation (c) in press Guilford, it is also suggested that you stay away from foods that make you overly emotional. Can you think of any foods in particular that create an overly emotional response in you? I’d be curious to hear what type of food and why you think this happens.)
A: Avoid mood-Altering drugs (self-explanatory and includes alcohol)
S: Balance Sleep (This is different for everyone. We each have an optimum number of hours that we know we need in order to feel refreshed, energized, and ready for the day. Unfortunately, when he have mental health issues, our healthy sleep habits and patterns are disrupted. We may sleep too much or too little. Most people I connect with share that they suffer from insomnia, while I tend to majorly oversleep. Either way, it’s important to try to get the right amount of sleep and to take any prescribed medications to help achieve this.)E: Get Exercise (The thing about exercise is that it not only can help us look better, but it can also help us to radically feel better. I get this conceptually, but when it’s time to actually do some type of exercise, I can be so stubborn and resistant. I don’t understand why, really. Nearly every time I follow through, I feel so much better mentally, so I don’t know why it’s like pulling teeth each time. Can you relate? Maybe you are someone who loves to exercise. I’d love to hear about your experience with this. I think that the most important thing is to find something you enjoy doing so that it feels like less of a chore. Thinking about it this way, I enjoy walking and aerobic dance. What types of exercise do you actually enjoy?)
I especially needed to dig into these skills today because I’ve been very un-mindful about my body and physical health these past couple of days. Yesterday was amazing. I finally presented my new book to the world. It was truly a labor of love and is a deep sharing of my walk with Borderline Personality Disorder and DBT thus far. Because I was so excited to get it out there, I ignored my body’s all too familiar cues that I was spending too much time at the computer. My posture was poor, I was eating quick meals in front of my screen, and my left wrist swelled up (carpal tunnel).
As a result, I woke up this morning in severe musculoskeletal pain. It’s the same type I’ve experienced from the same behaviors in the past. My day started out with two Tylenols and a lot of moaning and groaning. It’s unfortunate that it had to get to this point for me to break out of my stubbornness and take a break from the computer, but this evidently is what it took.
Today I took lots of deep breaths. I did some yoga stretches and then got outside and experienced Northern California fall temperatures of over 100 degrees. I had a sandwich by the ocean, and I supported someone close to me at his medical appointments.
I took my needed break, and I’m feeling better, but not 100%. I am making a commitment to be more mindful of the PLEASE skills and to practice them. If we do not take care of our physical health and needs, we often get stopped in our tracks and become unable to cope with even the littlest of things. We can become so emotionally vulnerable that everything seems exaggerated and challenging – especially when we have physical pain.
Are there some signs that you are ignoring or being stubborn around? Are you good at practicing the PLEASE skills on a daily basis in your life?
Thanks for reading.
More soon.

Ruth Haveland says:

March 30, 2013 at 10:17 am

I have difficulty around the exercise bit because of osteoarthritis. I constantly have to move to stop stiffening up, but anything more than a short walk leaves me in agony. Even Yoga and Tai Chi leave me in a lot of pain. I do try and incorporate walking as much as I can, but it just isn't enough to get the endorphines flowing 🙁 I wonder if there are any of your followers or yourself who have some suggestions on how I can do something without too much pain. Brilliant article and one I shall have at the top of my bookmark list. Thank you 🙂

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