Behavioral Therapy: A Casual Update

blog post
[Image shows three spoons laying on a laptop keyboard. Overlaid is a clip-art of torn notebook paper with a red paper clip. On the paper is the neurodivergent rainbow infinity symbol and reads “Behavioral Therapy: A Casual Update”.]

Over the last couple months, my therapist and I have been working on a lot of different things which she classifies as behavioral therapy.

We started with learning to identify emotions, having to journal everything I did that day and how it made me feel since we discovered I’m not good at identifying emotions besides “I feel awkward” or “I feel overwhelmed”.

So we expanded on those, and then started to work on identifying why I thought I felt that way. This was much harder since I often explained how I felt by “I just do”, but learning to expand on why I felt a certain really helped me understand some of my more irrational feelings.

And with that we started working on how what we think about a event can then cause emotions and how those emotions determine our behavior and working on changing our views about situations in order to better the outcome of our response to these situations.

We got a bit side tracked though after a few sessions where I was getting overstimulated and had to spend the last couple sessions finding ways of calming me down from my meltdowns. Which has led us to the next step in our therapy: Dialectical Behavioral Therapy. Which she tried to explain to me exactly what it meant, but was a tad bit confusing so she printed me off a booklet from DBT Skills Training Handouts and Worksheets by Marsha M. Linehan.

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[Image shows a stack of papers that read “Distress Tolerance Handout 1: Goals of Distress Tolerance” and then reads “Survive Crisis Situations without making them worse”, “Accept Reality: Replace suffering ad being “stuck” with ordinary pain and the possibility of moving forward”, “Becoming Free of having to satisfy the demands of your own desires, urges, and intense emotions”, and “Other:___”  ]

It talks  about when to use your crisis survival skills, such as when you have intense pain that cannot be helped or won’t go away (great for me since chronic pain is a normal thing), you want to act on your emotions but it will only make things worse, when your emotions threatens to overwhelm you, when you are already overwhelmed, in highly stressful situations, etc.

Then it goes into some skills or things you can do to help such as the STOP Skill (Stop, Take a step back, Observe, and Proceed Mindfully), making pros and cons on acting on crisis urges, TIP Skill (Tip the Temperature, Intense Exercise, Paced Breathing and Paired Muscle Relaxation), Distractions (Activities, Contributions, Comparisons, Emotions, Pushing Away, Thought, Sensations), Self Soothing with the 5 Senses, ways to improve the moment, and Sensory Awareness,

She wants me to practice at least two of these each week over the next couple sessions and find which ones help me and which ones don’t work. We have also worked on breathing exercises and grounding exercises which have both been helpful so far as long as I have someone else helping me through them, I have yet to lead them with myself.

But she is hoping for me to learn a handful of them before I go on my family vacation so that I can fully enjoy it with minimal meltdowns. While I’m not psyched about having therapy homework over the summer, I will say that I have never felt so good about therapy. Knowing why I feel the way I do, how it works, and how to counteract it and all explained in a non-cliche way that I can really understand and appreciate makes a huge difference. It’s been really helpful so far and I think that the more I work at it and the more I learn the better it will get.

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