DISTRESS TOLERANCE WORKSHEET 12 _(oistrss tolerance Handouts 15, 15a) Mindfulness of Current Thoughts Due Date: Name: Week Starting: Describe your efforts to observe your thoughts in the past week. Practice observing thoughts each day at least once. Don't focus just on thoughts that are painful, anxiety-provoking, or full of anger; also observe and be mindful of pleasant or neutral thoughts. For each thought, first practice saying, “The thought [describe thought] went through my mind.” Then practice one or more strategies to observe and let go of thoughts. Check off any of the following exercises that you did, 1. Used words and voice tone to say a thought over and over; as fast as | could; very, very slowly; in a voice different from mine; as a dialogue on a TV comedy show; or as singing Relaxed my face and body imagining accepting my thoughts as sensations of my brain. Imagined what | would do if | stopped believing everything | think. Rehearsed in my mind what | would do it | did not view my thoughts as facts. Practiced loving my thoughts as they went through my mind. Refocused my mind on sensations | was avoiding by worrying or catastrophizing. Allowed my thoughts to come and go as I focused on observing my breath coming in and ‘out. Labeled the thought as a thought, saying, “The thought [describe thought] arose in my mind.” 9. Asked, “Where did the thought come from?” and watched my mind to find out. 110. Stepped back from my mind, as if | was on top of a mountain (11. Shuttled back and forth between scanning for physical sensations and scanning for thoughts. 12, Imagined that in my mind thoughts were coming down a conveyor belt; were boats on a river; were train cars on a railroad track; were written on leaves flowing down a river; had wings and could fly away; were clouds floating in the sky; or were going in and out of the doors of my mind. (Underline the image you used.) 0113. Other: Describe thoughts you were mindful of during the week. State just each thought as it went through your mind, 4, Thought: Describe strategies you used or give numbers from above: Circle how effective was this at helping you be more mindful and less reactive: 1 2 2 4 5 Not effective Somewhat effective Very ottoctve oO NOWLON co o oooooo 2 2. Thought: Describe strategies you used or give numbers from above: Circle how effective was this at helping you be more mindful and less reactive: 1 2 3 4 5 Not efective Somewhat effective Very effective 3. Thought: Describe strategies you used or give numbers from above: Circle how effective was this at helping you be more mindful and less reactive: 1 2 3 4 5 Not etfective Somewhat effective Very ettectve From DBT Stile Training Handouts and Worksheets, Second Editon by Marsha M. Linehan. 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Circle a number below. | stl couldn't stand | was able to cope somewhat, I could use skis, the situation, even atleast fra lito whi. tolerated distress, and {or one more minute. Ithelped somewhat ‘resisted problem urges. 1 2 a 4 5 Did this skill help you cope with uncomfortable emotions or urges, or avoid conflict of any kind? Circle YES or NO. Describe how the skill helped or did not help: 2, Describe the situation and how you practiced the sh How effective was the skill in helping you cope with the situation (keeping you from doing something to make the situation worse)? Circle a number below. | stl couldn't stand | was able to cope somewhat, I could use skis, the situation, even atleast fora lite while. tolerated distress, and {or one more minute. Ithelped somewhat resisted problem urges. 1 2 3 4 5 Did this skill help you cope with uncomfortable emotions or urges, or avoid conflict of any kind? Circle YES or NO. Describe how the skill helped or did not help: From DBT Skis Training Handouts and Worksheets, Second Editon by Marsha M. Linehan, Copyright 2015 by Marsha M, Linehan, Permis- sion to photocopy ins workshest is granted fo purchasers c this book for perconal use only (see copyrght page for detals), Purchasers may download a larger Version o! this worksheet rom waar gulflordcomabt worksheets, 403,DISTRESS TOLERANCE WORKSHEET 14 _(vistross Tolerance Handout 17) (p.1 of 3) Planning for Dialectical Abstinence Due Date: Name: Week Starting Problem Behavior: Check each activity and describe what you did. PLAN FOR ABSTINENCE To maximize the chances I'll stop , [need to aim for abstinence. Q Plan activities to do instead of problem behaviors (e.g., work, find a hobby, go to a support meeting, volunteer), These will include: O Spend time or touch base with people who will reinforce my not engaging in problem behaviors and my engaging in effective behaviors (e.g,, effective friends or family members, co-workers, employers, my therapist, people from group). These people include: Q Remind myself of reasons to stay abstinent and be effective (e.g., to reach long-term goals, to keep/get relationship, to save money, to avoid shame). These include: O Bum bridges with people who represent a temptation (e.g,, lose their numbers, unfriend them, tell them to stop contacting me, make them not want to hang out with me). These people include: Avoid cues for problem behaviors. Cues include: (continued on next page) From DBT Skis Training Handouts and Worksheets, Second Editon by Marsha M. Linehan, Copyright 2015 ay Marsha M, Linehan, Perms Sion o photocopy ins warksheat is granted fo purchasers c this book for perconal use only (see copyrght page fr detals), Purchasers may download a larger Vorsiono! his worksheet rom wan gullordcomabt worksheets, 404DISTRESS TOLERANCE WORKSHEET 14 6.203) O Use skills (things to do to avoid urges, interpersonal effectiveness, distress tolerance, emotion regulation, mindfulness), The most useful skills for me include: O Find alternative ways to rebel. These include: Publicly announce I've embraced abstinence and effective behavior. PLAN FOR HARM REDUCTION If [have a slip, | don’t want the slip to turn into a slide, To avoid a slide, I must have plans to regain my balance and get back to abstinence and effectiveness. Q Call my therapist, sponsor, or mentor for skills coaching. His or her number is: O Get in contact with other effective people who can help (e.g., friends or family, people from group). These people include (with contact information): 0 Get rid of the temptations (e.g., drugs, comfort food); surround myself with cues for effective behaviors (e.g., workout clothes, frit) Review skills and handouts from DBT. The most helpful skills/handouts for me are: Q Opposite action (Emotion Regulation Handout 10) can be rehearsed to fight guilt and shame. If no other option works, go to an anonymous meeting of any sort and publicly report your lapse. Q Building mastery and coping ahead for emotional situations (Emotion Regulation Handout 19), and checking the facts (Emotion Regulation Handout 8), can be used to fight feelings of being out of contro. (continued on next page) 405,DISTRESS TOLERANCE WORKSHEET 14. 30°3) O Interpersonal skills (Interpersonal Etfectiveness Handouts 5-7), such as asking for help from family, friends, sponsors, ministers, or counselors, can also be helpful. If you are isolated, help can often be found via online support groups. These people or groups include: Conduct a chain analysis to analyze what prompted the lapse (General Handouts 7, 7a) O Problem-solve right away to find a way to “get back on the wagon’ and repair any damage you have done (Emotion Regulation Handout 12). QQ Distract yourself, self-soothe, and improve the moment. O Cheerlead myself (¢.g,, “One slip is not a disaster,’ “Don't give up," “Don't get willful,” “I can stil climb back on the wagon.”) My cheerleading statements will include: Q Do pros and cons of stopping again now. O Stay away from extreme thinking. Always look for the middle ground. Don't let one slip turn into a disaster. (Check each extreme thought | am giving up and the middle ground | am accepting.) Extreme thinking: Middle ground: Q Ihave not quit yet; therefore | am doomed and might as well give up O Relapsing once does not doom me to never stopping Q Now that I've relapsed, | might as well keep going. O I relapsed, but that does not mean Ihave to stay relapsed. | can be effective and get up now. Q I missed an appointment, so !m done with treatment O I missed an appointment, but I can get in to see my therapist ASAP. QO Other: Q Other: O Other: O Other: Q Recommit to 100% total abstinence. 406