DBT For Dummies. Gillian Galen

inner critic or repeat loops of worry thoughts, low self-worth, or even self-hatred. Negative, or unhelpful, thinking patterns can have a strong and often adverse impact on work, family, and relational life.

      There are ineffective ways to deal with negative thoughts. If you struggle with these thoughts, you might try distracting yourself from them or avoiding them altogether. Some people use drugs and alcohol or other short-term self-destructive behaviors to try to prevent the negative thinking from repeating over and over, and it makes sense that they would, given how painful the negative thoughts can be.

      Negative thought patterns are repetitive, unhelpful, unwanted thoughts. These thought patterns typically leave a person feeling worse off about themselves and their situation. Through analyzing the pattern of thinking, DBT teaches people to recognize and then fully identify the pattern as it occurs. This process of stepping back from thoughts is called cognitive defusion. It’s the act of noticing thoughts rather than being caught up in them as if they were something other than thoughts. When people get caught up in acting as if their thoughts were real, this is known as cognitive fusion.

Cognitive defusion includes the practice of letting thoughts come and go rather than holding onto them. In cognitive defusion, you learn to recognize that thoughts in your head are simply thoughts. If you instead fuse with your thoughts, your tendency will be to take them seriously as if they were true. You believe them, particularly when there is no, or little, factual basis to the substance of the thoughts.

      

When you are not fused with your thoughts, you can step back into cognitive defusion. You then hold the thoughts lightly, and this makes it easier to let them go. This is the first step in letting go of negative thoughts. Simply turning them into positive thoughts is not the goal, if the positive thoughts also have no basis. The positive thought is recognizing that you don’t have to live believing that your negative thoughts are real and that you can recognize them simply as thoughts that you don’t like, and thus don’t have to spend too much time dwelling upon them. We look further into how to deal with difficult thoughts in Chapter 7.

      Switching self-destructive behaviors to healthy ones

      Self-destructive behaviors are those that a person engages in that are likely to cause harm to the self, whether physical or emotional. The types of self-destructive behaviors that people bring to DBT when they are looking for therapy include suicide attempts, cutting, binge eating, dangerous driving, gambling, dangerous sexual behavior, substance abuse, and others.

      

In the short term, people who use these behaviors say that the behaviors bring them some relief from the pain of emotional suffering. This likely happens because certain chemicals are released into the brain. For instance, when people cut themselves, research shows that the brain releases a chemical that is a type of opiate. Drinking alcohol can lead to sedation because of alcohol’s effects on the brain. Driving dangerously is a risk-taking behavior that can cause the brain to release dopamine and cause the person to feel elated. All these dangerous behaviors can temporarily change how a person feels, but those who use them tend to discover that the effects are short-lasting and often leave them feeling worse in the long run, as many of these behaviors are ones that cross their values.

      DBT focuses on the formation of healthier habits such as avoiding drugs and alcohol, getting to bed on time for a full night’s sleep, exercising, and focusing on healthy eating habits. What people who practice these healthier behaviors discover over time is that although these behaviors don’t have the immediate impact that the self-destructive behaviors have, they last longer and have an overall positive impact on general well-being, mental and physical health, and relationships. We dig deeper into addressing behaviors in Chapter 6.

      Increasing your trust in your responses

      

Ultimately, if you rely on others to tell you whether you have made a good choice, you’ll never learn to trust yourself. If you can’t trust yourself, you won’t learn to make effective choices, or if you do make a choice, you won’t know whether it was the right choice. The only option you have then is to make choices based on the opinions of others, or what others pressure you to do. The problem with even a well-intentioned other giving you advice is that it doesn’t teach you to make decisions based on who you are and what you need. Also, what will happen when they are no longer there? Because of the impact of repetition on the brain, if you spend years not trusting your ability to make a choice, you’ll end up with a life made up of others’ advice. Many people who don’t trust themselves experience chronic unhappiness and depression.

      How did you not learn to trust yourself? For many people who are emotionally sensitive, being punished for having had big displays of emotion meant that they learned that they were bad or wrong for having displayed these emotions, and so they look around to see what other people do. There is a huge problem with this approach. Here’s a slightly different example: Imagine that a child was punished for being allergic to peanut butter, that their body had a huge allergic response when they were exposed to peanuts. And if in their situation no one else had such an allergy, and they were teased by others for having it, it makes sense that they might feel bad about themselves and try to make excuses for the reaction they have.

      Similarly, if certain situations trigger a big emotional response in you, that is your nature. There is nothing wrong with being sensitive. It is only when you don’t know how to deal with being sensitive that you get into trouble, and this is made worse by others having reacted negatively, judgmentally, or punitively to your response. Children who don’t learn to trust their experience grow up to be adults who don’t trust their experience.

      

The key to learning to trust yourself is built into your body and your brain. Your body gives you physical and emotional signals all the time; however, some of us haven’t learned to pay attention to these signals. A slightly trivial example of this is that we are given the sense of temperature. When we touch something that is hot, a message is sent to our nervous system telling us to pull our hand away. We trust in our body’s experience. We don’t need to question this. Similarly, when you’re about to do something that is inconsistent with your values and long-term goals, your body and brain will send you a signal warning you. Maybe that signal is a spike in anxiety, maybe it’s a feeling in the pit of your stomach, maybe it’s a headache. The first step to learning to trust yourself is to pay attention to these body sensations and emotions. When you don’t pay attention and act reactively, you never give yourself the chance to truly know your experience, and without doing so, you’ll never learn to trust yourself and your choices.

As you learn to branch out and pay attention to your mind and body, and you begin to make choices based on the signals your body is sending you, you’ll almost certainly make mistakes. But here is the great news : They are your mistakes. The DBT therapist works with patients in a way that they are rewarded for trying and not punished for making mistakes. There can be no learning without making mistakes, and it is in making them and then realizing what went wrong that patterns can be corrected. Another vicious cycle happens when the fear of making any mistake prevents us from even trying, and that in turn can lead to more mistakes when a decision-making situation arises. The task is to begin to trust both your successes and errors along the way. Even trust your mistakes because you never know where a mistake might take you.

      One of the risks that sensitive people face when learning to trust themselves is that they will be judged. How can you trust what you are thinking about yourself? Are you filtering your decisions through how you think others will respond? The truth is that most of the people in your life are probably so caught up in their