In many situations it actually makes sense to just react. However, if our responses are based simply on our fears and insecurities, then those responses are often not in our long-term interests.
Choosing, on the other hand, is taking all the elements of a situation into consideration before then deciding on the best course of action. This includes integrating values, long-term goals, emotions, current circumstances, and so on.
A more concrete example is that your best friend goes to a party and doesn’t mention to you that she is going. You immediately react by angrily calling her. Now both of you are upset. You have worsened the relationship, which is likely inconsistent with your values and relational goals.
If instead you choose your response, you’ll notice your anger reaction. You can then use the STOP skill (see Chapter 11), which essentially asks you to pause, take a breath, and reflect on the situation. Do you know all that was going on with your friend? Do you know her intentions? Was it her goal to reject or disregard you? Does it help you to dwell on what happened? The choice might then be to call her and say that you were feeling hurt about not having been told about it, or to let her know that you were confused. Or you may even just let it go, knowing that your best friend may have had a good reason for not having invited you, and that she cares deeply about you.
After the pause, pay attention to the reaction urge. You’ll notice that it passes. Everything always passes. It is the nature of impermanence that it will pass. Eventually it will go away altogether. Think about all the urges that you have ever had in the past. Where are they now? They have all passed. Once the urge has passed, the task is to consider what the wise and — if dealing with another person — compassionate response would be. Ask yourself: “What response will help my relationship?” and “What response will help me stick to my values and reach my long-term goals?”
Transforming Negatives into Positives
DBT often uses metaphors to teach. One type of metaphor is known as a short, which is similar to a parable, a short story that illustrates a point. One that we use is the story of the farmer and his horses, which goes like this:
An old farmer had worked his crops for many years. He was considered wealthy by his neighbors as he had ten horses. One day, during a terrible storm, his horses ran away. Upon hearing the news, his neighbors came by to commiserate: “What bad luck you’ve had,” they said sympathetically. “Maybe,” replied the farmer.
The next morning, the horses, hungry from being out in the wild, returned and brought with them ten wild horses. “How wonderful! You are a rich man!” the neighbors exclaimed. “Maybe,” replied the farmer.
The following day, his son tried to tame one of the wild stallions. The horse bucked the boy off and he broke his leg. The neighbors again came to offer their sympathy. “Your son won’t be able to help you in the fields. What bad luck!” they said. “Maybe,” said the farmer.
The next day some military officials came to the village looking to draft young men into the army as they prepared for war. On seeing that the son’s leg was broken, they passed him by. The neighbors again came out and congratulated the farmer on how well his circumstances had turned out. “Maybe,” said the farmer.
Setting new thinking patterns
Many people who come for DBT treatment struggle with negative thinking. Some have a judgmental 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.
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.
