Out-of-ControlDBT-CBT is a life-changing recovery program that inspires people
to make the life changes that will change their lives.
This program has turned many defeated hearts into empowered spirits
that are psychologically prepared to take on the challenges of
GETTING ON and STAYING ON the Recovery Path.
Come join us in our journey.
Welcome to the DBT-CBT
Excerpts Page!
Here you'll find a shortened version of the Table of Contents for the Out-of-Control DBT-CBT Workbook. The actual Table of Contents lists almost every heading and subheading in the workbook, but for the purposes of this excerpts page, some are left out. For instance, the completed worksheets, the instructions for completing the worksheets, and all the sections that relate to one topic are not included...like the "Applications," "Skill Builders," and "Figures" for "The Cycle of Suffering" or "The Big Picture of My Life." So, what you see below is a short version of the Table of Contents!
Notice the topics below that are in the green font. These are linked topics. If you click on one of these, you'll be able to read that section of the workbook. The links will take you to parts of this website that contain the workbook text or to a pdf file connected to this website.
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~ Table of Contents ~
Introduction
Recovery Requires Us…
Our Humanity
On Acceptance
On Recovery
Click here to view a PDF version of the "Introduction"
FAQs and More
What is DBT?
What is Borderline Personality Disorder (BPD)
What Is DBT-CBT? What Is This Program All About?
How Was DBT-CBT Developed?
The Six Major Problem Areas Addressed by DBT-CBT?
How Is This Program to Be Delivered?
Words of Warning
What Are Some Goals of This Study?
Saving Face: DBT-CBT in Action
An Overview of the Three Mind States
Click here to view a PDF version of
"An Overview of the Three Mind States"
An Overview of the DBT-CBT Process and the
Pathways of Recovery and Relapse
How Bad Do I Really Want Recovery?
Section One
The Cycle of Suffering:
“Why Is My Life So Out-of-Control?”
Chapter 1: The Nature of the Problem
Figure 1.A: The Two Parts of Emotional Mind
Figure 1.B: A List of Negative Emotions
Application: Why Do We Become So Overwhelmed with Our Emotions?
Application: What Happens if We Act on These Intense Emotions?
Figure 1.C: A List of Common Self-Destructive Coping Behaviors
Application: “The Cycle of Suffering”
“The Tragedy of the Problem”
Figure 1.F: The Cycle of Suffering in My Life Worksheet (Completed)
Skill Builder: Using “The Cycle of Suffering in My Life Worksheet”
*Chapter Review & For Reflection
*Figure 1.H: The Concepts and Skills Tracking Sheet – Chapter 1
*(These two sections are at the end of each chapter and will not be listed below for each chapter.)
Chapter 2: The Big Picture of My Life
Skill Builder: “The Big Picture of My Life Worksheet”
Figure 2.B: The Cherished Parts in the Big Picture of My Life
The Purpose of “The Big Picture of My Life Worksheet”
Application: How Emotion-Driven Behaviors Affect the Big Picture of Our Life
The Impact of “Drinking Again” on the Big Picture of
Our Life
The Effects of an Affair on the Big Picture of Our Life
The Effects of Going into Rehab or a Psychiatric Hospital
The Effects of a Suicide Attempt on the Big Picture of
Our Life
Application: When We Over-Respond to One Part of Our Life,
the Effect on Other Parts Can Be Tragic
Application: Teri’s Life Story
Skill Builder: Teri’s “The Big Picture of My Life Worksheet”
Skill Builder: The Impact of Self-Destructive Behavior on Teri’s Life Application: Teri’s Story: A Story of Real Life
There’s No Other Way Out
Application: The Importance of “The Big Picture of My Life”
Skill Builder: Drilling It into Our Mind
Chapter 3: The Pathways of Recovery
Why Try? Nothing Ever Changes
The Truth Behind the Lies
Application: A Walk Through the Pathways of Recovery
Figure 3.A: The Pathways of Recovery
From Treatment to Pavement…Hitting the Road to Recovery
The Truth About the Lies
When a Boulder Lands on Our Recovery Path
To Flee or Not to Flee
What’s That Major Downer at Point D?
The Truth…Life Got Better Until We Relapsed
The Truth…Things Get Bad Again Because We Make a Bad Choice
A Self-Fulfilling Prophecy
The Recovery Path Is a Rocky Road
Application: Why Bad Things Happen to Good People
Application: The Least We Can Do…Should Be the Most That's Expected
Application: A Partial Relapse?
Application: A Successful Failure?
If We’re Contemplating if We Can Safely Relapse, We’ve Already Relapsed
Chapter 4: Mindfully Protecting My Peace and Stability
Application: Using Mindfulness of the Big Picture of Our Life to Talk Ourselves Through a Difficult Situation
“Dan’s Story”
Skill Builder: Using Mindfulness in the Heat-of-the-Moment
Figure 4.A: “Dan’s Story” Worked Out
Mindlessness
Application: Normal Mindlessness?
Skill Builder: Mindfully Prioritizing the Must Do’s
Application: When We’re Not Minding Our Emotions
Application: When We Keep Hurting Ourselves…Mindlessly
Skill Builder: Turning On Mindfulness to Turn Off Mindless Rumination
Application: Mindlessly Allowing Ourselves to Get All Stirred Up
The Joiner
The Fixer
The Complainer’s Ear
The Dance Partner
Application: Which Type Are You?
Application: The Infant Analogy
Skill Builder: “The Mindfully Protecting My Peace and Stability
Worksheet”
Figure 4.C: Examples of Things in Our Inner Circle
Figure 4.D: Examples of Things Coming At Us
Application: The Purpose of “The Mindfully Protecting My Peace and
Stability Worksheet”
Skill Builder: Dealing With the Things Coming At Us
Application: The Upsetting Phone Calls and Visits
Skill Builder: Managing the Upsetting Phone Calls and Visits
Skill Builder: How to Mindfully Protecting Our Peace and Stability
Chapter 5: Mindfulness Is a Skill
Learning Skills: From Mindful to Mindless Application
When the Automatic Process Goes Awry
Getting Control of Our Out-of-Control Emotion-Driven
Reflexes
Skill Builder: An All Day Daily Devotional
Application: From the Old to the New and Back Again
Skill Builder: Catch Relapse in the Making
Observing and Describing
Skill Builder: Don’t Let It Get You Down
Skill Builder: Mindfully Talking Ourselves Down and Refocusing
Skill Builder: Putting an End to a Conversation
Skill Builder: Observing Our Body
Skill Builder: Mindfully Observing Our Thoughts
“The Next Two Thoughts”
“The Conveyer Belt”
“ Put It on a Cloud”
Other Imagery Options
Tips for Observing
Using Imagery as a Coping Tool
Mindfully Describing Our Observations
Skill Builder: Opinions Vs. Facts
Tips for Describing
Another Mindfulness Skill: Being Nonjudgmental
Application: Love at First Sight or Blinded by Love
Application: She Loves Me, She Loves Me Not
Application: One Bad Apple Doesn’t Spoil the Bunch
Application: “Inappropriate” Thoughts and Feelings
Skill Builder: One-Mindedness and Turning Our Mind
Skill Builder: A One-Minded Solution for Chronic Worriers
Application: Being One-Minded About Recovery
Road Map: Where We've Been...What Ground We've Covered
Road Map: Where Do We Go From Here?
Road Map: How Do We Get There from Here?
How the Three Mind States are Similar to Other Theories
Section Two
The Three States of Mind:
“How Do I Get Control of My Life?”
Skill Builder: The Raw Emotions of Emotional Mind
Skill Builder: The Depth and Breadth of Our Emotions
Application: “Getting Into” a Sad Movie
Application: Revisiting the Drama Queen
Application: The Shop-a-Holic
Application: Blinded by Love
Application: Losing Our Temper
Application: Crash n’ Burn Dieting
Application: Having a Panic Attack
Application: When Help Is Destructive
The Adaptive Nature of Emotional Mind
Skill Builder: About Emotion-Driven Thoughts
Application: The Abusive Lies We Come to Believe
Application: Out-of-Control Emotion-Driven Thinking
Skill Builder: Managing Rumination
Application: What Turns On Emotional Mind
Skill Builder: Requesting Time-Out
The Purpose of Rational Mind
Application: The Meeting of the Minds
Pete’s Story
Skill Builder: Pete’s State of Mind
Skill Builder: How to Get Control Once We’ve Lost Control
Skill Builder: Cutting Always Helps
Skill Builder: Just One Drink Doesn’t Matter
Skill Builder: I Can’t Deal With This
Skill Builder: I Can’t Stand to Be Alone
Skill Builder: A Bad Relationship Is Better than No Relationship
Skill Builder: I Don’t Deserve Any Better than This
Skill Builder: I’m So Fat, No One Would Want Me
Skill Builder: I’d Kill Her if I Had the Chance
Skill Builder: I’ll Show Them…They’ll Be Sorry
Skill Builder: Failing to Succeed…or Successful Failures
Skill Builder: My Family Would Be Better Off Without Me
Application: The Truth, the Whole Truth, and Nothing but the Truth
Skill Builder: Challenging My Emotion-Driven Thoughts
Application: When a Warped Thought Is Normal
Application: Red Flags for Irrational Statements
Application: When It’s Hard to Think Straight
Chapter 8: Challenging Extreme Judgments
Application: How Extreme Judgments Backfire and Ignite the Situation
Skill Builder: Extinguishing Extreme Judgments
Skill Builder: When We Apply Extreme Labels to Ourselves
Application: Challenging Negative Judgments About Me
Skill Builder: “The Challenging Negative Judgments About Me
Worksheet”
My Story…Challenging a Negative Judgment of Me
Figure 8.A: The Challenging Negative Judgments About Me
Worksheet
Application: The Origin of the Judgmental Lies
Application: Stupid Is as Stupid Does?
Skill Builder: Using Our Smarts to “Dis” Dysregulation
The Basics of Wise Mind
Skill Builder: How to Bring On Wise Mind and Live Effectively
Skill Builder: Tips for Participating Wisely and Effectively
Ancient Wisdom
“The Well Analogy of Wise Mind”
Skill Builder: Talking Ourselves into Wise Mind Behavior
Skill Builder: Drew Got Dumped…Talking Our Way Through It
Skill Builder: From One Level to the Next…Going Deep to Reach Wise
Mind
Application: Just Say “Yes” to “Just Say No”
Application: Wisdom Lies Deep Within Us All
Skill Builder: “The Well Analogy Worksheet”
Chapter 10: The Wise Mind Worksheet
The Wise Mind Worksheet: Just an Example (We’re Toxic
for Each Other)
Skill Builder: Completing Drew’s Wise Mind Worksheet
Figure 10.B: Drew Got Dumped – Short Version
Skill Builder: More on Challenging Emotion-Driven Thoughts
The Long Version of “Drew Got Dumped”
Skill Builder: How Drew Maintained Self-Control
Skill Builder: Four More Wise Mind Worksheets
Figure 10.G: Having to Start Over
Figure 10.H: Have Bipolar - Must Quit Drugs and Alcohol
Figure 10.I: Must Stop Smoking
Figure 10.J: Can’t Keep a Job
Skill Builder: Completing Your Own Wise Mind Worksheet
Should I Follow My Head or My Heart?
Application: When Our Emotions “Have Done Gone Crazy”
Application: There’s an Order to Things
Application: The Good Counselor
Application: Listen to the Voice of Wisdom
Rest Stop #2
Section Three
Tolerating and Coping with Distress:
“How Do I Stay in Control?”
Chapter 11: Distress Tolerance
Leaning Into the Painful Situation
Application: To Be Human Is to Suffer Loss
Application: Major Distressors and Everyday Distressors
What is Distress Tolerance?
Pain and Suffering
Application: To Grieve or to Be Grieved
Application: We Grieve Many Types of Losses
Application: Suffering Is a Triple Whammy of Pain and Distress
Application: Problem Defined, Now What?
Application: The Good, the Bad, and the Ugly of Change
Application: Hurry Up and Wait!
Application: Once is Not Enough
Application: Accepting the Pain and Distress of Recovery
Application: A Painful Plan
Application: Changing Our Attitude About Emotional Surgery
Application: Dying from a Broken Heart…When the Pain Is Killing Us
Some Acceptance Statements for Recovery
Basic Principles of Accepting Reality
Application: Acceptance of the Bad, Horrible, Rotten Things We’ve
Done
Skill Builder: The Art of Reframing
Acceptance Doesn’t Require Giving Up on Something
Skill Builder: The “I Can’t Win Them Over” Situation
Skill Builder: Radical Acceptance and the Hurtful Phone Calls
Application: Radical Acceptance of Serious Life Consequences
Fighting Reality – Radical Non-Acceptance
Skill Builder: Peace Comes by Accepting the Unacceptable
Skill Builder: Radical Acceptance of Complicated Life Situations
Skill Builder: Turning Our Mind to Acceptance
Application: The Baseball Analogy of Life…We’re Always at the Plate
Application: It All Comes down to Our Will: Willingness vs. Willfulness
Chapter 13: Life-Enhancing Coping Skills
Hmmmm…Which Do I Choose?
Figure 13.A: The Levels of Emotion Chart
Application: How Coping Mechanisms Reduce Negative Emotion
Figure 13.B: “The Emotional Thermometer”
Application: To Eliminate or to Reduce
Application: Hurry Up! I Can’t Stand This Any Longer
Application: The Tried N’ True or the Iffy N’ New
Application: The Long and the Short of It
Application: A One-Shot Deal…I’ll Drink to That!
Application: A Time of Reckless Abandon…or a Time to Abandon the
Reckless
Remember These Truths…
Application: How to Get Hooked on Normal Life
Application: How Do “Normal” People Do It?
Application: The Destructive Coping Behaviors of Normal People
Application: The Not So Normal “Normal Appearing People”
How to Build a Normal Lifestyle
Skill Builder: “The Life-Enhancing Coping Activities Worksheet”
Skill Builder: “The Activity Calendar”
Skill Builder: Planning Our Day and Week
Figure 13.G: The Weekly Calendar
Skill Builder: Using Distress Buffers to Mindfully Protect Our Peace and
Stability
Figure 13.I: How I’ll Mindfully Protect My Peace and Stability
The Structure of a Game Plan
Figure 14.B: A Typical Game Plan
There’s More to It than JUST Action Steps
Application: How Can I Get Out of Doing This?
Application: The Hardest Part of Our Recovery Plan
Skill Builder: Setting Up a Game Plan
Figure 14.C: The Game Plan
Skill Builder: The Game Plan Tracking Sheets
The Final Rest Stop
Road Map: Where We've Been...What Ground We've Covered
Our Souvenirs and Snapshots: A Time to Remember
Where Do We Go from Here? Where Is This Road
Leading?
References
Some Excerpts From the "Out-of-Control"
DBT-CBT Workbook
The following excerpts are linked from the Table of Contents above.
The small numbers in the yellow highlight below are "footnotes" that relate to
the text in the yellow margin on this page.
Click hete to go to that section called "Margin Notes"
APPLICATION: Why Do We Become So Overwhelmed
with Our Emotions?One reason is that we’re experiencing TWO SOURCES OF IRRITATION14 AT ONCE! When we’re in an emotional state, we’re HIT BY RAW EMOTIONS AND EMOTION-DRIVEN THOUGHTS. That’s double the distress!15 THEY FEED OFF EACH OTHER, TOO! For instance, the more depressed we become, the more hopeless and depressing our thoughts become. As our mind fills with depressing and hopeless thoughts, WE FEEL MORE DEPRESSED AND HOPELESS! This works the same for other emotions. Consider how anger and jealousy build up. The more we think about what happened, the angrier we get. The angrier we get, the more our angry thoughts intensify and rage through our mind…AND the madder and more jealous we become. Our angry feelings and thoughts feed off each other and become more and more intense…UNTIL WE GET CONTROL OR WE BLOW!
To make things even more challenging, when we’re in an emotional state, we’re NOT ONLY dealing with here-and-now stuff, but WE’RE ALSO HIT BY UNRESOLVED16 EMOTIONS and SITUATIONS FROM THE PAST that are brought up by the current situation. That makes things even worse!
FURTHER, when we’re upset, we experience MANY EMOTIONS AT ONCE. For instance, if we’re going through a break-up, we tend to feel depressed and angry. Right? Well, what about feeling lonely, lost, betrayed, anxious, worried, rejected, empty, abandoned, mistrusting, suspicious, frustrated, and overwhelmed! We’re often FULL OF EMOTIONS when we’re going through a difficult time. Sometimes we get so overwhelmed by our emotions that we’re in a state of emotional upheaval.17 We CAN’T THINK STRAIGHT. We may not even know how we’re feeling. We may feel like we’re going to FALL APART or EXPLODE. We’re SO FULL OF FEELINGS that our MIND IS RACING…thoughts are FLYING THROUGH OUR HEAD. We’re so AGITATED,18 so FULL, so PRESSURED, and SO DESPERATE FOR RELIEF.
Return to where you were in the Table of Contents!
APPLICATION: What Happens if We Act on These Intense Feelings?
What do you think happens when we allow Emotional Mind to control or drive our behavior when we’re upset? What is our behavior like? What are we likely to do? ___________________ _______________________________________________________ _______________________________________________________ When we’re filled with difficult emotions, we often act on them through Emotional Mind. We’re desperate for relief so we do things that provide IMMEDIATE RELIEF. We often do the things that have worked for us in the past. Some of our “favorite” or most preferred coping responses include drugs and alcohol; suicide attempts, gestures, and threats; cutting ourselves; overtaking medication; walking off and abandoning the situation; withdrawal; and verbal and physical aggression.19 What other types of Self-Destructive Coping Behaviors can you think of? _______________________________________________________ _______________________________________________________ See Figure 1.C for “A List of Common Self-Destructive Coping Behaviors.”
Return to where you were in the Table of Contents!
~~~~~~~~ CHAPTER REVIEW ~~~~~~~
1. What are the two parts of Emotional Mind? ________________ _______________________________________________________ 2. What are Emotion-Driven Thoughts? Describe what they are rather than just giving examples. ___________________________ _______________________________________________________ 3. List some Destructive Emotion-Driven Thoughts you have when you’re upset. _______________________________________ _______________________________________________________
_______________________________________________________
_______________________________________________________
4. What are three reasons why our emotions can become so overwhelming? __________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ 5. What are Emotion-Driven Coping Responses? Describe what they are rather than giving examples of specific ones. ________ _______________________________________________________ _______________________________________________________ _______________________________________________________ 6. Are Emotion-Driven Coping Responses the same thing as Self-Defeating Coping Responses and Emotion-Driven Coping Mechanisms? YES / NO
7. List eight types of Self-Destructive Coping Behaviors.
1. ___________________________ 2. ________________________ 3. ___________________________ 4. ________________________ 5. ___________________________ 6. ________________________ 7. ___________________________ 8. ________________________ 8. Describe the Nature of the Problem in your own words. _____
_______________________________________________________ _______________________________________________________ _______________________________________________________ 9. Describe the Cycle of Suffering in your own words. _________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ 10. What are the five parts of the first cycle in the Cycle of Suffering?
1. _____________________________________________________ 2. _____________________________________________________ 3. _____________________________________________________ 4. _____________________________________________________ 5. _____________________________________________________ 11. What’s my hope for you? What’s the purpose behind this workbook? _____________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ 12. What’s YOUR hope for this study? _______________________ _______________________________________________________ _______________________________________________________ _______________________________________________________
Return to where you were in the Table of Contents!
The Effects of a Suicide Attempt on the Big Picture of Our Life
As mentioned, many folks wind up in the hospital because of a suicide attempt, be it by overdosing, cutting, hanging, gunshot, or other means. Consider how this Self-Destructive Coping Response affects the Big Picture of Our Life. Turn back to “The Cherished Parts in the Big Picture of Our Life” (Figure 2.B) and mark the areas that are likely to be seriously affected or jeopardized22 by suicidal behavior. If a suicide attempt is due to relationship problems, our relationship may be seriously jeopardized or lost. If suicide attempts are frequent and especially if they’re just one type of Emotion-Driven Coping Behavior we do, many of our relationships may be impacted and our people may pull away from us.23 We may also lose housing because of the trauma, drama, and heartache a suicide attempt causes the people we live with.24 We may lose the privilege of staying in special housing programs (halfway houses, group homes, rehabs) for similar reasons.25 We may lose jobs and careers.26 We may cause our bodies physical damage from scarring or disfigurement27 and damage to our brain, organs, and nerves.28 All in all, the losses and problems caused by suicidal and parasuicidal29 behaviors are similar to those caused by substance abuse and being hospitalized or in rehab. Most, if not all, the areas listed in the chart would be affected, especially when suicide attempts and gestures occur frequently.
Return to where you were in the Table of Contents!
Teri has Bipolar Disorder and a substance abuse problem. She is on probation for a DWI and possession of cocaine. She is bright, has worked as a LVN, and has tried many times to complete an RN program. Something Always Happens and she has to drop her courses. Her LVN license has been suspended due to legal problems. She has had many jobs. She loses jobs due to using too much sick time or not showing up for work. Her family is angry with her for all the trouble and heartache she has put them through. They have tried to help her many times, but she continues to have more and more problems. THEIR HELP ISN’T HELPING…IT HAS NO LASTING EFFECT. Their phone calls and visits are filled with conflict. She is often broke and asks friends and family for money to pay for food, medical care, rent, etc.
She’s twice divorced and has two kids. One is with the father, the other is in foster care. She is behind on child support and cannot see her child until she catches up. She chooses abusive men. She is abusive to the men, too. She “can’t stand to be alone” and jumps from one relationship to another. She had a difficult childhood. Her father left when she was two. Her mother drank and was physically and emotionally abusive. She thinks her mother is Bipolar. She was molested by an uncle until age 12 and was raped by a boyfriend at age 20.
She believes in God and attends church when she is clean and living a Recovery Lifestyle. She’s been through many rehab programs and has been hospitalized several times for mania, depression, and suicidal behavior. After treatment, she does well for 3-6 months. However, Something Always Happens and she returns to drugs and alcohol, stops her Bipolar meds,34 has a relationship blow-up, and overdoses or cuts herself. This cycle generally ends with hospitalization or another rehab stay.
