Emotion regulation is another key aspect of DBT. It involves learning to identify and change negative patterns of thinking, managing emotions, and reducing intense emotions. This can be done through techniques such as positive self-talk, identifying and challenging negative self-talk and beliefs, and using “opposite action”.

STOP

The first skill is called “STOP”, which stands for Stop, Take a breath, Observe and Proceed. When you find yourself feeling overwhelmed or emotional, it’s important to take a moment to stop and breathe. This allows you to be more present in the moment and better manage your emotions.

Build Mastery

You can build mastery by doing things you enjoy. Examples can be cooking, creating art at home, doing the wordle of the day, or playing a musical instrument. Discuss what you have learned and write about what you’ve learned. Practice in order to build mastery and with time, feel competent.

Cope Ahead

The next skill is called “Cope Ahead”. This involves planning and preparing for potentially stressful situations in advance, so that you’re better equipped to handle them when they arise.

1. Describe the situation that you anticipate may prompt uncomfortable emotions. Check your facts. Be specific when describing the situation. Name the emotions and actions likely to interfere with using your skills.
2. Decide what coping or problem-solving skills you want to use in the situation. Be specific. Write down in detail how you will cope with the situation.
3. Imagine the situation as vividly as possible in your mind.
4. Rehearse in your mind exactly what you can do to cope effectively. Rehearse your actions, your thoughts, what you say, and how to say it. Rehearse coping effectively with your most feared catastrophe.
5. Practice relaxation after rehearsing.

For instance, imagine a scenario in which Matt was invited to present on a specific disease the next day on rounds. He used the Cope Ahead Skill to prepare for his presentation. 

Matt reviewed a book chapter as well as two recent articles on the topic the night before. He also researched multiple treatment options, both surgical and non-surgical. He realized he would likely feel anxiety on rounds and thought about how he had faced tougher situations than this in the past. He imagined how he would calm himself so that he would do well with his presentation in front of the team.

Positive Self Talk

Positive self-talk is another important skill. It’s essential to be mindful of the thoughts and beliefs you have about yourself and to challenge any negative self-talk. Instead, try to focus on positive self-talk that promotes self-compassion and self-confidence.

Opposite Action

Opposite action involves taking actions that are opposite to our intense emotions, in order to regulate them. For example, if we’re feeling anxious, we might try taking slow, deep breaths and engaging in a physical activity to help calm ourselves down.

Anger tells us to enter fight or flight mode at work and perhaps respond impulsively.

Opposite action is to walk away from a fight or display kindness towards the other person.

Depression convinces us to be inactive or feel unworthy.

Opposite action is to draw on sources of energy in your life and move forward.

Disgust causes us to avoid issues or shut down.

Opposite action is to face the problem head on.

Fear tells us to become activated to protect ourselves.

Opposite is to draw on inspiration for courage and move towards a solution to the problem. It’s ok to move slowly.

Shame makes us want to isolate ourselves and hide.

Opposite is to connect with others and feel comfortable expressing yourself. Stand up tall.

Practical Uses of Emotional Regulation in the Hospital

These are skills that are beneficial to all of us who work in the high-stakes healthcare setting. Over time, practicing these skills will help you become more comfortable in stressful environments, and can improve your own mental homeostasis. By avoiding reactive responses, you will gain confidence in yourself and be able to focus on your work in a healthy manner.

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