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Paula asks Dr. Lou

Hello Everyone,

Hope the start of your week is going well. What have you smiled or laughed about lately? Take a moment to think about it and remember it. Another question I was asked comes from Paula, who writes:

Dr. Lou, This would be my question. I’ve learned so many great coping skills in cbt & dbt. I practice them, and they are usually effective. What though can I do when I go from 0-60? I feel I am past the point of skill use. What can I do then?

Paula, first of all, I am glad to hear that most of the time the various CBT and DBT strategies you have learned are effective.  You are right that most of the time these do not work when you go from 0-60.  Ideally, you want to catch yourself before reaching 60.  However, as you point out, that is not always possible.  Know that even during such situations, there are things you CAN DO.

Often when we are at 60, we are at a point of no return.  This is one of the most difficult and challenging situations we face. During such situations, as long as safety is not an issue then we typically need to isolate ourselves.  You can go take a nap if possible, go exercise or take a walk. If safety is a concern, you need to contact your supports and explain the situation.  One of the most important ingredients is for you to be mindful. You can do this by reminding yourself that, “This has happened before. It will only last XXX amount of time.”  Remind yourself of the times you have been doing well and situations you managed to stabilize your emotions.  Staying mindful during such experiences is important.  This often normalizes and de-escalates us.

Hope this helps.

Best Regards,

~ Dr. Lou

P.S. A couple spots remain for the group starting in September. If you are interested, please email me.

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