Dialectical Behavior Therapy: Cope Ahead
Post by: Emily Morris, MSWI
We all regularly find ourselves in stressful, emotionally-intense situations, and it can be extremely overwhelming to cope during these times of high emotional intensity. In particularly difficult times, it is common for us to resort to coping methods that are ultimately harmful and ineffective in the long run. Cope ahead – an emotion regulation DBT skill – is focused on preparing you for these types of situations and equipping you with more effective ways to cope with stress and intense emotions.
What is DBT?
First of all, what is DBT? DBT stands for dialectical behavior therapy and is an evidence-based psychotherapy modality that is effective in developing coping strategies, regulating emotional responses, improving relationships and communication, and gaining awareness of oneself. DBT is commonly used to treat a range of disorders, such as depression, anxiety, bipolar disorder, and borderline personality disorder.
DBT treatment focuses on four main skills categories: emotion regulation, distress tolerance, interpersonal effectiveness, and mindfulness. Cope ahead, which we are discussing in this post, is an emotion regulation skill, which means that it is aimed at managing and navigating difficult or intense feelings to respond to emotional situations in a way that feels more tolerable and balanced. (Subsequent posts in this blog series will focus on other skills in the additional three categories.)
When Should I Use This Skill?
There are many opportunities where you might find the cope ahead skill useful in your daily life! Identify a situation that may provoke anxiety or be challenging for you in the future. Perhaps this is a situation where you feel afraid or threatened, or where you anticipate your emotions being so high that it may be difficult to effectively respond. Some people also find it helpful to use the cope ahead skill for new situations, as the unfamiliarity and unpredictability of a new environment can make it challenging to regulate one’s emotions. Other beneficial scenarios to apply this skill could be situations where you feel strong urges that are difficult to navigate, for example, responding with violence, using drugs or alcohol, or engaging in harmful behavior.
Why is Cope Ahead Helpful?
Research shows that we can learn new skills and ways to cope simply by imagining and rehearsing them in our minds. From sports to art to emotion regulation, studies have shown that many of the same areas of the brain are activated when imagining the activity or skill and when actually engaging in the skill! Below is an outline of the steps to practicing cope ahead.
Cope Ahead: 5 Steps
In five steps, you can learn to cope ahead and feel prepared going into difficult emotional situations. This skill is most effective if you are writing out each of the steps, rather than answering in your head.
Describe. Describe a situation that you anticipate being highly emotionally intense and difficult to cope, or that may prompt a behavior that you consider problematic or maladaptive. Use as much detail as possible when describing the situation. The more specific, the better! Ask yourself, “Would this situation present a problem if it occurred?” Identify and name the emotions and/or urges that may interfere with you effectively coping in this situation.
Decide. Decide upon coping strategies or skills (i.e. problem-solving) that would be helpful in navigating this situation. How would you cope with intense emotions or urges? Write it out, and again, the more specific, the better. During this step, tap into other skills you have learned in the past.
Imagine. Next, vividly imagine the scenario in your mind. It is important that you imagine yourself actually in the situation, rather than watching the situation unfold. Similarly, imagine this occurring in the present, not in the future or past. Remember that details are key! The more vividly you imagine the situation, the better it will help you cope ahead.
Rehearse. Now, in your head, rehearse coping effectively in this situation using the skills and strategies you identified in step two. Practice the actions, thoughts, and dialogue that would come up in this situation when you are coping effectively. What would you do if a new problem arose during the situation? What is your most feared outcome in this situation? Rehearse coping with any additional issues that you could anticipate hindering your ability to cope.
Practice relaxation. Because the rehearsal step could bring up intense emotions while you are imagining what you anticipate may be a stressful situation, it is important to leave time to relax after using the cope ahead skill. Relaxation can look different for everyone. Perhaps you want to practice some deep breathing exercises, or maybe take a walk to clear your mind.
Remember that practice is the key to building mastery! Like any skill, as you continue to rehearse and practice coping ahead, you will feel more confident using this skill and will benefit even more from it. The more you practice, the more likely the chances you will automatically use these effective coping skills when faced with a challenging situation.
References:
Linehan, M. M. (2014). DBT skills training handouts and worksheets. The Guilford Press.
Linehan, M. M. (2014). DBT skills training manual. The Guilford Press.
