This month, the skill I’d like to highlight is a great one to use when you find that you’re engaging in behavior which you would like to change. In DBT it is known as “behavior analysis” or “chain analysis”.
This skill incorporates a lot of other skills that we can use instead of engaging in undesired behavior but for many undesired behaviors, we’ve been doing them so long, we really don’t think too much about them. Doing chain analysis helps us to look at what we’re doing a bit more closely and hopefully figure out where to insert more skillful behavior so that it will be harder (or less impulsive) to engage in the undesired behavior.
Let’s take an undesired behavior that many of us struggle with—eating too much unhealthy food. To make the example clearer, I’m going to say that the behavior was overeating some cookies. That is going to be our “action”. Now we can back up a bit and start looking at what came right before we decided to eat the cookies. For the purposes of this example, let’s say that right before I ate the cookies, I had a fight with my husband. That might be a “prompting event”. In DBT, we’re very interested in looking at vulnerabilities, so we want to look at what my vulnerabilities were even before I had the argument with my husband. Let’s say I didn’t sleep well the night before and I skipped breakfast. Now we can start filling in the “chain” to get a visual example of what happened:
You can also see that I have added the surface emotion that came as a result of the combination of vulnerabilities and the prompting event. In this case, it is frustration or possibly anger. The underlying emotion was sadness and the self talk I was using was that “I am a bad wife because I can’t manage my finances” (assuming the fight was about finances). So, as a result of these things, I have the urge to eat cookies and, because I failed to use any skills at any point prior to this, I actually engage in the action of eating cookies which results in my feeling sick and guilty, along with a good bit of shame, no doubt. These are just some of the possible the consequences of the behavior. Having filled in the above chain, I can begin to see that at any point, I could have used skills to possibly break the chain that led to my eating the cookies. Let’s continue to use this example to see how I could insert skills.
Recognizing first thing in the morning that I had poor sleep, I could have decided that I really need to do a good job of taking care of myself in every other way today. Perhaps I’m going to go back to bed or, if I don’t have time to do that or it is simply not an option, I could plan to take a nap later on. In the meantime (or if I’m also unable to take a nap during the day) I can perhaps take a really relaxing, soothing shower while I listen to my favorite music. Perhaps I could add some time to meditate. I could have made sure that I ate a good breakfast that was healthy not only as an act of self care but also to reduce my hunger which may have played a role later on down the chain. I could engage in eating my breakfast in a very mindful way.
With an awareness of my poor sleep, when my husband wanted to discuss finances, I could possibly have said that now would not be a good time to have the discussion because of the vulnerabilities or at least let him know in advance that because I didn’t sleep and haven’t eaten, I may be less able to engage in healthy communication with him.
If delaying the discussion is not possible, I could use some communication skills with him that may reduce the heightened emotions that, without using them, may lead to an argument.
If I didn’t do anything prior to the emotions stage, I could have recognized my emotions and labeled them and even expressed them to my husband. I could have recognized my unhelpful self-talk and gave myself a replacement thought which would have been more helpful and may have reduced the underlying feeling of sadness.
I could have recognized my urge to eat cookies and done some opposite action instead so I could have avoided engaging in the action while it was still an urge. I could have found an alternative to eating the cookies—perhaps more self-care such as applying hand lotion or taking a walk.
Even at the action stage, I could have implemented some skills! I could have eaten only one cookie (moderation or a middle-of-the-road choice) and done so in a mindful way to fully experience and appreciate the cookie and then reduce the need to eat multiple cookies!
Of course, as we get to the consequences of my behavior, there are certainly opportunities to use more skills—again with some cognitive work on my self talk and self care it may reduce the negativity that came from my behavior.
I’m now going to list all of the skills that I could use just with the one example above. They all, incidentally, can be used at more than one location on the chain. I have also linked them to other posts that discuss them in more detail. For those without links, check back to the Skill of the Month in future months, and I'm sure I'll get to them as well! They are, in order of appearance:
Self Care (shower, music)
Cognitive Restructuring (Replacing the Automatic Thought with a more Reasonable Thought)
Walking the Middle Path (Moderation or Middle of the Road Option)
I’m sure if we really thought about it, we could come up with even more skills that might have been effective at breaking the chain and leading to consequences that were more desirable.
To help you begin to use this very helpful tool, here are the questions you can ask yourself.
What were your vulnerabilities?
What was the prompting event (in other words, what was the trigger or what set it off)?
What was your surface emotion (the one mostly easily noticed)?
What were the underlying emotions (the ones hidden underneath—you may really have to think on this one)?
What self-talk did you engage in?
What was the action urge (what do you want to do/feel like doing/what is the impulse)?
What did you do (what is the action or behavior)?
What were the outcomes or consequences?
What skills can you use next time for each of the areas listed above?
The reason that therapists like to use the visual chain is that it can make it very clear that each item is part of the whole. Additionally, each link in the chain could (and very likely does) have a chain leading out from it as well. For example, the reason I had poor sleep was that I was ruminating about an event at work. Then the vulnerability can become a separate chain off of the chain shown above. The skipping breakfast as well—I skipped breakfast because my time management was very poor… jumping to the action urge—my urge to eat cookies is because the day before, I bought the cookies and I did this because… You can see that although we simplify it down to a straight chain, in reality its more like chainmail!
I think if you use this tool when trying to change a behavior, you can really get some good insight into what you’re doing, why you’re doing it, and perhaps most importantly, highlight the numerous opportunities that every situation presents to make a different choice of behavior. Another time to try to do it is IN THE MOMENT or in PREPARATION for an event that has been troublesome before.
Here’s an example of what I mean. If I know that my husband will want to have this conversation about finances, I can probably fill in the entire chain in my imagination! “I’ll be restless/worried at night, leading to poor sleep, I’ll be rushed as I always am in the morning leading to me skipping breakfast. We’ll have this huge fight because I’ll already be on edge and feeling frustrated at my inability to save money and control my spending habits. That will lead to me feeling even more terrible and angry at him which will lead, as it usually does, to me seeking refuge in the bottom of a bag of Chips Ahoy… then I’ll feel terrible about having yet again eaten cookies which does not help my goal of losing weight and living a healthier lifestyle.” (Sorry for the run-on sentence!) Now that I’ve pictured it in my head, I can say “that is one possibility but maybe I can have a different chain. Knowing that my husband wants to discuss finances, I can show him I’m really interested by gathering up my receipts, checkbook, bank statements, etc. instead of trying to avoid them at all costs. I can work out a budget ahead of time—something that I can actually DO, again so he sees that I’m really trying to change this. Heck, I could even do a behavioral analysis of my spending! If we do end up having an argument, I can recognize my urge to eat cookies and instead I’ll plan to go for a walk so I’ll be away from the cookies and can give myself time to cool down.”
I hope that you will give this skill a try this month and hope that you find it as useful as I do!