Can you explain how you drill in to a problem, such as overeating or lack of motivation, using the DBT technique of behavior chain analysis?
Note: Chain analysis isn’t just DBT, all the behavioral therapies use it!
So essentially what we are doing in chain analysis in understanding the chain of internal and external events that lead to an outcome, which is often an emotion, a dysfunctional coping mechanism (like self-harm), some other kind of undesired or harmful behavior (yelling at your partner), or another symptom. However, it could really be anything (including something positive)- but usually in therapy we are doing it to identify what events occur that lead up to something harmful or undesirable.
Remember that we are interested in both internal and external events: so, this includes thoughts, emotions, behaviors of the person, things other people do, environmental factors, etc.
So typically we start with the outcome, and look at a very specific event- not “in general.” Let’s say the outcome is a self-harm behavior. So we’d look at what happened right before that behavior occurred- like in the seconds to minutes range. This first chain is usually a feeling, thought, or behavior by the person (so not external). Then we’d look a little further back- what led to that feeling or thought? And so on. We create a timeline of events until we come to a natural end, and can see the start of the chain that began the metaphorical dominoes leading to the self-harm. That way, we understand one example of what happens in the lead up to something we want to change, reduce or remove, and can find points to intervene at. We can also look at what happens after the event- what the short and long term consequences are, including positive, negative, and neutral, to understand how those might impact future events.
Here’s an example of a chain (trigger warning: self harm)
New person I’m dating cancels dinner plans because they have to work late
“They don’t care about me. They’re going to take me for granted like everyone else.”
Think about past times people I love have hurt me
Feel sad, angry, resentful
Call new person back but they don’t answer
“This is proof they don’t care about me.”
Leave long, angry voice message to new person
“I’m going to be alone forever and it is my fault”
Feel shame, sad, angry at self
“I deserve to be punished”
Prepare to self harm (gather materials etc)
Short term consequence (of specific event only, not entire chain!): relief, numbing, fatigue. some kind of harm depending on self-harm activity. [varies of course based on person and specific harm activity]
Long term consequence (of specific event only, not entire chain!): shame, regret, sadness. could result in long-term health impacts. [varies of course based on person and specific harm activity]
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