Summary UP Module 7 - Putting Your Skills into Practice

Putting Your Skills into Practice

This is a summary of the module Putting Your Skills into Practice for your reference.

You’ll take everything you’ve learned and apply it to your daily activities. 

Because it’s so important to your success, you’ll work on it slowly over 3 weeks. 

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First, a homework check. Did you complete your Emotion Assessments and Progress Record this past week? Are you noticing any changes in your assessment answers?

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From the previous module, did you practice the physical sensation exercises using the Physical Sensations Test Exercises and Physical Sensation Practice forms?

In order to better tolerate intense sensations, most people have to repeat the exercises a lot.

If you haven’t practiced, please get started. If you have practiced, please continue.

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Emotion Exposure

This part of the program is built on everything you’ve learned and practiced. It is at the top of the “emotions” house. It is here where the greatest changes occur.

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Practicing Emotion Exposure

You'll do things that bring up strong emotion on purpose, so you can use the skills you’ve learned to face and manage your emotions when you’re in an emotional situation.

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Why is emotion exposure so important?

1. The best way to challenge your negative beliefs about your emotions is to face them.

2. You have the opportunity to gain confidence in your ability to handle intense emotions.

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You’ll be able to experience the strong emotions at a pace that’s comfortable for you. That’s why you’ll take your time going through this module.

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Learn By Doing

Imagine learning a new skill without actually doing it. Let’s say you want to learn Spanish. You can study Spanish and listen to Spanish-speaking people. But, the best way to learn is to speak the language in real-life and imaginary situations.

That’s what you’ll do here with emotion exposure.

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You’ll use all of the skills you’ve learned to face even more challenging situations.

The idea is to feel the discomfort and continue anyway. This is how you’ll be able to handle and learn about the emotional experiences you previously avoided.

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The exercises in the previous module on Emotional Sensations gave you an idea of what you’ll experience with emotion exposure. That is why physical sensation practice is such an important part of this program.

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Before we move on, how are you feeling about the physical sensations you’ve experienced? Do you feel like you got enough practice? Could you use some additional practice?

This might be a good time to pause and take some extra time with the exercises on your Physical Sensation Practice form.

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Practicing the skills you’ve learned is only part of emotion exposure. You’ll also face your usual negative reactions to emotions. You can “test” your negative beliefs by experiencing the emotions and seeing if your beliefs are true.

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Here’s an example.

Let’s say you’ve had panic attacks when in social situations. You’re afraid you’ll really lose control, so you avoid getting together with friends.

You don’t have panic attacks, but neither do you have the experience of a good outcome. You don’t have the chance to realize that you are able to get through the panic attack without losing control.

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Think of an activity or situation you avoid. Which of the following do you believe about it?

  • The uncomfortable emotions I experience won’t go away.

  • I can’t cope with the emotions.

  • I have to avoid situations where I have intense emotions.

  • Something else.

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By facing intense emotions associated with situations or activities you learn that:

  • Intense emotions are temporary.

  • You can cope with intense emotions.

  • You don’t have to avoid situations even if you have intense emotions.

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Make Time For Homework

As with every week, complete your Emotions Assessments and Progress Record.

You might also take some time to practice your physical sensation exercises from the last module. Remember, the goal of the physical sensations exercises is to:

  • Notice the sensations without interpretation/judgment;

  • Learn to cope with the sensations; and

  • Increase your belief in your ability to cope with future uncomfortable sensations.

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Putting Your Skills into Practice - Part 2

Previously we asked you to think of an activity or situation that you avoid. Bring that situation to mind. Which of the following is your main uncomfortable emotion?

  • Sadness

  • Anger

  • Guilt/Shame

  • Other

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Here are some examples of emotion-provoking situations that commonly bring up strong emotions:

  • Returning to the site of a traumatic event

  • Being in a crowded, closed-in, or very open space

  • Speaking in a group or to someone new

  • Visiting a sick friend or the grave of a loved one

  • Calling someone who made you feel anger or shame

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What about situations that bring up positive emotions?

Some people avoid situations that bring up positive emotions, like activities with friends.

During the situation, some may think they should feel more joy and excitement than they actually do. So, they feel distressed and judge their emotions. This, in turn, makes them feel sad and disappointed.

Others may be afraid that they’ll feel negative emotions after the situation. They believe their happiness will be replaced by sadness or they’ll feel “let down” once the event is over.

Is this something you’ve experienced? If so, you can use a positive situation for your emotion exposure.

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You might want to pause here and think about some of the situations or activities that cause intense emotions for you. You’ll use the information for your homework.

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Types of Emotion Exposures

You can use different types of emotion exposures to practice.

The types are situation-based, imaginal, as well as physical sensation. You've already learned about physical sensation exercises. We'll go over the other two in more detail.

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Situation-based emotion exposure means you put yourself in a situation that brings on strong emotions.

For example, if you are afraid to speak in front of groups, you might use an upcoming meeting for your situational exposure.

You’ll prepare your notes, go through the presentation on your own, practice it in front of a friend/coworker, arrive in the conference room, begin your presentation, and complete your presentation.

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With imaginal emotion exposure, you use your imagination to “put yourself” in a difficult situation.

You can use it when:

  • Thinking of a situation causes intense emotions, e.g. worry or fear.

  • Situations are impractical to create in real life, e.g. taking several flights when you are afraid of flying.

You’ll “picture” the activity or situation in as much detail as possible. Hint: Some people write down, and then read and record it.

For example, you might imagine a difficult memory that brings up sadness, anger, guilt/shame, etc.

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You can continue using your physical sensation emotion exposures from the previous module.

You can add one of them to a situational or imaginal exposure. Increasing the challenge helps improve your confidence in your ability to experience intense emotions.

For example, if you chose to “run in place” to experience physical sensations. You might do so before entering (or imagining you’re entering) a crowded space.

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Emotion Exposure Hierarchy

An emotion exposure hierarchy is a list of situations/activities that you avoid because they bring up strong emotions.

You’ll work on a hierarchy for your homework.

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Steps

1. Make a list of everything you can think of that brings up strong emotions. Include:

  • Imaginal emotion exposure ideas

  • Physical exercises that produce strong physical sensations

  • Various situations (e.g. at home and at work, alone and with others, etc.)

2. Think of ways to make the items a little easier or harder (e.g. if you have “make a mistake” on your list - it’s easier with a friend versus your boss).

3. Order the items from least to most difficult.

4. Add the list of items to the Emotion Exposure Hierarchy form in your workbook.

5. Rate them by emotional distress and avoidance levels as in the instructions.

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Make Time for Homework

  • Complete your weekly Emotions Assessments and Progress Record.

  • Complete the Emotion Exposure Hierarchy form. Talk with your coach if you need help. You can ask them for extra forms if you need them (you can also copy the blank form in your workbook).

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Putting Your Skills into Practice - Part 3

Once you’ve completed your Emotion Exposure Hierarchy form, you’ll begin to practice the exposures.

Notes
  • Make sure you start with a situation that brings up, at least, moderate distress.

  • A situation may come up that you planned to do later or that you hadn’t considered. In either case, it’s okay if you go ahead with it.

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Emotion Exposure Practice

The Emotion Exposure Practice Record will take you through each emotion exposure exercise. You’ll complete the first part before and the second part after your exposure.

Before The Exposure

Once you choose an exposure task, identify any negative automatic thoughts you have about doing it - e.g. "This will not help me."

Use your cognitive flexibility skills to come up with alternative thoughts that will help you engage in the exposure - e.g. "This might be hard for me, but will help me in the long-term.”

Next, identify any avoidance behaviors you might engage in during the exposure to avoid how you're feeling - e.g. you put it off or procrastinate.

Then choose an alternative action for each avoidance behavior - e.g. set an alarm and complete the exposure when it goes off.

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After The Exposure

First, you’ll identify the emotions you experienced and then break them down into your thoughts, physical sensations, and behaviors.

Then, you’ll rate (from 0-10) how effective you were in using:

  • Mindful emotion awareness. Were you able to stay present and experience the emotions?

  • Cognitive flexibility. Were you able to identify alternatives for negative automatic thoughts?

  • Countering emotional behaviors. Were you able to use alternative actions instead of avoidance (emotional) behaviors?

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Review and analyze the exercise

Take some time with the last, and very important, part of the exercise. Ask yourself, “What have I learned about my emotions/ability to cope?” “What might I do differently with my next emotion exposure?”

You might talk this over with your coach.

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Pointers for emotion exposures

You’ll need to practice. As with learning any important skill, the more you practice, the better.

Before you feel more comfortable with your uncomfortable emotions, you may need to face the same situation more than once.

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Sometimes setbacks occur during exposures (e.g. you may have trouble completing an exposure.). Don’t be discouraged. Try not to judge yourself. For additional support, consider talking to your coach.

You can make adjustments or changes and then continue. You can also go back to an easier exposure, then try the harder one again.

Create a routine. Don’t put off your exposures, make them part of your day - you might put them on your schedule or calendar.

To move forward, you need to face your fears about what will happen when you allow yourself to experience strong emotions. Work on accepting, rather than fighting, strong emotions.

It’s possible that your worries about an exposure may actually come true. That’s okay! Your exposures may not always go as planned. Having such an experience can actually help you make lasting changes.

It allows you to learn how to cope with unexpected challenges. And, you may surprise yourself and handle things better than you expected.

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What motivation did you take from your Decisional Balance Form?

Write about how Emotion Exposures can help you achieve your goals.

What progress do you feel you’ve made toward your Treatment Goals?

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Make Time For Homework

  • Continue your weekly Emotions Assessments and Progress Record.

  • Practice emotion exposures. Plan to practice every day (or as often as possible). Use the Emotion Exposure Practice Record for each exposure. That means you’ll need multiple forms. Again, you can ask your coach for extra ones or make copies of the blank form.

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Quiz

Which of the following are true?

  • Putting Your Skills into Practice is the part of the treatment where the greatest changes occur.

  • Situation-based exposure means you avoid situations that bring up your uncomfortable emotions.

  • Different forms of emotion exposure shouldn’t be practiced together.

  • Once you make progress towards your emotion-focused goals, setbacks don’t happen.

Answers

  1. True. Using your skills in emotion-provoking situations can help you change.

  2. False. Situation-based exposure means you put yourself in situations that bring up uncomfortable emotions. 

  3. False. You may use different forms emotion exposure together to further challenge yourself.

  4. False. Even with progress, setbacks can still happen. When they do, resume practicing your skills as you face strong emotions!

Remember to keep practicing your exposures!