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Module 6: Problem Management Skills

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1 Module 6: Problem Management Skills

2 This week Review week 10 Practice Exercises from last week This module
More on validation and DEARMAN More on identifying and observing limits Problem management approaches What to do when change is not happening This week’s exercises Review Week 10 3 major relationship priorities - strategies DEARMAN - strategy for increasing Objective Effectiveness i.e. getting what you want GIVE - strategy for increasing Relationship Effectiveness i.e. keeping the relationship FAST - strategy for increasing self respect effectiveness i.e. maintaining your self respect. More on Observing Limits More on Validation – tried some more examples

3 Last week’s exercises Ref Student Notes page 33
5. Observe if and when your limits are stretched. Where does this occur the most? 6. If appropriate, observe your limits in a situation and write down your experience. 7. Describe an easy problem situation. a) Observe and describe your wants and desires: list them in the order of priority: objective, relationship, self-respect. b) Describe them each in two sentences. 8. Use DEAR MAN with someone: a) Describe what happened b) Write a DEAR MAN letter to someone where there’s a difficult situation to be discussed

4 Validation Revisited Validation is always about the OTHER person’s feelings, not about our own. Validation is not giving advice. If you do give advice when the other person is emotional, they may get angry with you. It is invalidating to be told what to do about an emotional situation. SHOW FRUZETTI’S VALIDATION SECTION OF VIDEO 7 (GLOSSARY) Validation is a tool that verifies that the other person’s feelings are valid, but doesn’t necessarily condone or agree with their behaviour. Remember, the behaviours come from feelings, beliefs and “action impulses” so they can be separated from behaviours. You are not “giving into” the person with BPD if you learn to validate their feelings. And, if you master validation, you might eventually receive validation back from your loved one, which is a remarkable improvement over IAAHF (“it’s all about his/her feelings”). Don’t expect it right way, but after some time, it can happen. With validation, you are basically saying, “Your feelings matter. It is OK to feel that way.” The way in which you validate someone else’s feelings is important. Many people believe that saying “It’s OK. I love you” or “You are safe with me” is a form of validation, but it is not. Those statements are about your attitudes toward the other person, not about his/her feelings. Validation is always about the OTHER person’s feelings, not about our own feelings. In some ways, this can get frustrating for us, because everything always seems to be about the other person’s feelings – and in the beginning, that is true. There are other tools that get your feelings on the table, but for now we need to focus on the other person’s feelings and how to validate them. Validation is not giving advice. In fact, if you do give advice when the other person is emotional, they are likely to get angry with you. People don’t like to feel that they are being told what to do about an emotional situation – that is quite invalidating. It feels like you are telling them how they should feel and they can’t control the emotions Most of the time, it is best to keep it short.

5 Validation Revisited (cont.)
Validation is communicating that we understand, appreciate or accept something in another person, such as their beliefs, emotions or actions. Though we may not be able to validate everything someone feels or does (especially with destructive behaviours) we can learn to find something in the person's feelings or behaviours that we can understand and agree with. This can be like sorting through a big pile of sand (or in a really tough moment, through a pile of manure) for nuggets of gold. We may need to get out our magnifying glasses (and shore up our faith that there is something worthwhile to find), but when we are able to offer validation it has a tremendously positive effect. This is especially true for people with BPD, because they almost constantly feel misunderstood and blamed, particularly within themselves. If family members can learn to validate what is indeed valid in a skilful manner, they will usually be heard in a whole new way by the person with BPD.

6 Validation Revisited (cont.)
As a fall back approach, you can almost always validate on the basis of the person's history. For example: "Given what you've gone through with [fill in the blank] it makes sense to me that you're feeling [fill in the blank]. I'd feel that way too if I'd experienced what you have." However, if you can find something you can agree with in a more direct way (e.g. " Yes, it sounds like that person really was rude"), that will be more powerful in helping a person calm down and feel understood.  If you start a conversation with validation, the person you're speaking with will probably be more receptive to whatever else you have to say. If there is difficult feedback you need to give, you can wrap it in validation before and after, like the meat between pieces of bread in a sandwich. Even more effectively, you can express the difficult feedback in the DEAR MAN format.

7 WHAT IF THE OTHER PERSON…
DOESN’T RESPOND WELL? DOESN’T MODIFY THEIR BEHAVIOUR? BECOMES EVEN MORE DYSREGULATED? VALIDATE, VALIDATE, VALIDATE!!! Examples: I can see that this is really difficult for you. I understand how hard this must be. I’d find it difficult too. I know you would really like to have that I can see you are finding this hard but I am not able to give you any more money for makeup/whatever ME TOO I KNOW OF COURSE In Manning, Shari Y. (2011). Loving Someone with Borderline Personality Disorder: How to Keep Out-of-Control Emotions from Destroying Your Relationship. New York: Guilford Press. Used with permission of the author.

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9 STEPS TO IDENTIFY AND COMMUNICATE LIMITS
Observe your experience to identify your limits. Notice whether your limit is being crossed. Decide whether to communicate that your limit has been crossed. If so, communicate with your loved one (start by regulating your own emotion if needed). Observe your experience to identify your limits. This means considering your past experiences and thinking about how you feel about what you have agreed to in the past. Your feelings will help you to decide what you are comfortable with. Notice whether your limit is being crossed. If you have felt resentful/upset/angry or some other negative emotion, it may be because at that time a limit was crossed. Decide whether to communicate that your limit has been crossed. You will need to weigh up what else is happening. You may decide this is not the right time, or that something else is more important for now. If so, communicate with your loved one (start by regulating your own emotion if needed). Regulating your own emotion means things like: Being mindful – staying in the present, staying calm. Tuning in to the other person – what’s happening for them. Sticking to the facts (minimise interpretations) Focusing on the big picture e.g. maintaining your relationship with the person. NOTE: Next slide – more on communicating with your loved one In Mannig, Shari Y. (2011). Loving Someone with Borderline Personality Disorder: How to Keep Out-of-Control Emotions from Destroying Your Relationship. New York: Guilford Press. Used with permission of the author.

10 STICKING TO YOUR LIMITS - STRATEGIES
Be a “broken record, repeating alternate versions of your limit Soothe disappointing reactions to the limit and perhaps offer alternatives Validate how difficult it is to have this “shift” in the relationship and perhaps “not getting what s/he wants” Be honest that setting a limit and why you are setting it relates to YOU not your “loved one” or someone else in your life “Giving in” will probably NOT be effective in the long run… Be a “broken record, repeating alternate versions of your limit Gently but firmly Not useful to get defensive and justify Soothe disappointing reactions to the limit and perhaps offer alternatives Validate reactions – “I know this is a change from how things have happened in the past. I understand this must be hard for you” Alternatives – only if appropriate Validate how difficult it is to have this “shift” in the relationship and perhaps “not getting what s/he wants” Be honest that setting a limit and why you are setting it relates to YOU not your “loved one” or someone else in your life Its not about punishment, or them - its about you and what you can manage “Giving in” will probably NOT be effective in the long run… Is confusing to the other person Undermines your self-respect And will make it harder next time

11 MORE ON STICKING TO YOUR LIMITS
Give careful thought to setting limits. Take your time in this process It may be difficult for your loved one, if this is new behaviour on your part. It will likely evoke emotions that will perhaps tempt you to reconsider. Guilt, shame, and fear may be evoked in you which will also make you want to reconsider. Be willing to change a limit if circumstances change, BUT be careful about inconsistencies and backing down!

12 Can be flexible and fluid May change with circumstances
LIMITS Can be flexible and fluid May change with circumstances Can be extended or relaxed Reflect OUR needs

13 CLASS PRACTICE – OBSERVING LIMITS
Write down on a piece of paper general areas where you observe limits in your lives (friends, work, relatives) (2 mins) e.g. no mobile phone calls during teatime. Pair up with another participant (preferably one you don’t know well) and spend 2 minutes sharing your limits. Still in pairs - choose one item on each list. Clarify each limit in behavioural terms. (e.g. “Please put your phone on to silent during mealtimes.” Back as a whole group, if you feel comfortable, share these experiences.

14 PROBLEM MANAGEMENT Fruzzetti prefers the term Problem Management to Problem Solving. The problem may not be able to be solved….

15 Options for Approaching Problems (Linehan)
You can try to solve the problem You can change the way you feel about the problem You can try Radical Acceptance: accept and tolerate both the problem and your response to the problem You can stay stuck and miserable This may be an appropriate time for Liz to tell Tracey’s story about her son How radical acceptance led to a change in Tracey’s approach How she identified her goal How she went about achieving her goal And how over time, things improved.

16 Problem Management If you don’t want to stay miserable you can ask for change. This is difficult if you are not used to asking for change or if the person is unwilling to change. Be mindful of the timing. Be prepared to negotiate or compromise. If this does not work Step back, Take a break. We can put a lot of work and energy into getting the situation to change, years even. Focussing on getting the person to change can lead to more judgment towards the person, and be non-productive. 2 useful quotes to remember: “If you always do what you’ve always done, you’ll always get what you’ve always got.” “Insanity: doing the same thing over and over again and expecting different results” (Attributed to Albert Einstein)

17 Problem Management - two approaches
Non- collaborative Foot in door Door in Face DEAR MAN and GIVE FAST Collaborative Collaborative Problem Management Problem chain analysis Note: The collaborative approaches require lots o practice. You need to be skilled at validation, accurate expression, and emotional self management etc. What is the difference between these two approaches? Non-collaborative – where the other person does not want to engage in managing the problem - use Foot in Door, Door in Face and DEARMAN, GIVE, and FAST. Collaborative problem solving – doing it together. Starts with defining the problem. Then goes step by step, collaboratively (together), through understanding what the problem is. Involves each person saying what they want. There are opportunities in this process for validation, for self validation, and accurate expression. There are opportunities to be collaborative in the sense that, okay, what could I do to make it worth your while to change something. So there’s a lot of negotiation involved. Also includes Problem Chain Analysis technique. WE WILL TAKE A CLOSER LOOK AT EACH OF THESE APPROACHES.

18 NON-COLLABORATIVE PROBLEM MANAGEMENT where the other person is unwilling (at least at first) to try a collaborative approach “Foot-in the-door” – DBT technique. Aims to find some way in that is OK with the other person. It can be just getting in there and chatting about nothing – or music – or whatever. At the very least you are opening a conversation. Make an easy request first, then follow up with a more difficult request. This technique aims to encourage or increase the likelihood that the other person will also want to solve the problem. Key is to think of what will encourage the other person to want to open up a dialogue. E.g. Do you think I could drive you to school today so I could hear how your week is going? (small request, initial) to Do you think we could spend the weekend together doing something fun? (larger request, eventual) You start by opening the channels of communication with something the other person is doing or is interested in, or whatever, hoping to get something more. If you get agreement you can validate, and appreciate. This provides a good footing for more agreement now or later. . “Door in face” technique. Opposite to foot in door. Used to get compliance in which a large request is made knowing it will likely be refused, so that the person may agree to a much smaller request. The smaller request is your ultimate goal. E.g. ask for agreement the person will not self-harm in the coming week (large request) then ask for something smaller e.g. agreement to call therapist before harming herself. (smaller, more reasonable request). DEARMAN, GIVE, and FAST The other person doesn’t have to say, “I agree there’s a problem; I’m willing to work on it.” We just jump in; we start working on it. Sometimes, the other person doesn’t see the problem or doesn’t agree with how we define the problem; but we can still work on changing it by being more and more effective at the DEARMAN, GIVE, and FAST for negotiation later on. You can try: “FOOT-IN THE-DOOR” “DOOR IN THE FACE” DEARMAN and GIVE FAST

19 Some more to think about - Foot in Door, and Foot in Face approaches.
These are used, often by salespeople or charity drives. You can combine them. An example of a combined approach would be first asking a child/partner not to engage in a problem behaviour at all in the coming week, then eliciting a commitment instead to not use the behaviour on at least one day that week. Later, or at another time, you may be able to negotiate for the client to use the behaviour on no more than 4 of the 7 days.

20 DEARMAN AND GIVE FAST - REVISION
D = Describe the situation E = Express your feelings about the situation A = Ask for what you want R = Reinforce your willingness to help, and work together on the matter M = Be mindful of your goals A = appear confident N = Negotiate GIVE G = Be gentle in your approach I = Be interested; listen, don’t interrupt V= Validate E = Easy manner, use a little humour if possible, don’t be too intense FAST F = be Fair to yourself and to the other person A = (No) Apologies for making a request, saying no, or disagreeing S = Stick to your own values T = Be Truthful, don’t lie or exaggerate.

21 TIPS FOR DEARMAN and GIVE FAST
Practice each of these skills separately in easy situations then in more and more complicated and upsetting situations with somebody or in your head before you actually say anything.

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23 COLLABORATIVE PROBLEM MANAGEMENT MODEL
8 Steps Step One: Define the problem. In stating the problem, always begin with something positive The collaborative problem management approach starts with problem definition and then goes step by step, collaboratively (together), through what the problem is and how to understand it, and what you want. There are opportunities for validation, self validation, and accurate expression. There are opportunities to be collaborative in the sense that, okay, what could I do to make it worth your while to change something. So there’s a lot of negotiation, and it just goes step by step by step through this. Step One: The goal is for family members to develop a clear, specific definition of the problem from each person’s perspective. (This can be more difficult than it looks). Start with something positive. Validate the value of the relationship, the other’s value as a person, family member’s feelings, thoughts, legitimate actions. helps create a receptive atmosphere demonstrates a desire for a collaborative discussion demonstrates that problems in the relationship are not the only things you notice Do not discuss making any changes until this definition has been specified. Make no attempt to solve the problem in this phase Be brief

24 COLLABORATIVE APPROACH (cont.)
Step Two: Be Specific Step Three: Express Your Feelings Step Two: Be Specific Formulate the problem mindfully in terms of behaviour (e.g., behaviour of other person in this situation, rather than the situations themselves or the personality of the other person). Be descriptive. What is it about the behaviour that is problematic (e.g., frequency, time, place of occurrence)? Step Three: Express Your Feelings How do you feel when the other person engages in this behaviour? What are the consequences? Validate your own feelings; that is, do not disown them as “wrong” or “foolish.” Be careful not to downplay or exaggerate how you are feeling in order to protect yourself or punish your relative. Doing so is self-invalidating.

25 COLLABORATIVE APPROACH (cont.)
Step Four: Identify Your Role in the Problem Step Five: Deal with Only One Problem at a Time Step Four: Identify Your Role in the Problem Most problems are mutual problems. Avoid placing the sole blame for a problem on the other person, or yourself. Be specific. What do you do (or what you have not done) that may contribute to the problem behaviour, including its maintenance? Step Five: Deal with Only One Problem at a Time Avoid the temptation to go into a list of complaints. (Puts people on the defensive) Keep the problem at a level that is solvable. One thing at a time, not more than one.

26 COLLABORATIVE APPROACH (cont.)
Step Six: Summarise What the Other Person is Saying Step Seven: Avoid Making Inferences about the Problem Behaviour: Stay Mindful Step Eight: Commitment Step Six: Summarize What the Other Person is Saying Increase understanding by highlighting areas of miscommunication or misperception. Validate the other person’s statements and perceptions (This will slow you down and keep you from reacting impulsively) Step Seven: Avoid Making Inferences about the Problem Behaviour: Stay Mindful Talk only about what you observe (e.g., “When you do X, I feel Y”) Keep discussion of problem on track. Avoid blaming the other person or yourself (e.g., character judgments, ascribing motives). Step Eight: Commitment Make sure you want to solve the problem - does it need to be solved, or just understood? Do you all jointly commit to working on a solution? Or, do you agree that just talking about the issue so far has been a sufficient benefit to the relationship and may have resolved anything corrosive going on? If this is true, tension should be decreased, and both people should notice the decrease (see Relationship Mindfulness, and Validation handouts). Commit to visit this issue again to make sure it is OK. (Note when.) (e.g., you can say: “Are you willing to work on this? Can we talk again tomorrow to iron out details?” During entire process, keep things simple. Don’t keep rehashing things)

27 COLLABORATIVE APPROACH 8 steps summary
Define the problem. Be Specific Express Your Feelings Identify Your Role in the Problem Deal with Only One Problem at a Time Summarise What the Other Person is Saying Avoid Making Inferences about the Problem Behaviour: Stay Mindful Commitment

28 Role Play Lynda to introduce the situation
Identify the problem - When I go to work and Jane is not up Sarah is not being supervised and is potentially unsafe. Possible solutions brainstormed in advance Identify the outcome you are working towards - what I would like is to be able to go to work unstressed knowing that Sarah is safe, with Jane up. Raise the issue when both in a good place, calm. Not when the problem is happening. Lynda and Liz to role play. Class to observe. Rod to lead discussion after about the 8 points – were they covered? Liz :Jane, you’re a great mum. I know you always try to put Sarah first. There is a problem though, which is that Sarah’s not safe when I’ve gone to work if you aren’t up to look after her. Lynda – Of course I always put Sarah first. She’s the reason I’m alive! Liz – Yes, I know you really care for her. She always looks well dressed and happy,. However, there have been times when you haven’t been up when I leave for work and she’s not supervised. I feel very worried about her safety. Lynda – Well, how am I supposed to get up when I don’t get enough sleep. Sarah wakes up really early and I just can’t get up. It’s not my fault I cant get up. Liz: Yes, it must be really hard to get up when you haven’t had much sleep. In the past I have often looked after Sarah in the mornings. I wanted to help you, but I’ve realised I can’t keep doing this. Lynda – Well, why can’t you look after Sarah in the morning? Liz: I understand this is really hard to talk about. I get really stressed going to work knowing Sarah is unsupervised, and would like us to try to think of some way we can resolve this problem. Lynda – What can I do? I don’t know what to do. Anyway, Sarah’s fine – she just watches TV, she’s OK. Liz – Jane, I’m really worried about this. Are you willing to work with me on this? Perhaps I could wake you up half an hour before I leave for work so you have time to wake up properly and have a coffee before I go. How does that sound? Wold you like to think about this and we can talk again in a day or two? Lynda – I don’t want to talk about it any more now. I can’t get up. A day or two later: Liz – Jane, have you had a chance to think about how you might be able to get up in the morning to look after Sarah? Can we try what I suggested for one morning a week? Lynda – OK, whatever Liz – OK, let’s try it on Wed.

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30 COLLABORATIVE APPROACH - PROBLEM CHAIN ANALYSIS
Steps Choose a specific instance of the problem to analyse. Describe the sequence in detail, step by steps, like you would describe a chain reaction. Remember that if we understood every detail, every person’s behaviours would make perfect sense. Benefits of using this process are that it helps to keep things specific and descriptive. It demonstrates how behaviours make sense in a context which reduces blame, and it ratchets down negative emotions that can interfere with thinking and problem management. Best used for interpersonal problems or misunderstandings, or recurring arguments or disagreements. Other problems might be better handled with negotiation. All of the following aspects of the interaction will be links on the chain: Vulnerabilities that you bring to the situation – was I hungry, tired, cold, hurt, distracted etc? What was the trigger or prompting event? What were my emotions, thoughts, judgements (inside my head) What did each of you say? Did the “interaction” work? Good to use if both people have a level of skill in expressing accurately, and validating. Can be hard to do, because as soon as somebody feels misunderstood, or starts to escalate, or not express accurately, or fail to validate, the willingness to do this collaboratively can evaporate very quickly; and then, of course, you can’t proceed in this way.

31 PROBLEM CHAIN ANALYSIS
The chain depicts your thoughts, emotions and feelings – and the other person’s thoughts, emotions and feelings, each on a separate chain. Where the chain joins up into a larger circle, these are the common links, where the 2 parties are in a room together and there is an interaction between you both. The links before the interaction are important as they influence the interaction. Example: Your thoughts about a situation may be resentment, disappointment, anger, frustration, etc. Your loved one may be thinking that its not a big deal/not important. The outcome of the interaction is either positive or negative. The larger circles (where you come together) are where you insert a change e.g. you might be more explicit about how you explain what they need to do, or they may agree to write a post-it note to remind them to do something. You use the chain yourself to chart the flow of thoughts and evaluations to see where you can insert change. You do this yourself – you don’t sit down and work through the chain together. Just conceptualise it in your head. You are trying to turn ineffective action to effective action. Only takes one link to change the chain. Use it to process your own emotions. This is a DBT tool, used in therapy. If for example, the therapist is targeting suicidality they will use the chain to try to identify what happened just before the suicide attempt. Slice up what happened into tiny steps. Ask where you can make a change. Sometimes it is what happens at the beginning of the chain that is important e.g. not getting enough sleep, or not eating properly. Example: A person cuts themselves. The therapist identifies that this helps the anger and sadness they are experiencing to disappear for a while. However they still feel some shame at doing this. After the chain process, the therapist can ask how they feel now – has the anger, and sadness and the shame gone? If not, is there another skill that would work better?

32 Links on the chain include
Vulnerabilities Trigger, or prompting event Emotions, thoughts, judgments (inside somebody’s head) What each of you said. Did the interaction work? Situation – A teenager who is not yet 18 insists on disregarding curfew time, and basically doesn’t keep her parents informed about what she is doing. It’s Sunday, and last night she was supposed to be home at 1:00am, but came home at 3:30am. When she was not home at 1:30 you sent her a message saying “Are you OK? You’re not home”. Maybe she ignores it but let’s say she wrote back saying “I’m fine. I’ll be home soon.” At that point you have a tough decision. Do you say “OK, come home now?” How do you do that? If she doesn’t what do you do? You don’t want things to escalate. You decide to write back one more time “I’m glad you’re OK but I really want you to come home now. Your curfew was 1:00 and its already 1:40.” She then ignores you. Fast forward to Sunday afternoon. She’s got a good night’s sleep, and you’ve had a chance to think about this. In the context of problem management, you might say “Look, you didn’t come home until after 3:00am. Your curfew is 1:00. This isn’t OK, so we’ve got to do something about this. So I want you to try to figure out A how to help; you come home on time, and B, I want to figure out what consequences there are just for not doing what you’re supposed to do.” To help you understand why she did that, you might start with the chain. Her part in the chain is …OK, what was she thinking at 12:30 or 12:45 when it was time to come home. What was going on? What was she doing? That’s her chain. At this point she has the opportunity to say she was with friends, having fun, and she felt a lot of pressure to stay. What you might learn from this is that your teenager doesn’t have the skills to overcome peer pressure. Just punishing her (which might be perfectly appropriate) doesn’t help her to learn this important skill. Maybe you find out she was having a great time and that she just cant fathom out why it matters. She’s safe, at a friend’s house. Why is it such a big deal? She decided to stay. So now she is missing 2 skills – firstly the transition from having a great time to stopping it. That’s hard for many people, not just kids. Or maybe the skill is being able to remember that actually there was an agreement, and this is important to you.

33 That’s where your chain might come in
That’s where your chain might come in. Your chain starts when you start to worry about her. The reason for the curfew is about safety, and structure, and to do with her sleep cycle, because if she gets to bed late and sleeps in late then she has trouble going to sleep on Sunday night, and getting to school on Monday morning is a problem. There may be all kinds of things on your chain that she’s unaware of. Those are your things that you are thinking about, and paying attention to.. These are the things that led to the curfew in the first place. So those 2 chains collide at 1:00am when she decides to stay at the friend’s house, and you notice she’s not home. What were you feeling? Worried – well, she might not have understood that. She might have thought that you were just stuck with all these different rules in your head. By walking through the problem, you realise you have a bunch of problems to solve. Its not going to be as simple as saying “You’re grounded for a week” – or whatever else you would do. She needs more than that. It may be that you come up with solution A: which is some negative consequence for her blowing her curfew, but then B: maybe there’s a more flexible curfew. Maybe if she’s at a friend’s house, and the parents are home, maybe you decide the curfew could be 2:00am. Maybe you don’t. Maybe you work on the sleep cycle – maybe that is the bigger issue. So maybe she agrees that whatever time she gets to bed, she’ll be up by 9:00am, no matter what, and she won’t take a nap – so that she can sleep better on Sunday nights. That may be worth it to her, to stay out later . Or maybe it’s not safe at all, in which case you absolutely observe your limit and say “No, no, no. You can’t do that and this si what’s going to happen. Let me help you. This is how I’m going to help you make that decision, or this is how I’m going to help you overcome peer pressure” or son on. So the chain, step by step, allows her to understand your love, your caring, the reasons for the rules; and allows you to understand what makes it so hard for her to actually obey the rule or do what she’s supposed to do; because it’s probably not a simple solution.

34 PROBLEM CHAIN ANALYSIS (cont.)
Things to think about Vulnerabilities – choose your timing. Is now the right time? Trigger, or prompting event – be clear about what this is, will help you understand and define the problem Emotions, thoughts, judgments - be mindful of these, yours and the other person’s Use accurate expression – use mindfulness to identify what you feel and want. Afterwards (whether it worked or not) Consider what each of you said Did the interaction “work”?

35 When there is agreement - contract and commit to a solution
Commit to a trial period, if possible Specify what each of you will do Discuss the pros and cons of your solution. Is it realistic? What could get in the way? Troubleshoot any problems likely to sabotage your solution. Commit to continuing to try EVEN if your first (or second or third) efforts are not successful. Remember: If it was easy, you would have solved this long ago. Support and validate each other for your hard work Set a date for checking in on how the solution is going, and revise and recommit as needed.

36 Tips You can always try again another time!
Try to stay mindful of what you want to achieve. Brainstorm possible solutions that work for both Win/win vs Lose/lose or Win/lose If any one person wins, and the other loses, then the relationship loses Negotiate, negotiate, negotiate

37 When Change is Not Happening
Put the issue on the shelf for a few days, if possible Observe your limits. Sometimes you might need a time out, or ‘Relationship Vacation.’ Put the issue on the shelf for a few days, if possible. Timing can often make a big difference. Consider whether the person is able to give you what you are requesting. Do they have the capability to do it, i.e. Can they call you when you want them to? Observe your limits. Does the person’s behaviour go beyond what you are willing to tolerate, what is healthy for you to tolerate, or what is healthy for them for you to tolerate? If yes to any or all of the above, remove yourself from the situation and/or decline to comply with a request. Sometimes you might need a time out, or “Relationship Vacation.” This might be a consideration if and when the other person is not willing to work towards problem solving a particular issue that you feel is crucial at that moment in time and is truly burning you out.

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39 When Change is Not Happening
Another option is radical acceptance of the reality, if changes that you want are NOT actually happening Non-Acceptance/non-change really is a place of intense suffering Accepting that what you want is not happening can be just for now. It may not always be this way. If we continue to try to get what we want, the way we want it, we are going to lose something that we care about more – like our relationship or our happiness. Remember that if the problem is safety related, e.g. a violent relationship, it should be resolved and not be radically accepted.

40 True Acceptance – How to do it
Step 1: Cease and desist, tolerate Step 2: Be mindful of negative consequences Step 3: Let Go Of Suffering and Engage In Your Life As It Is

41 True Acceptance - Steps
Step 1: Cease and desist, tolerate Don’t try to make the other person change his or her behaviour (unless it is dangerous), at least for some period of time (weeks or months) Tolerate your own disappointment, even get yourself to grieve the loss of what you wanted and are letting go of; let go of judgments and anger (acknowledging judgments and not expressing them, but focusing instead on sadness will help reduce them) Accept that the other person’s behaviour may still bother you. (e.g., not willing to go to AA meetings). Step 1: Notice you aren’t getting the progress you want. Tolerate your own disappointment – work on letting go of judgements and anger (acknowledging judgements and not expressing them will help reduce them – practice being descriptive instead) Don’t try to make the other person change their behaviour (unless it is dangerous) Accept that the other person’s behaviour may continue to bother you.

42 True Acceptance - Steps
Step 2: Be mindful of negative consequences The focus turns from tolerating disappointment/anger to noticing the full range of effects of your previous “don’t accept” position. The consequences of disappointment and anger often include: being more vulnerable to further conflict more emotional distance from the other person more misery for the other person more misery of your own one or both stop participating in the relationship, which leads to further distance, conflict and unhappiness

43 True Acceptance - Steps
Step 3: Let go of suffering and engage in your life as it is Understand “meaning” of the other’s behavior In her or his history Given current/typical context Related emotions, beliefs, desires Practice “stimulus control” (and mindfulness), or adjusting the things to which you pay attention (seeing the whole, not just the undesirable parts) Engage fully in your life as it is rather than being side-tracked by non-acceptance. Step 3 If accepting the problem forever seems like too big a step to start out with, pick a trial period and see how it goes Try to understand the meaning of the other person’s behaviour given Their history The current or typical context Their emotions, beliefs, desires, etc In the future if that thing starts to bother you and you start to nag again, restart the process Tactics to try Stimulus control – adjusting the things to which you pay attention. Focus on what is as opposed to what is not. Noticing these things does not mean you have to agree with them or condone a behaviour. But adjusting what you pay attention to can help you get from a place of suffering that cannot be tolerated to pain that can be tolerated, and maybe even a place of compassion. Practice distracting – engage fully in your life as it is rather than being side-tracked by non-acceptance or obsession over the problem. Go to the movies, dancing, Tahiti! When you are calm and in wise mind, think about if the other person were not here – what would your life look like?

44 If you don’t want to stay miserable, then realistically, you must focus your energy on either effective acceptance, or change..... something different from non- acceptance/non-change.

45 MATCH YOUR STRATEGIES TO YOUR GOALS
IF YOUR GOAL IS TO: THEN TRY THIS STRATEGY Sort out your feelings Describe the situation, your reactions Communicate emotions, opinions, wants Describe them Support the other person Validate the other person Correct injustice Negotiate Induce the other person to change (they must want to change)! Mindfully engage in Problem Management together

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48 Take care! Family members do burn out.
You need to take care of yourself.

49 Exercises For next week: What have you learnt from this program? What skills do you need to practice more? Bring along some situations to brainstorm or practice.


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