Category Archives: Anxiety

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DBT Grounding Techniques – Part 5 Putting It Into Use

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Part 5: Putting It All Together – Creating Your Grounding Ritual

You’ve now explored Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness—each offering powerful tools to help you stay grounded in difficult moments. But real-life challenges don’t always fit neatly into one category. That’s why the final step is about combining these techniques into a structured grounding ritual that you can turn to whenever you need stability.

When emotions overwhelm you, drawing from all four DBT modules can create a powerful and structured grounding ritual. Combining these practices helps you address the physical, emotional, and relational aspects of distress, guiding you toward calmness and control.

By integrating skills from all four DBT modules, you can create a personalized approach to managing distress, regulating emotions, and staying present—even in the toughest moments. Let’s explore how to bring it all together.

Step 1: Pause and Breathe Deeply (Mindfulness)

Start by grounding yourself in the present moment. Mindfulness creates the mental space needed to approach the situation with clarity.

How to Practice:

  • Take a deep breath, inhaling for 4 counts, holding for 4, and exhaling for 6.
  • Visualize your breath as a wave, washing tension out of your body.
  • If your thoughts wander, gently guide them back to your breath without judgment.

Why It Works:
This activates your parasympathetic nervous system, calming your body and quieting your mind so you can think more clearly.

Step 2: Splash Cold Water on Your Face (Distress Tolerance)

Engage your body to interrupt the cycle of emotional overwhelm. TIPP skills are especially useful for regaining control in the moment.

How to Practice:

  • Use cold water, hold an ice cube, or place a cold compress on your forehead or cheeks.
  • Pair this with paced breathing to further calm your system.

Why It Works:
The temperature change triggers your dive reflex, reducing heart rate and calming the body. This brings you back to the present.

Step 3: Challenge the Thought Causing Overwhelmedness (Emotion Regulation)

Once your body feels calmer, examine the thoughts driving your emotional reaction.

How to Practice:

  • Ask yourself: “What triggered this feeling? Is it based on facts or assumptions?”
  • Use the “Check the Facts” technique to reframe exaggerated or unhelpful thoughts.
  • Example: Replace “I can’t handle this” with “I’m feeling overwhelmed, but I can take it one step at a time.”

Why It Works:
Shifting your perspective helps you address emotions logically, reducing their intensity and making them easier to manage.

Step 4: Communicate Using DEAR MAN (Interpersonal Effectiveness)

If another person is involved in the situation, use DEAR MAN to express yourself effectively and maintain the relationship.

How to Practice:

  • Describe the situation: “When you didn’t respond to my message…”
  • Express your feelings: “…I felt hurt and unsure if you were upset with me.”
  • Assert what you need: “I’d appreciate a quick reply, even if it’s just to say you’ll respond later.”
  • Reinforce the benefit: “This way, I’ll know everything’s okay between us.”

Why It Works:
Clear, calm communication reduces misunderstandings and fosters connection, even in emotionally charged moments.

Creating a Flow for Your Grounding Ritual

  1. Pause and Focus (Mindfulness):
    Take 1-2 minutes to ground yourself through breathing or observing your surroundings with the Five-Senses exercise.
  2. Shift Your Physical State (Distress Tolerance):
    Use a temperature-based TIPP skill or self-soothing technique to calm your body. Radical Acceptance of the situation may assist now or at the next stage in this flow.
  3. Examine and Adjust Your Thoughts (Emotion Regulation):
    Check the facts or use opposite action to address unhelpful emotional patterns.
  4. Engage With Others Mindfully (Interpersonal Effectiveness):
    If the situation involves another person, use DEAR MAN or FAST to maintain your boundaries and self-respect while fostering understanding.

Example in Practice:

Scenario: You’re feeling overwhelmed after receiving criticism from a colleague.

  1. Mindfulness: Step outside for a moment, take a deep breath, and focus on the sensation of the air against your skin.
  2. Distress Tolerance: Hold a cold water bottle against your wrists to calm your body.
  3. Emotion Regulation: Ask yourself, “Was their criticism factual, or am I interpreting it as a personal attack?” Reframe the thought: “This feedback is an opportunity to grow, not a judgment of my worth.”
  4. Interpersonal Effectiveness: Use DEAR MAN to address the issue with your colleague:
    • Describe: “When you shared your feedback earlier…”
    • Express: “…I felt caught off guard and a bit overwhelmed.”
    • Assert: “I’d like to understand more so I can improve.”
    • Reinforce: “This will help me meet expectations better in the future.”

Why This Works

By integrating techniques from all four DBT modules, you address the emotional, physical, and relational aspects of distress. This holistic approach helps you regain control, navigate challenges effectively, and build resilience over time.

12 Step Meeting, Anger, Anxiety, Belief, Choice, Depressed Anonymous, Depressed Anonymous Workbook, Fellowship, Grief, Higher Power, Journaling, Negativity, Purpose, The 12 Steps

When you’re depressed all you’re interested in is survival – Dorothy Rowe

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THE ORIGINS of MISTRUST

I want to share with you how Dr. Fitzgibbons, a psychiatrist, provides examples how our lack of trust can originate in early childhood. Patterns of isolating behavior and negative thinking, grow strong in a home environment where the child is not loved and nurtured.

Dr. Fitzgibbons, tells us “that the seedbed of mistrust resides in childhood. Many times this lack of trust, of others and ourselves and the world around us, may have begun with the loss of a parent, sister, brother, or a close friend. A serious illness in a parent, sibling or oneself can be the cause of depression. Many times mistrust comes about because of an alcoholic parent so that a child never knows if a drunken loved one is coming home, or in an angry drunken stupor. Anger and rejection by caregivers and/or peers can also have an effect on the ability to trust. Parental divorce or separation can have an effect on a child. Also a cold distant, and unloving parent can have a negative effect on a child. Add to this, a legacy of mistrust and fear in the family will negatively influence a child. Finally, poverty may also be a cause of mistrust”

Brenda, (not her real name ) shares with us some of her own story:

“I have often reflected on how a lack of trust in myself and in others, had a crippling effect on my early childhood development. It was only until I began examining my own childhood, later in life, that I discovered reasons for my mistrust of others. I accomplished these discoveries by getting in touch with those early negative feelings that constantly bombarded my everyday thinking. Most of these early feelings remained unconscious and hidden, until I started to examine my childhood relationships, especially with those significant others who were my caregivers.”

By utilizing the Depressed Anonymous Workbook with its’ 12 STEP COMMENTARY, and questions, directed toward one’s early life experiences, special attention was centered on those caregivers and significant others in one’s family, who, charged with caregiving, to provide the child with the love that a child deserves. For many children, who grew up in a home environment, filled with anger, parental arguing, and violence, made it impossible for a child to defend themselves against such abuse, including mental, sexual, and physical abuse. Some children create fantasy worlds, some with imaginary friends, with whom they can confide in and feel secure in a home environment where chaos reigns.

In our Depressed Anonymous fellowship, we can begin to open up to group members, giving us that opportunity to share and trust, others, who are like ourselves. We happily discovered that we are now no longer alone. Most of us come to our program of recovery, looking to find help, and that welcome relief from the daily crippling burden of depression, which has forced us to isolate from others, believing that we are not good enough.

Earlier, Dr, Fitzgibbons has listed some of the major causes of our childhood depression, and we can resonate with them within our hearts and minds. And in your moments of personal quiet and reflection, celebrate who you are and not who others say you are.

So get a notebook, and begin to write down your answers to those questions in the DA Workbook, which hold meaning for your own personal life and recovery, to which you can relate. Share your DA Workbook with your therapist, sponsor or friends in Depressed Anonymous at the ZOOM meetings online, and/or face to face meetings.

So now, not only will you be a survivor, you will no longer be a victim of those circumstances, which made you believe that you were worthless, unlovable and unacceptable. Progress, not perfection.

By completing my Fourth Step inventory, it became possible to uncover those areas of my early life which made trusting an impossibility. As mentioned earlier, and later into my early adult life, it was my own spiraling downward, into the darkness of depression, the only thing that I could think of was my survival. I was desperate to stop the descent into the darkness and physical pain. I knew that I must get active, preventing my paralyzing desire to take comfort in sleep and shut out the world.

My life is very different now. I continue to take inventory of my life on a daily basis and I finally believe in myself and the Higher Power that has helped me believe that I have a purpose and a meaning for my life. I also believe in a power that is greater than myself and who continually leads me, everyday, on this wonderful journey of hope! Progress and not perfection.

TRUST IS A FEELING OF BEING SAFE IN RELATIONSHIPS AND IN LIFE.

HUGH S., FOR THE FELLOWSHIP

12 Step Meeting, Anxiety, Despair, Fear, Fellowship, Grief, Pain, Powerlessness, Stress, Suffering, Supportive Actions, The 12 Steps

Proneness to depression

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“It must be repeated again that I consider, injustice, discrimination, material deprivation and painful disappointments as such and as causes of depression and depression-pro ness. What causes depression is the discrepancy between what children–and adults have learned to believe and expect, and the reality they meet. This discrepancy, when uncomprehended, causes chronic lack of self-esteem, or the loss of self-esteem that, writes Birling, has been associated with severe depression. Men and women can bear a remarkable amount of misfortune and grief, as long as they need not see them as a result and proof of their own inferiority.”

Excerpt from Emmy Gut, Productive and Unproductive Depression. Harper, SanFransisco. 1990. p.195. as quoted in THE ANTIDEPRESSANT TABLET (1991) SUMMER VOLUME 2:4. p.3

Anger, Anxiety, Depressed Anonymous Workbook, Honesty, Hope, Positivity, Supportive Actions

How do I deal with anger in my life?

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DECISION 8: I WILL BE MORE ACCEPTING OF ANOTHER’S ANGER AND NOT ALWAYS TAKE IT PERSONALLY.

When you are both the focus and the cause of the person’s anger, you will need to find responses other than cutting yourself off from the person, by doing that, sharply reinforces your barrier of loneliness.

D.Rowe tells us that we find the cause of the anger and discuss the matter. For whatever reason for the anger, it might be best to write a letter the person. Or, Possibly, a friendly visit between the two of you will help solve the problem.

Making an apology when we see ourselves trapped, weak, worthless and hopeless, by making an apology to the person who caused the anger, seems frightening and humiliating.

Making amends, an apology to those we have injured us, seems gracious and creative, allowing a relationship to be strengthened and resumed.

In some families, there was no teasing, absolutely not. Maybe outside the family it might be allowed. Everything in the family was 100% serious. If a family member was teased, then this could result in a sulk and long term silence.

But in school, children might be teased, but never knowing how to tease back. We want to distinguish between friendly and malicious teasing. We could put bullying at the top of the list as one of the most harmful ways of malicious teasing. When I make an effort to get along with other people, distinguishing between friendly or imaginary teasing, this makes our relationship stronger, the other builds barriers.

TOMORROW DECISION 9: I WILL IMPROVE MY SKILL IN DISTINGUISHING BETWEEN REAL AND IMAGINARY ENEMIES.

12 Step Meeting, Act As If, Anxiety, Avoidance, Depressed Anonymous, Depressed Anonymous Workbook, Fear, Isolation, Mutual Aid, Purpose, Step 01, Step 02, Step 03

LEAVING LONELINESS BEHIND – DISMANTLING THE BARRIERS

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Leaving loneliness behind. Dismantling the barriers.

THE TWELVE DECISIONS
What is loneliness?

“Loneliness is the state of being cut off from other people, through fear of other people. Loneliness is felt as a barrier and an emptiness between yourself and other people. You reach out to other people but the barrier intervenes. You take a step toward other people, but there is no place to put your foot. People come towards you and your loneliness shuts them out.”

“It is your loneliness rather than the absence of other people that leads you to be alone.” Dorothy Rowe. Ph.D
The only person that is going to take your loneliness away is you. This is what you do. You make 12 decisions and carry them out.

DECISION 1. BECAUSE I VALUE MYSELF AND ACCEPT MYSELF I WILL END MY LONELINESS.
In our planned conversation about how to leave our loneliness behind, I have noticed my own presence, as at a Depressed Anonymous meeting, whether on ZOOM or Face to face, each of us is provided a way to risk telling others who we are and what we are not. This presence gradually instills in our mind the fact that “Hey, I feel more with others when I can share.” I no longer feel so alone now. After our sharing at a DA meeting, others in the group connect with who we are.This personal sharing tells others how we intend to live out our lives. We share how our lives were before coming to the meeting of others like ourselves.

I believe this personal sharing and risking things about ourselves, will carry out beyond this one hour of meeting, having a gradual and positive effect in our world where we live out our lives. Now, you are able to maximize a good experience (group sharing) being being accepted and loved. This online group or a face to face group, is like a surrogate family. Whereas, when you were born into a family–not of your own choosing, you make a decision to choose this DA group as your family. I make a choice as to who I share my life. By making the decision, you will begin to value yourself as a worthwhile person. At the meeting, people really listen to what I have to say.

It helps to get close to others by helping them tell us who they are. We will hear their stories. And to get closer to others, you can do this by asking questions, asking how they are, what they are interested in, and other areas of their lives. They will begin to let you into their private world. You will let them into your world. A barrier has been dismantled.

This sharing at our DA meetings, a place of feeling safe,I can allow myself to chip away the barriers that once made me feel alone and afraid. THe old thoughts that we once felt we had to defend ourselves against, by erecting walls, built during our childhood days, will no longer be needed.

It is this first decision that we make, to value and accept ourseves and risk sharing my story with others. This will be the start, for breaking down those barriers which kept me from telling others who I am.

Tomorrow, we will Share Decison 2: “I will take the risk of approaching others.” Stay tuned.

Hugh S.

NOTE: Quotations are from Dorothy Rowe’s “Breaking the bonds. Understanding Depression, finding freedom. Fontana, 1991. London, UK.

Anxiety, Focus, Purpose

Slow is smooth, smooth is fast

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Slow is smooth, smooth is fast.
– Navy Seal credo

If I am in a frantic state, I will make many mistakes. Then I need to do things over again and that takes even more time.

If I do things slowly and follow a process I am far less likely to make mistakes. I need to do things right the first time. The best way that I know to do that is to follow a process. I can have processes about many things: how I shave, how I iron a shirt, how I troubleshoot a problem in my professional IT career, how I approach my recovery from depression and anxiety.

Sometimes in a highly excited anxious state it seems incredibly hard to slow down and calm my mind. I sometimes see my issues with anxiety as a block of wood with really rough edges. I may not be able to have a smooth block of wood immediately. I can however start the process of sanding down the roughest edges of my anxiety. My anxiety may be so intense that I can’t go from frantic to calm and serene. But perhaps it is possible to lessen my anxiety by 1%. I will be in a better place of mind. I want to be serene and calm, but in this moment I may only be able to achieve a 1% reduction.

Progress not perfection.
– 12 step recovery slogan

Another benefit of having a process is that you will develop muscle memory about the process. When in the thick of a fight, or deep in anxiety, it may not be able to think clearly. Wouldn’t it be great to have muscle memory about a process that you can follow?

It is better to sweat in training, than to bleed in war.
– Wisdom sometimes heard in military training

This week at work there were some major problems. Systems critical to the business were not functioning preventing action on revenue generating jobs. There was immense pressure to get those systems back online and functioning again NOW. As I felt the anxiety in me rise I would repeat the mantra several times and my anxiety would lessen a little bit. I had a process and it helped.

Slow is smooth, smooth is fast.

Yours in recovery, Bill R

12 Step Meeting, Acceptance, Addiction, Affirmations, Anxiety, Attachment, Compulsion, DA Literature, Fellowship, Grief, Hope, Purpose, The 12 Steps

The Circle Dance

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If you have ever been depressed or are depressed at this moment, you are familiar with the Circle Dance.

I know the dance steps well, and in fact, I could share with you some of the basic steps, illustrating familiar dance steps.

First of all, let me say that you already know those steps that automatically get you to perform the “Circle Dance. You get caught up emotionally, the moment certain negative thoughts come bouncing across the dance floor into your mind. You know them as that painful hollowness in your gut, a desire to quit the dance and lay down, or to bash yourself with thoughts of how bad you feel.

Sometimes, starting with those life events from childhood, when your caregivers, be they parents or guardians, made you feel worthless and unwanted. These thoughts and feelings are constantly triggered by those with whom you share this life. You avoid people, think of yourself as unlovable –and the dance goes on and on in your head.

The Feelings of hopelessness produces unpleasant feelings. The feelings produce an unpleasant mood and the dance begins. The mood speeds up the dance and whisks you away into that painful circle with its attendant anxieties, sucking you down into the mental quicksand, swallowing you with all the terror and fright of losing all hope, much less your future. The Circle Dance will take you, everyday and in every way, to where you know you don’t want to go.

This dance is familiar. It is like the helpless insect caught in the web of the spider. The why of this hellish addiction to sadness, is never fully addressed with any solutions or answers. We want to know how to stop it. How to control it. We ask ourselves, how is it that I am depressed? How did I get into this terrifying circle, this loop which keeps me locked in a mood of hopelessness and despair. Where did all this sadness, anxiety originate? Will I ever find a way out? Is the dance, on automatic pilot, going to destroy me? Am I, a victim, without a source of help? Is this the way life is for me to be–forever filled with misery?
So much of the time I feel like I am on a train, heading toward a precipice, with no way of stopping it or escaping disaster?

Through all this, pain and confusion, you become an expert dancer, in fact, you know of others who like you, are expert dancers — trapped in dancing within their own Circle Dance.

The dance, it is so familiar. It is a defense, a comfort. We gradually learn to use it to protect us from the pain, without ever having a clue as to how it took over my life.

“A famous psychiatrist, a Dr. Freud, once theorized “that the reason a person continues to do the Circular Dance within themselves, is an effort to touch an unpleasant early life behavior or that long since forgotten event, buried in one’s unconscious. The Circular Dance promotes our addictive nature and the compulsion to repeat, is an effort by our mind to remember what it was that is the cause of our present cycle of misery, spinning us around and around – looking for answers as to what we do and why we do what we do and feel the way that we do, but never able to unlock the prison of our sadness.”

The Depressed Anonymous 12 step fellowship provides us with a possible solution to this question of no longer allowing the Circular Dance to determine the our life’s direction.

It is my belief, after participating in Hundreds of Depressed Anonymous meetings, over three decades or more, that the compulsion to repeat these sslf-destructive thoughts and images, may be linked to early childhood periods, accompanied with their painful, traumatic events. It is in those early days, that our Circular Dance took root and began to keep us locked down in its circular loop.

It is here, in the 12 Step Fellowship of Depressed Anonymous, that those unpleasant feelings, resultant from physical. emotional and mental abuse by significant others (parents and/or guardians, others) can be shared, voiced and talked about safely, and confidentially in the light of the accepting fellowship that we experience in all of our mutual help meetings.

It is possible that with time, patience and work, that these early feelings of hurt and feeling worthless, to name just a few, can be identified and shown how they have affected us negatively in the way we feel about ourselves today. With the help and work of the group, we are able to locate and make conscious those early life experiences that have been pushed aside. Because the feelings were too powerful and painful to examine and so they were buried in our unconscious. Basically, we can say, that there is no longer a need for that compulsive and addictive Circular Dance that our mind had used to punish us with guilt and shame. We now have the freedom to live life, recover from the wounds of the past, and live life today with hope and purpose. That is my wish for you this day.. And for myself.

No one puts me down, for saying that I am depressed. We never hear a “Snap nap out of it” at our meetings. If we could “snap out of it” there would be no need for our meetings. With work, time and the fellowship we no longer need a dance that goes nowhere but down. Now we are spiraling upward. We thrive!

Hugh S., for the Fellowship

Copyright(c) Hugh Smith (1986, 2013) 2nd Edition. I’ll do it when I feel better. Depressed Anonymous Publications. Louisville, KY.
Pages 64-65.

All Or Nothing Thinking, Anxiety, Choice, Helpful Thinking, Hope, Mindfulness, Purpose, The Promises

Life is unpredictable

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Life is unpredictable. Every living organism operates with a certain amount of unpredictability and uncertainty. The uncertainty of life creates in us a desire for predictability. If we do not believe in the possibility of change, we would all be hopelessly lost and forever bored. Hope would be lost. Potential for a better life would never exist. When there is hope, change is possible. The experience of depression is much the same. Depression is so predictable and unchanging that we lose hope for the pain of our isolation ever coming to an end.

–Copyright(c) Depressed Anonymous, (2011) Depressed Anonymous Publications. Louisville, KY. From the Introduction, Page 20.

12 Step Meeting, Anxiety, Choice, Depressed Anonymous, Faith, Fear, Helpful, Helpful Thinking, Mindfulness, Mutual Aid, Positivity, Prayer, Stress, Supportive Actions

Catastrophic Thinking

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Dorothy Rowe shares with us some helpful thoughts on how to deal with those thoughts which we label as catastrophic.

Suppose that there is some event looming and you are frightened of what is going to happen. Your Mother may be coming to stay or you are required to go to the firm’s ball, or your daughter expects you to go to her graduation or your son wants you to take him along – all fearful events of course – and you can’t see any way of avoiding them other than being very depressed. Try something else. Write down what it is you are expected to do and then say, ‘if I do this, what is the very worst that could happen?’

Write down your answer and look at it in the cold light of day. If you have said ‘I’ll die’ then rejoice your troubles will soon be over.

If you have said, ‘I’ll make a fool of myself’ ask ‘What is the opposite of making a fool of oneself’? Then ask ‘Why is this important’? See if you dare commit to paper just how vain you are.

Then go back to the original situation and say, ‘How many different outcomes can I see?’ List them all, the good ones as well as the bad, the fantastic ones as well as the prosaic, see if you can predict what then actually happens. (No cheating by using self-fulfilling prophecies like ‘I am sure I won’t enjoy it.’)

Then there are the things that you feel compelled to do. No strange force is compelling you, not any person other than yourself. When you see your own values clearly you can ask, ‘Do I do this because I believe it is right or do I do it because the parent in my head tells me to and I am too scared to disobey’?

You are you, you are the parent in your head, you are the child who is scared to disobey. You can spend the rest of your life `going around as three squabbling people, or you can choose` to make into yourself one whole person.

Resource
Copyright(c) Dorothy Rowe. Depression: The way out of your prison. SECOND EDITION. 1983, 1996. Routledge, New York, NY.pp.225-226.

12 Step Meeting, Acceptance, Anxiety, Choice, Courage, Depressed Anonymous, Exercise, Faith, Fear, Fellowship, Helpful, Honesty, Hope, Isolation, Mutual Aid, Negativity, Positivity, Purpose, Spirituality, Step 12, Stress, Supportive Actions, The 12 Steps, The Promises

Depression made me think I was losing my mind, until I did two things that changed my life forever

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“What is happening to me,” I asked myself, as I spent another week of struggling to get out of bed. It was like a 500 pound lead weight had dropped on top of me. I felt that whatever commands I issued to my body, “like get out of bed,” the message never reached my body.

The only thing that I knew what to do was to force myself to move the body and hopefully the mind would follow, be it reluctantly. And that is exactly what happened. Every morning after was a struggle, but I did manage to push myself out of bed and I got myself to work. When work ended, I went home and immediately hit the bed. What’s going on here? I asked. I had no clue that what was the matter was that my body was shutting down and that my mind gradually became powerless to make any positive changes in my behavior or thinking.

It was only as I started to walk five miles a day in a local mall, just to promote the fact that I was up and out and able to get to work. I want to make the point here that even though this walking continued for over a year and half, I still was forcing myself to get out of bed. Every morning the debate in my head started all over again. By now I had developed some resistance to staying in bed and just realized, if I was to save my job, I had to walk.

Eventually, the walking was a way out of the prison that my mind had constructed. Eventually, I learned that the way I was living my life and the negativity that I had embraced in my thinking, together threw me into a deep dark pit. Before I was able to figure out what was happening to me, I became depressed. The more I tried to figure out, in my mind, why I was depressed the more I became further depressed, isolated and alone. Then I did something that changed my life to this very day.

The first thing that I did was to force myself to get out of bed and walk, walk, and walk some more. (I still walk three times a week). I know first-hand, the potential life-threatening nature of depression.

The second most important discovery for my recovery was to find a group of men and women just like myself, all who were depressed and looking for a way out of their depression. It was this 12 Step fellowship group, Depressed Anonymous, that has been an integral part of the way I live my life today. If you are looking for what I found, namely, a way to quit saddening yourself, this support group may be your lifeline as much as it continues to be for me today. And I still attend this meeting, even though I have not been depressed for many years, I attend because I find that I can help others to find the hope and peace that it promised and provides for me today.

Discover important information at www.depressedanon.com for our online virtual Zoom meetings which meet every day of the week. Other DA sponsored groups also meet during the week. There are no fees and dues. Come and share or just come and listen. You will find that you are not alone. We are all on this journey of hope together…and we do recover.

For the fellowship, Hugh S.