DBT PLEASE Skills in a Pandemic
When you hear the world “self-care”, what comes to mind? A bubble bath? A pint of ice cream? Turning off your alarm and sleeping in? Self-care is something that comes up constantly in therapy, as it is the practice of taking care of ourselves. Sometimes this means decadence and treating yourself, and sometimes this means doing the hard thing, like waking up 20 minutes earlier to practice a meditation or make sure we eat breakfast.
In DBT, we often talk about the importance of taking care of our bodies to take care of our minds. The PLEASE skill is at the core of self care and our well-beings! PLEASE is an acronym that stands for: treating physical illness, balanced eating, avoiding mood altering substances, sleeping, and exercising. This is a skill that is often met with a sigh or eyes rolled when we teach it in group, because it likely feels so obvious (even though we may struggle with practicing it!). I often hear people replace breakfast with iced coffee, routinely forget to take their medicine, skip their vitamins because they ran out, try to tough out a sports injury without seeing a doctor, and the list goes on and on. Does any of this sound like you? Of course it does, this is all of us! Life gets busy and taking care of ourselves is a tremendous amount of work. At the same time, when we’re focused on our PLEASE skill, we’re laying out the foundation we need to increase stability in our lives.
Then came a Covid-19…
March 2020 was certainly an unprecedented time. Suddenly, we were cut off from many of the things that help regulate us and keep us feeling engaged and excited in our lives. We all know that anxiety breeds in uncertainty, which abounded at that time, and we know how easy it is to get into a mindset that there’s no harm in staying up well past midnight, to overindulge in a number of ways, and to abandon the things we typically do to keep ourselves healthy because things are tough! The reality is that the PLEASE skills are hard to prioritize during regular times, so it was no surprise that when our world was flipped upside down these skills went out the window.
Although we are now in a new year, and have adjusted as much as possible to this new normal, it seems as though we’re all starting to feel the impact of a bitter winter without much to do. We once again need to come back and re-center on the PLEASE skills. In taking a look at this seemingly simple skill, take a moment to ask, “what is off?” and “what am I missing?” This is the skill that gets us back to basics, and serves as our emotional bubble wrap when we need it most. Making the smallest changes in these areas, and being more mindful of our body, can make a tremendous impact on our mood, even in the midst of this Covid Winter.
Without judgement and self criticism, it is a helpful daily practice to turn inwards and take notice of what we can control to enact small, but meaningful change. Perhaps it is building a better nighttime routine, or focusing on drinking more water everyday. In DBT, we always aim to set realistic goals, meaning we look to take positive baby steps, not demand unattainable perfection. Take a moment and ask yourself: what on my PLEASE list can I work on today?
Treating Physical Illness: taking medication as prescribed, going to the doctor when needed.
Balanced Eating: eating when you are hungry, not restricting or eating past the point of being full. This can also include planning out meals ahead of time to not make emotional decisions about food. The balanced part of this skill allows us to decrease black and white thinking about food, which can lead to restricting and then overeating/binging.
Avoid mood altering substance: alcohol, nicotine, e-cigarettes all impact our mood. As does caffeine!
Sleeping: create a nighttime routine to help fall asleep, get enough sleep for you body, practice DBT Sleep Hygiene Protocol
Exercise: get fresh air everyday! Move your body in a way that feels good- if that is running, fantastic, if that is walking, that is superb. Do not compare what works for other people- any exercise that you are willing to do is good exercise!
-Carolyn Goldman