Out-of-ControlDBT-CBT is a life-changing recovery program that inspires people
to make the life changes that will change their lives.
This program has turned many defeated hearts into empowered spirits
that are psychologically prepared to take on the challenges of
GETTING ON and STAYING ON the Recovery Path.
Come join us in our journey.
Welcome to the DBT-CBT website!
This website contains a lot of information about the DBT-CBT workbook and program. It also contains actual pages from the workbook so you’ll be able to read parts of it and see some of the worksheets and charts.
How This Website Is Organized
HOME - That's this page! Here you'll get an overview of the DBT-CBT workbook and program...and information about how this site is set-up!
FAQS - Find answers to some Frequently Asked Questions about this program and workbook. Actual text from the Introduction and the FAQS section of the workbook are included.
EXCERPTS - See a “Table of Contents” which will show you some (but not all) of the topics discussed in the book. You’ll be able to read sections of the workbook, too.
ABOUT THE AUTHOR - You’ll learn some things about Dr. Melanie Sheets. She even answers some questions about herself.
SEMINARS AND PRESENTATIONS - Find out when and where Dr. Sheets is scheduled to speak on DBT-CBT. You’ll also find information about hosting a speaking engagement.
ORDERING - This is where you can order the DBT-CBT workbook and other program materials. Quantity discounts are offered and bulk quantities of worksheets and charts are also available.
FEEDBACK FORUM - Read some comments and reviews of the DBT-CBT program and workbook…and leave your own feedback!
CONTACT US - Find out how to contact Recovery Works Publications.
Notice: All information on this website is copyright protected.
DBT-CBT Is a Recovery Program for
Self-Destructive Coping Behaviors
Self-Destructive Coping Behaviors are things we do to feel better and
to change our mood. They are coping mechanisms that help us to
Numb-Out our feelings...and White-Out our thoughts. They help us
to avoid dealing with our pain and problems. They’re self-destructive because they cause us A LOT MORE pain and problems. When we make a habit of using these coping mechanisms, we end up losing many things that we cherish and value...things like relationships, jobs, kids, pets, housing, vehicles, possessions, trust, self-respect, our health and freedom...and more.
Check out the list of Self-Destructive Coping Behaviors below.
This list was adapted from Figure 1.C in the DBT-CBT workbook.
A List of Common
Self-Destructive Coping Behaviors
Avoidance Strategies
Denial • Oversleeping • Procrastination • Stuffing Our Emotions
Walking Off - Leaving • Withdrawal - Isolation
Flight into Activity (staying too busy to think about our troubles)
Eating Disorders
Anorexia • Bulimia • Overeating • Comfort Eating
Passive-Aggressive Behavior
“Harmless” Jokes • “Forgetting” (forgetting on purpose!)
“Accidents” (accidently doing something on purpose!) • Sarcasm
Procrastination • Talking Behind Someone’s Back • Gossiping
Physical Aggression
Towards People, Animals, and Property
Self-Harmful Behavior
Suicide Attempts - Gestures
Self-Mutilation (cutting, burning, scratching, hair pulling,
and other forms of self-inflicted body damage)
Substance Abuse / Dependence / Self-Medicating
Alcohol • Illegal Drugs • Over-the-Counter Drugs • Prescription Drugs
Vengeful Acts
Taking Revenge (getting even…or ahead!)
Verbal Aggression
Saying Hurtful Things to Others • Hostile - Threatening Remarks
Screaming Fits - Temper Tantrums • Threats to Harm or Kill Ourself
Telling People Off • Bluntness - Speaking Our Mind
Other
Gambling • Habitual Lying • Codependency - Enabling
Rebound Relationships • Promiscuity (sleeping around) – Affairs
Overshopping • Being the Drama King or Queen
Getting Involved in Other People’s Problems
Criminal Acts (stealing, property damage, setting fires, etc.)
High Risk - Reckless Behavior (driving too fast, “playing chicken,”
road rage, "taking chances for the fun of it," etc.)
How many of these things do you do? Most of us do MANY of these things...and we end up with a lot more problems to deal with!
Who Is This Workbook Designed For?
~~ The following information is excerpted from the DBT-CBT Workbook
(The FAQs section of the Introduction) ~~
DBT-CBT addresses the six major problem areas below. Examples of the types of problems we might have in each area are also noted. This workbook is designed to meet the needs of people who suffer from problems in SOME or ALL of the six areas.
1. RELATIONSHIP PROBLEMS
Conflict-Filled or Stormy Relationships • Abusive Relationships Relationship Disappointments or Frequent Ups and Downs
Unfulfilling Relationships • Short-Term Relations
Love - Hate Relationships • Few or No Close Relations
Fear of Rejection / Actual Rejection / People Have Pulled Away
Co-Dependency / Dependency • Attention-Seeking Behavior
Fear of Abandonment / Actual Abandonment • Mistrust
Mad at Everyone • Loneliness / Can’t Tolerate Being Alone
Shyness / Fear / Major Discomfort in Social Situations
2. MOOD SWINGS - DEPRESSION - ANXIETY - ANGER
Moodiness / Major Mood Swings • Easily Angered • Rage
Guilt / Shame • Being a "High Drama" Person
Unbearable / Intense Emotions • Anxiety / Panic
Depression / Helplessness / Hopelessness / Worthlessness
Believe Things Won't Get Better / Want to Give Up
Feel Out-of-Control / Overwhelmed / Suicidal
3. UNHEALTHY THINKING
Worrying / Overthinking / "Stewing" over Things
Dwelling on the Past • Preoccupied with Revenge
Pessimistic Thinking / Negative Expectations • Irrational Beliefs
Catastrophizing / Blowing Things Out of Proportion
Black and White / All-or-None Thinking
Putting Ourselves Down / Focusing on Our Worst Qualities
4. UNHEALTHY COPING BEHAVIORS
Please see the "List of Common Self-Destructive Coping Behaviors" above.
5. OTHER IMPULSIVE BEHAVIORS - BAD CHOICES
Doing Things on a Whim / Making "Snap Judgments"
Not Thinking Things Through and Having Negative Consequences as a Result
6. QUALITY OF LIFE PROBLEMS
Burnt-Out / Life Is a Chore • Nothing to Live For
Emptiness / Meaninglessness / Boredom
More Problems Than I Can Bear • Must Start Over
Financial Problems / Bankruptcy • Job Loss / Can't Keep a Job Loss of Career or Professional License
Demotion / Probation at Work • Loss of Relationships
Family Pulled Away • Can't See Children
Loss of Trust From Others • Reputation Damaged
Loss of Self-Respect and Integrity • Loss of Self-Confidence
Problems Getting an Education / Not Completing Semesters
Underachievement • Loss of Housing • Loss of Transportation Loss of Possessions • Loss of Pets • Loss of Freedom
Legal Problems / Probation or Imprisonment
Health Problems / New Medical Diagnosis
What the DBT-CBT Workbook Is All About
~~ The following text is excerpted from the three section summaries,
the "Rest Stops" in the DBT-CBT Workbook ~~
Section One - "Why Is My Life So Out-of-Control?”
This section helps us to understand our Emotional Mind and our Emotion-Driven Behavior. It explains why we become so overwhelmed with our emotions...and what happens when we act on an out-of-control Emotional Mind. The process of relapse and recovery is also addressed with the focus on challenging self-sabotaging Emotion-Driven beliefs like "Why try, everything gets screwed up anyway?," "Why change, nothing ever changes?," and, "What's going good today won't last." This section ends with a discussion of the importance of "Mindfully Protecting Our Peace and Stability" and finding ways to limit and manage the upsetting things in our life. Several thought control and boundary setting coping skills are practiced to help us gain control over our upsetting emotions, experiences, and thinking patterns.
In Chapter 1, “The Nature of the Problem,” we looked at why our life ends up like a train wreck…full of problems and loss…with everything precious to us strewn about like the debris of a train wreck. We looked at what causes our life to blow up right in front of our eyes.
We learned that "The Nature of the Problem" is…THE THINGS WE DO TO FEEL BETTER END UP CAUSING US MORE LIFE PROBLEMS. We feel worse because of the painful consequences of our Destructive Coping Behaviors. When we feel worse, we do our preferred Emotion-Driven Coping Behaviors again…and we end up with EVEN MORE consequences and losses. The result…we feel WORSE. This is THE CYCLE OF SUFFERING. As this cycle runs its course, we feel worse and worse and the CONSEQUENCES of our coping behaviors become more and more severe. The losses and problems in our life become more intense and widespread UNTIL EVERYTHING WE LOVE AND CHERISH IS LOST, DESTROYED, OR FILLED WITH CONFLICT.
In Chapter 2, “The Big Picture of My Life,” we identified the most precious and important things in our life. These are the things that give our life meaning…and bring joy and satisfaction. We saw how the consequences of Emotion-Driven Coping Behavior lead to problems in some areas of our life. Then, like a Domino Effect, these problems cause problems in other areas of our life…and so on. This goes on until the Big Picture of Our Life is overtaken by problems, losses, emptiness, and pain.
By way of the first two chapters, we gained great insight into why we have the problems we have…and why our life becomes filled with pain and suffering. We’ve gained an understanding of why things are the way they are. We answered the questions, “How did this happen?” and “Why me?”
In Chapter 3, “The Pathways of Recovery,” we rationally challenged “WHY TRY? THINGS WILL GET SCREWED UP ANYWAY.” We determined that MANY GOOD THINGS HAPPEN in our life WHEN WE’RE ON THE RECOVERY PATH. It’s when we relapse into Emotion-Driven Coping Behavior that life takes a turn for the worst… and many bad things begin to happen again. We noted that bad things happen to all of us and it doesn’t matter how good or self-disciplined we are, bad things and difficult times WILL Come Our Way. We learned that when we’re faced with a difficult situation, we have TWO CHOICES. One is TO STAND and face our troubles and to Fight to stay on the Recovery Path. The other is to relapse into Destructive Coping Behavior. WHY TRY? WHEN WE TRY good things happen…and when we KEEP TRYING, we GET THROUGH tough times and good things CONTINUE to happen.
In the Mindfulness Chapters, 4 and 5, “Mindfully Protecting My Peace and Stability” and “Mindfulness Is a Skill,” we learned that many of our problems are caused by mindless and impulsive behavior. We learned that MINDFULNESS IS THE FIRST STEP IN GAINING CONTROL over our life. Mindfulness is awareness in the “here-and-now” moment. It’s awareness of our thoughts and feelings and the reality of our troubling situations. It’s awareness of what we’re doing, what we’re thinking about doing, and how our behavior will affect the Big Picture of Our Life and our life goals. We also learned about MINDFULLY PROTECTING OUR PEACE AND STABILITY and the importance of being Mindful and dealing with the things Coming At Us. We learned Mindfulness is a skill that requires lots of practice.
The first section of this workbook answered, “WHY is my life SO TROUBLED?” and “HOW has my life become SO OUT-OF-CONTROL?” We learned that it’s because of the THINGS WE DO IN THE HEAT-OF-THE-MOMENT! We went through some VERY penetrating and painful material to gain this understanding. We had to look at and process some very difficult things. However, this is PAIN FOR GAIN. This is a very therapeutic type of pain that will help to END OUR SUFFERING and bring PEACE, STABILITY, and SATISFACTION to our life. This transformation DOESN’T HAPPEN OVER NIGHT, it COMES TO US as we make our way along the RECOVERY PATH.
Section Two - “How Do I Get Control of My Life?”
In Section Two, we discussed the three mind states in detail (Emotional Mind, Rational Mind, and Wise Mind). We focused on how to use Rational Mind and Wise Mind to GET CONTROL of an OUT-OF-CONTROL Emotional Mind...and how to GET CONTROL of OUR LIFE!
In Chapter 6, “Emotional Mind,” the two parts of Emotional Mind were discussed in detail. We gained more information about our Raw Emotions and Emotion-Driven Thoughts. We also discussed several common Emotional Mind experiences which are fueled by intense emotions and irrational thoughts. Some of these included LOVE AT FIRST SIGHT, CRASH N’ BURN DIETING, PANIC ATTACKS, and ENABLING.
We also reviewed some positive aspects of Emotional Mind. In addition, we gained insight into HOW WE COME TO BELIEVE the abusive and hurtful statements people say about us. We determined that these statements are EMOTION-DRIVEN LIES which say more about the speaker than us. We also discussed ways to control painful RUMINATION and ways to REQUEST TIME-OUT…so we can COOL OFF IN THE HEAT-OF-THE-MOMENT and gain control over our Emotional Mind.
In Chapter 7, “Rational Mind,” we focused on how to use Rational Mind to deal with an upset Emotional Mind. Many common Emotion-Driven Thoughts were challenged, like “CUTTING ALWAYS HELPS.”,
“I CAN’T STAND TO BE ALONE.”, "I CAN'T DEAL WITH IT.", “JUST ONE DRINK DOESN'T MATTER.”, “I’M SO FAT, NO ONE WOULD WANT ME.”, and “KILLING MYSELF WOULD MAKE LIFE EASIER FOR MY FAMILY.” Focus was also given to the LIES we tell ourselves about SUCCESS and FAILURE and the irrational nature of ALL-OR-NONE thinking. We also identified emotional and physical states which make Turning On Rational Mind more of a challenge.
We reviewed “Pete’s Story” about how he relapsed into substance abuse and suicidal thinking after Something Happened. He blew up on the job and faced TWO CHOICES -
TO STAY ON THE RECOVERY PATH OR TO RELAPSE. He initially chose Relapse Route. We witnessed how he rationally and wisely WORKED THROUGH his relapse and STEPPED RIGHT BACK ON THE RECOVERY PATH!
In Chapter 8, “Challenging Extreme Judgments,” we explored the destructive nature of Extreme Judgments. We took a close look at the effect OUR Extreme Judgments have on OURSELVES and OTHERS… and the effect OTHER PEOPLE’S Extreme Judgments have on US.
We determined that Extreme Judgments often become Self-Fulfilling Prophecies. This means that WE tend to become what WE CONSIDER OURSELVES to be…and OUR PEOPLE tend to become what WE CONSIDER THEM to be…and WE tend to become what OTHERS CONSIDER US to be.
We also worked with “The Challenging Negative Judgments of Me Worksheet” and rationally challenged the negative judgments made of us. We PROVED these to be EMOTION-DRIVEN LIES. We determined that these labels have little or nothing to do with us, but SPEAK VOLUMES about the emotional issues of the speaker. We also noted the difference between our BEHAVIOR and our CHARACTER. We saw that “Stupid ISN’T as stupid does.” We learned we’re NOT STUPID because we do foolish things. We learned WE HAVE GOOD JUDGMENT…but, we don’t ALWAYS act on it!
When we’re dysregulated and Out-of-Control, we don’t control ourselves and we act in ways we KNOW are NOT in our best interests. It’s not an issue of intelligence, it’s an issue of impulse control!
In Chapters 9 and 10, “Wise Mind” and “The Wise Mind Worksheet,” we learned about Wise Mind and two tools for getting to Wise Mind. We learned that when we use BOTH Emotional Mind and Rational Mind to deal with a situation, WISE MIND TURNS ON. Wise Mind is respectful of our EMOTIONAL ISSUES and CONCERNS and WHO WE ARE AS A PERSON…as well as the TRUTH and REALITY of the situation AND the Big Picture of Our Life. Wise Mind leads us to WISE UNDERSTANDINGS and a GAME PLAN for dealing with our situation. Wise Mind urges us to ACT IN OUR BEST INTERESTS and to gain and MAINTAIN PEACE AND STABILITY. We discussed that Wise Mind is ACTION-ORIENTED since there isn’t anything wise about NOT Following Through with what We Know to do!
"THE WELL ANALOGY WORKSHEET” and “THE WISE MIND WORKSHEET” were discussed in detail in these two chapters. These are Mindfulness tools that help us to THINK THROUGH BEFORE WE DO and to TALK OURSELVES THROUGH the Heat-of-the-Moment. The story, “Drew Got Dumped,” was used as an example of how to TALK OURSELVES DOWN the Wise Mind Well…out of some very desperate and aggressive impulses…and INTO Wise Mind. We also worked with Drew’s story to learn how to complete a Wise Mind Worksheet.
In these Wise Mind chapters, we also discussed “Six Tips for Participating Wisely and Effectively.” Some of these included STOPPING OURSELVES from carrying-out destructive behavior, PLAYING BY THE RULES, and DOING WHAT WE NEED TO DO WHETHER OR NOT WE LIKE IT OR WANT TO! We also addressed FOLLOWING OUR HEAD OR OUR HEART, CARRY-OVER EMOTIONS, and how there’s AN ORDER TO THINGS such that Rational Mind must be Turned On before we’ll accept Wise Mind suggestions for problem-solving and coping. The ways of “THE GOOD COUNSELOR” and the importance of LISTENING TO THE VOICE OF WISDOM were also discussed.
Through the second section of the workbook, we learned that when we’re Big-Time in Emotional Mind, we often do desperate things to relieve the emotional pressure so we can return ourselves to a more comfortable emotional state. If we allow Emotional Mind to “run its' course,” we often end up acting in IMPULSIVE and DESTRUCTIVE ways. We must STOP OURSELVES and Turn On Rational Mind and Wise Mind to manage our emotional state. That’s the only way to TAME A RECKLESS and OUT-OF-CONTROL Emotional Mind. That’s the only way to GAIN CONTROL of our life and our life outcomes. That’s the only way to Mindfully Protect Our Peace and Stability and the Big Picture of Our Life. If we don’t STOP OURSELVES, our Out-of-Control behavior WILL destroy us and everything that’s important to us.
Section Three - “How Do I Stay in Control?”
This section focused on how to accept and deal with the difficult things in our life...and how to set-up and live a RECOVERY LIFESTYLE.
The development and use of positive coping skills, rehab-attitudes,
and Game Plans for recovery were discussed.
In Chapters 11 and 12, we discussed the process of healing and recovery and how it involves Distress Tolerance and Acceptance. We learned that we must ACCEPT that pain and distress is a NORMAL part of life. We must LEAN INTO and do…whatever we have to do…to WORK THROUGH our pain and problems…so we can GET THROUGH them. We must use Distress Tolerance skills FOR AS LONG AS IT TAKES for our changes to Take Root…for the distress to subside…and the benefits of our changes to be fully experienced. We must be WILLING to feel worse for awhile so we can feel better down the road. We have a CHOICE to Go Through the TEMPORARY PAIN of dealing with our problems and losses…or the LONG-TERM PAIN and SUFFERING of avoiding and stuffing them…and carrying them throughout our life.
We learned to use the skill of Radical Acceptance TO ACCEPT the things that AREN’T ACCEPTABLE. We must accept things even if it’s not right or fair that we have to…because NON-ACCEPTANCE will keep us STUCK IN PAIN and NEGATIVITY. We also learned that we can EMOTIONALLY STEP BACK from “unchanging situations” and still try to make changes…AS LONG AS WE CAN BE OKAY while doing so. If we can’t be okay, we’ll have to Step Out of the situation because we MUST protect our peace and stability. We also discussed “The Baseball Analogy of Life” and how our job is to go up to bat…and DO OUR BEST to hit the balls Coming At Us. Our job is to use Wise Mind to make the best play possible EACH TIME we’re at bat and to use Distress Tolerance to keep ourselves in play during the toughest games and seasons.
In Chapter 13, "Life-Enhancing Coping Skills," we learned that we often choose Self-Destructive Coping Behaviors because they’re Tried N’ True, fun and exciting…they Numb-Out our emotions and White-Out our thoughts…and they give us QUICK RELIEF. We learned that when we use Life-Enhancing Coping Skills, we’ll have to use Distress Tolerance skills, too. That’s because Life-Enhancing Coping Skills REDUCE our pain and distress and LOWER our Emotional Intensity Level…but they DON’T WIPE-OUT our pain and distress FOR LONG PERIODS of time. We must ACCEPT and LEARN TO TOLERATE the distress of STILL HAVING SOME painful feelings and upsetting thoughts.
We learned to use “The Levels of Emotion Chart” to gain information about our emotional levels. We discussed that we ought to seek help when our emotional level is at a 5 or 6…while we HAVE ENOUGH Rational Mind going on that we CAN BENEFIT from help WITHOUT being institutionalized…and BEFORE we slip too much and cause ourselves extra problems…and BEFORE things get OUT-OF-CONTROL. We also completed “The Life-Enhancing Coping Activities Worksheet” and listed many positive coping activities that we WILL DO to reduce our emotional intensity. We learned to use an “Activity Calendar” to give ourselves many coping options in the Heat-of-the-Moment…when we really need support and distraction. We also learned how to use a “Weekly Calendar” to set up a busy Recovery Lifestyle.
In Chapter 14, "The Game Plan,"we learned how to write-up and use a "Game Plan." We identified the Wise Mind Action Steps that are critical to our recovery. We learned how we sabotage our recovery with Emotional Mind Excuses and Rational Mind Obstacles. We learned to use Rational Mind Challenges and Wise Mind How-To’s…to get passed and around the obstacles and excuses that are roadblocks…and get in our way on the Recovery Path.
A View of the Front and Back Covers
Click on the images above to get a larger view
of the front and back covers
What Does It Say on the Back Cover?
The text at the upper right of the back cover (white and red text with the black background) is the text at the top of this page
The text boxes below contain the other text on the back cover.
DBT-CBT is a modified version of DBT that addresses recovery from a wide range of self-destructive coping behaviors. This workbook explains why we do the things we do…and why we keep doing these things even though they cause us more pain and problems. THE NATURE OF THE PROBLEM is…
the things we do to feel better end up causing us to feel worse. Our lives spiral OUT-OF-CONTROL and into a CYCLE OF SUFFERING. This book is about what we do in the heat-of-the-moment…the emotional moment. It’s about what happens when EMOTIONAL MIND drives and RATIONAL MIND takes a backseat …and WISE MIND is left on the side of the road.
This workbook provides useful tools, attitudes, and plans for changing how we respond to life. Our goal is to GET CONTROL of our OUT-OF-CONTROL emotions, behaviors, and thinking. We do this by PARTICIPATING EFFECTIVELY in our lives and by using LIFE-ENHANCING COPING MECHANISMS to deal with our pain and problems. Our goal is to MINDFULLY PROTECT OUR PEACE AND STABILITY and the
BIG PICTURE OF OUR LIFE. Our goal is to STOP
the CYCLE OF SUFFERING.
"As I’ve interacted with the customers of Big Spring State Hospital who have participated in this program, I’ve noticed they reflect confidence and calm. Their insight into their own empowerment gives them great strength. I find it hard to imagine a psychiatric hospital charged with treating serious and persistent mental illness not embracing a product like this...Our customers actually complain if they’re late for class. Our problem isn’t motivating them to go, it’s making sure we run enough trams to get them there on time!” Edward Moughon, M.A., Superintendent, Big Spring State Hospital
“This is the best recovery program. It’s practical and it’s about my life. It pulls everything together and really makes sense. My family is reading this book and they’re learning to understand me better.” Anonymous
“Reading this workbook is like being in group. She doesn’t speak in a doctor language. She explains things in words normal people can understand. She’s down-to-earth and really cares about us.” Anonymous
“I don’t like to read, but I read my workbook and do the worksheets. I like the way the pages are set up. It breaks things up and makes it reader friendly. I love her sense of humor and all the sayings and extra information in the margins.” Anonymous
“This material saved my life. I was determined to talk my way out of the hospital and kill myself. Listening to her helped me to understand myself and what I was going through. I realized I created a lot of my problems by how I tried to cope. I realized I couldn’t change some situations, but I had a choice how to respond to them. I realized I had many choices and many things going for me. I got a Game Plan and I CHOSE TO LIVE.” Anonymous
This workbook can be completed as part of an Individual
or Group Therapy program, a support group, or as an independent home-based study.
Melanie Gordon Sheets, Ph.D., is a licensed clinical psychologist. She began her career at Richardson Medical Center in 1985 as a mental health technician working with Agoraphobia, Panic Disorder, Major Depression, and Borderline Personality Disorder. She earned her doctorate from Texas A&M University where her clinical training emphasized psychoanalytic and Jungian psychotherapy methods. She has worked at the Dallas VA Medical Center in the PTSD Clinic and the Substance Abuse Unit. She is currently a staff psychologist at Big Spring State Hospital in Texas and conducts the DBT-CBT Group for forensic and general psychiatric patients.
Many of our "abnormal" behaviors are normal given our experiences. They once served as survival skills. However, their period of usefulness is long over. We've overused these coping behaviors...and now, they're causing us great pain and they're destroying our lives.
