What’s Really Bothering You?
In my last blog I promised to show you an effective way to identify triggers, environmental stressors, antecedent precursors, and reinforcers of your cycle of “dis” order. As I mentioned; taking the time to do this is crucial as this self understanding will help you identify the best strategies for managing your symptoms and for sustaining stability, independence, and overall well being.
I began my blog my jumping right in and giving you tangible tools with which to begin your own personal self help program. Over the next several months, I will continue to offer you practical advice that can provide you with down to earth “how to” information, and can also deepen your understanding of the world of bipolar. With that said, I also intend to gently unfold your awareness and understanding of the “integral” paradigm and perspective to guide you toward integrating the use of empirically based, best practice approaches and practical tools, with more conceptual and intuitive awareness of inspiration, hope, faith,connection, and spirituality. Stay with me, and as you read blog after blog, you will have what has been called, the “Aha” experience. Things will come together and make sense to you.
Today we will begin work with a very effective “grounding” tool that is used by behavioral therapists. It is called Behavior Analysis. We will first look at an actual behavioral expression of distress that has caused you grief, pain, or suffering. We will look at the factors that surround the behavior. By gathering this information the same way that a scientist would, you will be able to empower yourself by identifying what approaches, changes, therapies, or interventions will really work for you personally.
The simple, but effective tool that I want to teach you today is called “ABC” Analysis of Behavior. It is called this because the letter A stands for Antecedent; the letter B stands for Behavior; and C stands for Consequence. First, take a look at the three columns below. You will see an antecedent column, a behavior column and a consequence column. Below these columns you will see the explanation for what you see here:
|Morning Groggy Not fully wake Cooking breakfast Argument with spouse Feeling dismissed Thinking “I can’t take this anymore” Face feeling hot Heart beating fast Thinking “That’s it, I’m leaving”||Threw eggs on the floor, screamed and yelled at spouse ,“Its Over! I want you out of my life!, I hate you!……” rant out of the house in pajamas, (leaving everything on in the kitchen) got in the car and drove off (driving too fast)-ran through red light.||Experiencing racing thoughts; feeling confused-Highway patrol officer pulled me over; gave me a ticket that will be very expensive.|
Explanation: An “Antecedent” is anything that happens/or exists immediately before your behavior was expressed. By understanding the antecedents of a behavioral expression of depression or mania, we gain insight into the environmental “cues” or “triggers” that precipitated the event. A “Consequence” is anything that immediately happens immediately after the behavioral expression of your distress. The behavior column is the place to write down the behavioral expression of your distress in as much objective detail as possible. Remember, this is something you are doing for you; no one else has to ever see your work. The reason we want to get a really good picture of your behavior, is so that we can get what is called a “baseline” that measures intensity and frequency of the behavioral expression of distress. This way, once we begin to use new coping skills and “balancing” strategies, we can measure our success by the decreases in intensity and of frequency of distress behaviors over time.
The above example could be the precursor to a full blown manic episode should things continue to escalate. Or, it could be a precursor to a depressive episode. The way to truly analyze a full episode is to create an analysis of the “behavioral chain”, linking a series of the ABC analysis together. For example, if this event leads to further escalation to the point where a person looses all control and possibly even experiences psychosis, as in a manic episode, then the “consequence” column become both a consequence and a new “antecedent” “triggering” the manic episode. So, you put the sets of columns together to make a running story of what happened. If being pulled over by the Highway Patrol officer, while already in a heightened emotional state triggers mania, this could be captured in the next “chain of analysis”. If you can remember the details of an event where you were triggered into depression or mania, write it down in as much detail as you can, using this format.
|Experiencing racing thoughts; feeling confused-Highway patrol officer pulled me over; gave me a ticket that will be very expensive.||Got out of my car and threatened to fight the highway patrol officerORBegan crying uncontrollably-feeling suicidal||Feeling more and more confused, threatened and frightened-Etc………..|
This example show us how the immediate effects (consequences) of the behavior often translates into the “trigger” to an escalation, with new behaviors. The Antecedent column describes the actual environment, what is happening in the physical environment, and what is happening in our “inner” environment (thoughts, feelings, emotions). The Consequence column can provide some clues about the actual “function” of the behavior, and I will explain further both the Antecedent and the Consequence in my next blog so that we can tie all of this together. Function does not mean “motivation” or “reason”, after my next blog you will have a better understanding. For now, take one or two events where you were triggered into exhibiting a behavioral expression of distress that ended up causing you even more distress. You will see how you can identify specific skills that will help to prevent episodes that you can integrate into your Wellness and Prevention Plan. (If you haven’t already done so, Please read previous blogs and learn about the Wellness and Prevention Plan- a very powerful tool for you)
Please leave your comments and questions- I will read them.