By: Alyson Dudley
Vulnerability factors such as hunger and illness can exacerbate emotional and physical dysregulation and so a fundamental piece of DBT treatment is reducing these vulnerabilities by paying attention to this and attending to the needs of our bodies. The PLEASE skill is the skill that can help us with that.
P and L: The P and L are about treating physical illness, seeing a doctor/medical professional when needed and remembering to take our medications as prescribed. Noticing if we are taking the time to attend to our bodies when we are sick rather than trying to push through illness, (which can make it worse). Feeling sick can make it difficult to function and cope, so it is important to care for ourselves so we can recover.
E: The E refers to balanced eating. Noticing if we are eating too much or too little for our body. It is important to use our mindfulness skills to tune into how our body feels when we eat certain foods and considering whether it is helpful/beneficial to continue to eat in certain ways. This includes noticing if there are urges or even actions for restricting, purging or bingeing and considering using skills to stop these behaviours. Balanced eating also refers to noticing our thoughts regarding eating and considering adjusting our thoughts if there are judgements or rigidity (e.g., Rather than, “I will not allow myself to have any treats”, instead consider“I can enjoy treats from time to time as part of balanced eating”).
A: The A refers to avoiding mood altering drugs. Mood altering drugs can greatly affect our bodies and therefore our resulting behaviours. We can use other DBT skills such as Wise Mind and Opposite Action to help ourselves to resist the urge to use substances that will negatively affect us and interfere with our ability to be skillful. Reducing substance use can also go a long way toward taking care of ourselves.
S: The S refers to balanced sleep. Getting adequate sleep can reduce vulnerabilities in that our bodies will be better prepared to cope with the day ahead. Sleep allows our bodies to replenish and repair and ensuring that this happens can help us to achieve our goals. Being mindful of sleep routines/hygiene can be very helpful as this can help our bodies to transition from daytime to nighttime, can provide predictability and make us more likely to continue with the routines.
E: The E refers to making sure to exercise/move our bodies. Moving our bodies in some way everyday, helps to maintain physical and mental health and can help to reduce depression and anxiety symptoms as it promotes behavioural activation. Exercise can also be a form of distraction and can be a pleasant activity involving socialization.
If you are noticing that you are in need of some reminders regarding how to care for yourself, consider using the PLEASE skill as above!
From DBT® Skills Manual for Adolescents, by Jill H. Rathus and Alec L. Miller. Copyright 2015 by The Guilford Press. Adapted from DBT® Skills Training Handouts and Worksheets, Second Edition. Copyright 2015 by Marsha M. Linehan. Adapted by permission.