ABC PLEASE
The skill you use when nothing is on fire — so that less of it catches.
STOP is for those ninety seconds in the moment. You feel the thing rising, you freeze, you take a step back, you observe, you proceed. It is a fire extinguisher. It works on the fire that is already burning.
ABC PLEASE is for the time between those moments. It is not for the fire. It is for the months when there is no fire — the ordinary, uneventful stretch of days when nothing in particular is wrong — and the work you do in those stretches to make the next fire smaller, slower, or less likely to start at all.
In Dialectical Behavior Therapy (DBT) the two skills live in different rooms. STOP and the distress-tolerance skills are intended for crisis survival: what you reach for when the only options are to ride the wave or break something. ABC PLEASE belongs to emotion regulation, and its whole premise is that you are less likely to be overwhelmed by a wave of emotion if you were not already worn thin when it arrived. Marsha Linehan, who built DBT, calls this reducing vulnerability to “emotion mind,” or that state we are in when we act on emotions instead of logic. The plain version: a rested, fed, occupied person handles a bad day better than a depleted one.
But everyone knows that already, right? The skill is a system for actually doing something to apply that knowledge.
It is two acronyms wearing one name. ABC is the part about building a life with enough good in it to absorb the bad. PLEASE is the part about not letting your own body sabotage you.
ABC — building the reserve
A Accumulate positive emotions
This works in two forms.
- Short-term: do things that are pleasant, on purpose, today, even when you do not feel like it and especially when you do not feel like it.
- Long-term: build a life that points at something you actually value, so the pleasant things are not just distractions but deposits. The idea is a reserve. You cannot withdraw from an account you never put anything into.
In prison, short-term meant engaging with those who were positive influences within a harmful space, cooking food I enjoyed, playing tabletop roleplaying games to pass the time. Long-term meant participating in treatment, pursuing my education, working a job that had a meaningful impact on others, all in an effort to use the resources available to me to learn and grow from my time there. Today, out in the community, this means talking with my loved ones each and every day, engaging with activities I am proud of, and continuing the rehabilitative work that I started inside.
B Build mastery
Do something, regularly, that makes you feel competent. Not relaxed — competent. The two are different. Mastery is the quiet, accumulating sense that you are a person who can do things, and it is built by doing things that are hard enough to count and not so hard that you fail at them. You pick the difficulty deliberately. You celebrate the small version.
Beyond the obvious answer of programming and education, I spent a lot of my sentence time on maintaining my physical health in a space that doesn’t promote healthy living by getting creative regarding ways to exercise, while also challenging myself artistically to write, draw, and facilitate pro-social events for other individuals in my environment.
C Cope ahead
Pick a situation you know is coming and know will be hard. Rehearse it. Name what is likely to go wrong, name what you will do when it does, and run the whole thing in your head before it happens, in detail, including the part where you handle it well. The rehearsal is not magic. It is practice, and your nervous system does not fully distinguish practice from the real thing.
The fun thing about prison is it provides plenty of stressful opportunities for you to plan for (and many you can’t). Each assignment that I presented for my treatment program was diligently practiced back in the cell with my cellmate, answering potential follow-up questions to feel prepared on the day of presentation. This also helped prepare me for my phone calls home to my dad and step-mom, where I walked them through each and every part of my treatment process. I practiced my disclosures, so that when I spoke to future employers, friends, and eventually a potential future romantic partner, I would be ready to share this part of my life with them with honesty and transparency.
In the community, these opportunities continue to exist. The work that is put in before a job interview. Studying before an exam for school. Disclosing to a new friend.
PLEASE — closing the back doors
PLEASE acts as five reminders that emotion is partly chemistry, and that you can lose a day to a feeling that was never really about anything except being tired, hungry, sick, or hung over. It is the least glamorous skill in the manual and possibly the most load-bearing.
PL treat PhysicaL illness
Take care of your body when it is sick. Take the medication as prescribed. An untreated illness is a standing tax on your mood, and you will misread the tax as a feeling about your life.
E balanced Eating
Eat in a way that keeps you steady — not too little, not too much, not all at once after none for hours. Stable fuel, steadier mood. The skill is not a diet; it is a refusal to let blood sugar make your decisions.
A Avoid mood-altering substances
The category is exactly what it sounds like. Anything that moves your mood artificially also moves it back, usually downward, usually at an inconvenient time. It is important to acknowledge this doesn’t necessarily mean felonious drugs. Sugar, caffeine, and nicotine all fit this description.
S balanced Sleep
Get enough, on something like a schedule. Sleep is the single biggest lever most people have over their baseline mood and the one they surrender first.
E get Exercise
Move your body, and move it regularly, enough to change your heart rate. It is an antidepressant you already own.
This was the first DBT skill I was tasked with learning by my therapist. He reasoned that it was likely learned behavior for me already, specifically with my athletic career and how I used it to cope with my home life. But when you don’t know the correct technique, much like when you first learn a workout, your form becomes bad and you end up doing more harm than good. Perhaps you only Accumulate short-term positive emotions, Build mastery in one activity, never Cope ahead, ignore PhysicaL illness because the event schedule of your career doesn’t allow for treatment, the social demands of your sport suggest less balanced Eating leads to better results, and really who needs a full eight hours of Sleep, anyways?
Despite the failure to implement entirely correctly, the foundation for understanding the skill’s intent was there, which is why for the majority of my year-long treatment, I was tasked with keeping an ABC PLEASE journal. Every day, for weeks on end, I broke down each letter of ABC PLEASE and logged exactly what I did that day. Creating this routine is applying the first half of the skill itself, keeping an itemized list of all the things you’ve done to accumulate positive emotions, building a mastery over the skill (and likely the things you are engaging in with some level of frequency), and coping ahead by having a reference for the work you’ve put in during times when you find yourself struggling.
Engaging with this journal helped me to overcome the often lackluster chow hall meals, the sleepless nights due to shared cells and regular count interruptions, delays in medical appointments, the occasional hostile interaction in the day room, and the debilitating anxiety of the future. Engaging with this journal encouraged me to really do the work that programming offered, to reconnect with my dad and step-mom, to talk about my past trauma, to learn what it means to be empathetic in an apathetic environment, to become a dungeon master, to lose at ping pong so much that I finally win the unit championship at multiple facilities, to continue my love of creative writing and poetry, to challenge myself as an artist with drawing and painting, and other ways I could find to be proud of myself.
The first two-and-a-half years were terrifying for me. There were a lot of days I wasn’t sure if I was going to make it through the process, because of my own accord or because someone else would decide it for me. Arriving at Monroe, looking forward to the opportunities that programming would present, and then being given the knowledge and space to enact change was a grounding and humbling experience I wouldn’t trade for the world.
These skills do not feel like anything while you are doing them. That is the hardest thing about them. STOP announces itself — you use it in a moment you will remember. ABC PLEASE is invisible. You will never have a day where you can point at the slept-enough, ate-something, walked-the-yard, called-your-father maintenance and say that is what got me through. You only notice it by its absence, weeks later, when you skipped all of it and the small thing knocked you flat.
You build the reserve on the days you do not need it. That is the entire skill. It is monotonous, but it is intentional, and it is the truth.
Sources
Marsha Linehan, DBT Skills Training Manual (2nd ed., 2014, Guilford Press) — canonical published source for the ABC PLEASE skill; its placement in the Emotion Regulation module under “reducing vulnerability to emotion mind”; the four-module structure of DBT (Mindfulness, Distress Tolerance, Emotion Regulation, Interpersonal Effectiveness).
Marsha Linehan, DBT Skills Training Handouts and Worksheets (2nd ed., 2015, Guilford Press) — photocopyable client-facing companion; the version of the ABC PLEASE handouts that circulate in clinical practice and rehabilitative programming.
University of Washington Behavioral Research and Therapy Clinics — Linehan founded and directs the BRTC at UW, where DBT was developed. depts.washington.edu/brtc