Chain of Events: How DBT’s Behavioral Chain Analysis Can Help YOU

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How to Do a (The Simple Version)

Reminder: A Behavioral Chain Analysis should be done in between crises when you are relatively calm and relax. Each part should be completed in excruciating detail. Lots and lots and lots and lots of detail.

DESCRIBE IN EXCRUCIATING DETAIL
  1. The problem behavior (YOUR behavior) that you’re focusing on changing
  2. The prompting event (the thing that led to the problem behavior)
  3. Vulnerabilities (in me and in my environment including other people, unmet needs, emotions, etc. )
  4. The links in the chain (thoughts, feelings, body sensations, events, beliefs, expectations, emotions, and things you and others do)
  5. Consequences of the behavior (other peoples’ reactions, your feelings, and effects on you and your environment) immediately and later
  6. Solutions you could have but didn’t use (connect them to the points in the chain where you could have made that choice). Coping behaviors and skillful behaviors.
  7. Prevention strategies to reduce vulnerabilities.
  8. A plan to solve the prompting event and keep it from happening again.
  9. Figure out who/what you harmed to plan repairs.
  10. Describe repairs, corrections, and over-corrections that make things better than they started.
  11. Reflection on your deepest thoughts and feelings on the thing that happened, comments on the analysis. Shift topics if it gets too deep.

And here is my quick tip reminder that it’s okay to make mistakes. You’re not turning this in for a grade:

 

How to Do a Behavioral Chain Analysis (The Detailed Version)

Now that you’ve learned the basics, let’s go deeper into how to do a behavioral chain analysis. This time I’m going to break down each step with detailed instruction and an example taken from the situation I looked at in the at the top of the article. If you want to use the original Behavioral Chain Analysis form from The DBT Skills Training Handouts and Worksheets, Second Edition you can order a copy from Amazon or Google “Behavioral Chain Analysis worksheet” to find any of the places where it is available online. I strongly recommend that you order the workbook because is a system and works best if you are getting all of the parts, including the individual and group therapy provided if you can find it in your area. (I don’t currently have affiliate links on my website. This is an unpaid endorsement). 

The example I’m using involves me yelling at my husband (and incidentally at my oldest son) when I had a miscommunication with my husband over the delivery of my new computer. 

Describe the problem behavior:

Whether you use Dr. Linehan’s form or some notebook or blank paper, sit down and describe what happened. If your first thought is to say “I had a meltdown”, break down what a meltdown looks and sounds and feels and smells and tastes like.

For instance: “My heart started racing and my head felt like it was going to explode. I was so angry I was afraid I’d hurt someone. Screaming and yelling and cussing and stomping through the house. I was so angry and distracted I couldn’t use any of my coping skills, even though I tried.”

You’re going to want to focus on your behavior here. This is not the place to discuss other peoples’ behavior that contributed. That comes later. Problem behaviors can include:

  • Yelling
  • Violence
  • Self-harm 
  • Abuse of substances
  • Avoiding things you need to do to reach your goals. 
  • Refusal or temporary Inability to do things that help you achieve your goals.
  • And any other behavior that you are trying to change

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The prompting Event (the thing that led to the problem behavior):

We’re looking for the trigger here. When did the switch get turned on or off? What was the moment you went from “okay enough” to “not okay at all”.  At what point did you set in your heels and refuse to do something (or demand to do something) that caused problems for you?  What caused you to feel that you were unable to do the thing you were trying to do? Include a time frame, if you can remember (this can help you recognize danger signs before things get out of control)

Example: “Less than a minute before I started yelling, my husband told me he signed for my computer, but I checked and found out he had actually signed for our dog food.” 

It’s entirely possible the actual event that caused the problem behavior won’t seem so bad, when you look at it without all the other stuff. I mean, what’s so bad about my husband signing for dog food instead of a computer? Well, keep reading…

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Vulnerabilities:

Vulnerabilities are things that made it more likely that you are going to struggle with your behavior. This can be things in yourself, like illness, lack of sleep, not taking meds. You can also become vulnerable because of things outside yourself, like being around too many people, too much or too little noise, worries about not being able to get what you want or need, etc. These are often the first links in the behavioral chain analysis. 

For instance: “The morning I had my “meltdown” and yelled at my husband, I hadn’t slept well the night before, I’d had a doctor’s appointment with a new doctor including long waits in uncomfortable chairs, a blood draw, and a flu shot. Hadn’t eaten yet because I was fasting for the blood draw. I was in a hurry to get to work and was rushing to get ready to go.”

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The links in the chain:

Now you list all the 

  • thoughts
  • feelings
  • body sensations
  • events
  • beliefs
  • expectations
  • emotions
  • and things you and others do. 

This is the meat of the Behavioral Chain Analysis. In between the prompting event and the problem behavior (and sometimes before), you will have felt and thought things that contributed. You and others might have done things that contributed. Your expectations and beliefs and emotions all played a part. You might have had body sensations that maybe warned you, contributed to the problem, or both. 

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My example (listing some of the links in the chain)
  1.  The excitement that I was getting my new computer that day
  2. Frustration when I realized the box that had been delivered was our monthly dog food order. 
  3. Asked my husband about the packages
  4. My husband told me that he had “signed for the computer”
  5. Panic because I believed that if he had signed for the computer and I didn’t get it, I wouldn’t be able to prove we didn’t get the computer and wouldn’t be able to afford to buy it twice. 
  6. Tried to check my phone to verify the delivery and the phone was almost dead. 
  7. Chest pounding and “black feeling” in my head as rage built. 
  8. Frustration at my husband not understanding why I was upset.
  9. Guilt as my son tried to step in and I wasn’t able to calm down. 
  10. Further frustration as my husband tried to explain again and made it more clear he didn’t understand the problem
  11. Worst of the problem behavior (it built through all of this)

It’s okay to not get the events in perfect order. Some of them are going to overlap, and that’s okay. You might forget a link and add it later. Also okay. Scribble all over your Behavioral Chain Analysis if you need to. 

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Consequences of the Behavior: 

This will include consequences for yourself, for other people, and in the environment. You’ll want to break these down into immediate, and eventual. Look at other peoples’ reactions, your feelings, and how it affects your situation and the places you live your life (such as home, school, work, and regular “haunts”). 

For instance:

“Immediately, my son expressed his disgust and (slight) fear. My husband kept trying to apologize and was confused. I felt ashamed and frustrated with myself. Was worried that I wouldn’t be able to calm down in time for my first appointment. I was afraid I’d really damaged my relationship with my son.”

“Later, I was even more ashamed as I realized my computer would be delivered separately in the evening. I had to spend time and energy coming up with ways to repair, correct, and overcorrect my behavior to try to avoid the situation again. My body remained on high alert all day.”

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solutions you could have used but didn’t

Now you take as many parts of the chain as possible and look at how you could have changed what happened. This is the “analysis”, sometimes the hardest part of the Behavioral Chain Analysis. It’s also one of the main reasons you do this when you have a “calm between storms”.  You’re going to want your executive functioning working as best as it can while you do this. You’ll look at what you can change because you don’t have control of other people or the environment. Some people find it useful to write the solution next to the point(s) in the chain where it could have helped. Not every link on the chain will have a solution, and that’s okay. 

It might go something like this:

  • Instead of panicking about the computer not being delivered, I could have asked my son to check the Amazon account to see if it was still out for delivery
  • I could have had a breakfast shake or other quick breakfast as soon as I walked in the door to deal with my hunger.
  • Clarifying what my husband meant by “signing for the computer” instead of jumping to conclusions.
  • Perhaps I could have stepped out of the room and calmed down when I felt the “black feeling” coming on. (I call it this because my vision literally goes black. A sort of hallucination, I think.)
  • I could have allowed my son to calm me down the rest of the way. (He’s good at that). 

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Prevention strategies to reduce vulnerabilities

Spend a bit of time looking at your vulnerabilities and figuring out what you can do to reduce them so that next time this situation comes up, you’ll be better able to handle it. 

For instance:

“I might want to grab a breakfast bar when I know I have labwork so I can eat it immediately afterward in case something comes up that triggers my ”.

“Get on medications for anxiety and and take them as prescribed”.

“Have everything packed for work the night before if possible”.

“When I go to the doctor’s office, bring a charger so I don’t let my phone die.”

“Take things with me to places that make my anxiety worse that help calm me, such as pens and a coloring book, or a book, or phone games.”

A plan to solve the prompting event and keep it from happening again: 

Take a look at the prompting event. What can you do to make it less likely that this thing will cause the chain of events that leads to your problem behavior (even if the prompting event was somewhat or mostly out of your control.)

My prompting event was a miscommunication with my husband that had several pieces to it:

  1. I didn’t take time to listen. (I can slow down and make sure I’m listening well.)
  2. My husband was having a bad cognition day. (Be mindful of my husband’s cognition issues and be more patient as he’s trying to explain.)
  3. I can double check my understanding of the situation. (I had the means to check whether my worries reflected reality, but didn’t use any of them to check. Next time I can fire up a computer or ask my son to do so). 

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figure out who/what you harmed to make repairs:

Spend some time looking through that long Behavioral Chain Analysis and write down a list of who and/or what you harmed with your problem behavior (regardless of whether or not you were also harmed by others). Include yourself in the list of people you harmed if needed. This is one of the easier pieces. 

Example: “I harmed my relationship with my husband. I harmed my son, who has anxieties specifically about being around people who are yelling. My behavior also harmed myself in that it made it more difficult to do the things I needed to do for the rest of the day.”

Describe repairs, corrections, and over-corrections that make things better than they started:

This is where you fix the harm you did to others and yourself and prevent that harm from happening again. You may not always be able to completely fix the harm nor prevent it from happening again, but do what you can. 

For instance: “I need to apologize without excuses to my husband and son”. “After work, I need to pick up something for my son as a ‘treat’ while we discuss our very different fear reactions so that we can build understanding with each other.” “I need to work on my mindfulness practice so that I’m more ready to be mindful when I need to be.” (p.s. I SUCK at mindfulness.)

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Reflection on your deepest thoughts and feelings on the thing that happened, comments on the analysis. Shift topics if it gets too deep.

The final part of the Behavioral Chain Analysis is to look at the whole long thing and at the situation that led to you doing all this work, and write down or express your feelings about the whole thing or any part of it. This might include your feelings about what you or others did in the situation, your feelings about the repairs and corrections you made, and/or your feelings about the process of Behavioral Chain Analysis itself. If you find that this is making you more emotional than you can handle right now, shift to a different thing to reflect on (vent on how difficult you find the Behavioral Chain Analysis, for example), and keep going until you run out of things to say. 

My example is going to be briefer than it would be if I were doing this for myself. It might go something like this: “It feels like I never get past these blowups that cause problems for the people I love. I sometimes feel incredibly guilty at how my yelling affects my son’s “stuff”. Even when I consider that I used to have these blowups at least once a day and now at most I have them a couple of times a month, it doesn’t feel like enough. I really hate the process of the Behavioral Chain Analysis because it’s so much work, but I feel so much more confident after I finish it. ”

In reality, I might spend several paragraphs on each of those points, comparing them to similar things in the past, reflecting on what I’ve tried before and what works and doesn’t work. But this article is already more than long enough, so I’ll stop here. I hope this helps when you feel overwhelmed at how much work a Behavioral Chain Analysis is. 

Thank you. 

I am sincerely grateful for the support of my family, friends, therapy participants, and Patrons. 

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IMPORTANT NOTES:

Finally, I donate half of every dollar I make from videos, podcasts, and writing to my best friend, Katherine Malone.  She has a deadly heart condition and needs a heart transplant. Before she can be placed on the transplant list, she must raise $20,000 for anti-rejection drugs. Learn more here and here, and go here to donate directly to her GoFundMe. This will continue until Kathy’s heart is fully funded. After that, I will continue to donate half up to $500 per month to help her pay for her anti-rejection meds. 

A final reminder:  You are each important and have much to teach, and much to learn.

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