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Most effective time: when the situation is not yet acute. However, preparing too early and intensively can also increase fear.", "longDescription": { "text": "Preparing for strain is a prevention-oriented situation in DBT — the goal is to reduce vulnerability before stress accumulates, rather than managing a crisis in progress. This distinguishes it sharply from crisis and acute emotion regulation situations. The relevant skill categories are PLEASE (Physical illness, Eating balanced, Avoiding mood-altering substances, Sleep, Exercise), ABC (Accumulating positive emotions, Building mastery, Coping ahead), and mindfulness for maintaining awareness of current vulnerability. The most common mistake is treating preparation as optional or deferring it until conditions are already difficult. Coping ahead is particularly underused: mentally rehearsing how to handle expected stressors makes the actual skills more available when needed." }, "preferredNodeIds": [], "conceptLinks": [ { "conceptId": "cope-ahead", "relationRole": "prepare" }, { "conceptId": "build-mastery-and-cope-ahead", "relationRole": "entry" }, { "conceptId": "please-skills", "relationRole": "prepare" }, { "conceptId": "ending-relationships", "relationRole": "prepare" }, { "conceptId": "contingency-management", "relationRole": "prepare" }, { "conceptId": "exposure-based-cognitive-rehearsal", "relationRole": "prepare" }, { "conceptId": "abc-please-skills", "relationRole": "prepare" }, { "conceptId": "clear-mind", "relationRole": "prepare" }, { "conceptId": "daily-mindfulness-regimen", "relationRole": "prepare" }, { "conceptId": "daily-practices-for-emotional-health", "relationRole": "prepare" }, { "conceptId": "weekly-regulator", "relationRole": "prepare" }, { "conceptId": "build-mastery", "relationRole": "prepare" }, { "conceptId": "question-what-helps-now-vs-long-term", "relationRole": "prepare" }, { "conceptId": "exercise-problem-solving-worksheet", "relationRole": "prepare" }, { "conceptId": "exercise-build-mastery-and-cope-ahead-worksheet", "relationRole": "prepare" }, { "conceptId": "exercise-practicing-please-skills", "relationRole": "prepare" }, { "conceptId": "exercise-steps-for-reducing-vulnerability", "relationRole": "prepare" }, { "conceptId": "exercise-putting-abc-skills-together-day-by-day", "relationRole": "prepare" }, { "conceptId": "exercise-sleep-hygiene-practice-sheet", "relationRole": "prepare" }, { "conceptId": "exercise-getting-from-values-to-specific-action-steps", "relationRole": "prepare" }, { "conceptId": "cognitive-vulnerability", "relationRole": "orient" }, { "conceptId": "dbt-diary", "relationRole": "prepare" }, { "conceptId": "problem-solving", "relationRole": "apply" }, { "conceptId": "sleep-hygiene", "relationRole": "prepare" } ], "bundleLinks": [ { "bundleId": "abc-please-skills", "role": "prepare" } ], "pathSegment": "situations" }, { "id": "schlafprobleme", "label": "Sleep problems", "shortLabel": "Sleep", "entryType": "prevention", "isDraft": false, "description": "For problems falling asleep and staying asleep or stressful nights.", "bodySensation": "Muscle tension when falling asleep, carousing of thoughts when lying down, hypersensitivity to noise or light, racing heart at night, exhaustion despite being in bed for a long time", "impulse": "Waiting in bed for sleep and thereby preventing it, screens as a distraction, wanting to force sleep, evaluating a bad night as a catastrophe", "intensityNotes": "Sleep problems exacerbate almost all other DBT-related problems. PLEASE module addresses sleep directly. Sleep hygiene and stimulus control are effective first steps.", "longDescription": { "text": "Sleep is treated in DBT as a core vulnerability factor, not a secondary symptom — disrupted sleep directly reduces emotion regulation capacity and increases reactivity the following day. Relevant skill categories are PLEASE (the sleep sub-component), ABC skills that reduce daytime activation, and distress tolerance for the sleep-onset anxiety loop. The most critical distinction is between sleep-onset problems (often driven by hyperarousal), sleep-maintenance problems, and early morning waking (often associated with depression) — interventions differ by type. A common mistake is applying sleep hygiene advice without addressing the emotional activation driving the problem. Sleep work is most effective when it targets the specific pattern and vulnerability rather than applying general wellness recommendations." }, "preferredNodeIds": [], "conceptLinks": [ { "conceptId": "nightmare-protocol", "relationRole": "apply" }, { "conceptId": "sleep-hygiene", "relationRole": "entry" }, { "conceptId": "exercise-practicing-please-skills", "relationRole": "prepare" }, { "conceptId": "exercise-steps-for-reducing-vulnerability", "relationRole": "prepare" }, { "conceptId": "exercise-sleep-hygiene-practice-sheet", "relationRole": "prepare" } ], "pathSegment": "situations" } ] }