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    "title": "PLEASE Skills",
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      "PLEASE Skills",
      "PLEASE-Fertigkeiten"
    ],
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    "applicationContext": "When mood, irritability or crisis are exacerbated by sleep, eating, substances, illness or lack of self-care.",
    "longDescription": {
      "text": "The PLEASE skills address the biological substrate of emotional vulnerability: an out-of-balance body makes negative emotions more intense and harder to regulate. PLEASE stands for treating Physical iLlness, balanced Eating, Avoiding mood-Altering substances, balanced Sleep, and Exercise. These are structural conditions that raise or lower the emotional threshold for all other regulation skills. Illness left untreated, irregular eating, substances that alter mood, sleep disruption, and physical inactivity each independently increase reactivity to emotional triggers. Consistent aerobic exercise is an evidence-based antidepressant. Regular sleep reduces emotional dysregulation. The PLEASE skills do not change emotions in the moment — they change the terrain on which all emotional responses occur.",
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          "sourceId": "linehan-manual-529p",
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    "comparisonDescription": "Sleep is one of the physical foundations covered by PLEASE. Sleep hygiene explores general habits and conditions; the nightmare protocol specifically addresses recurring nightmares. Both expand on this part of the bundle.",
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      "applicationContext": "When emotions seem diffuse, overwhelming or difficult to understand and a structured overall map of how emotional episodes are structured is needed.",
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        "text": "The DBT Model for Describing Emotions provides a systematic framework for understanding the components of an emotional response and where within the system intervention is possible. The model maps the sequence: vulnerability factors create the context; a prompting event triggers the emotion; interpretations and secondary emotions develop; biological changes occur in the body; action urges arise; and behavioral and verbal expressions follow. Because emotions are full-system responses, changing any component can shift the entire emotional experience. This model is taught before the regulation skills because understanding the structure of an emotion is necessary for choosing where to intervene.",
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    {
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      "priorityDescription": "This node is more about preparation, stabilization, or later deepening around prepare for stress.",
      "cardPreview": "If physical self-care is to be built as a daily practice.",
      "purpose": "Anchor PLEASE not just as a memory aid, but as a concrete, comprehensible daily exercise.",
      "applicationContext": "If body-related vulnerability is to be reduced and daily self-care cannot remain abstract.",
      "longDescription": {
        "text": "This worksheet tracks daily practice across all five PLEASE skills. The most useful pattern to notice is which skills are consistently skipped — those are typically the ones producing the most vulnerability. The worksheet is not about achieving perfection across all five; it is about identifying the two or three areas where consistent investment produces the most resilience. Tracking also reveals how days with good PLEASE adherence correlate with lower emotional reactivity the following day — which is itself motivating.",
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      "applicationContext": "When stress escalates repeatedly and the question is aimed at preventive reduction of susceptibility rather than acute intervention.",
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        "text": "This summary worksheet covers all ABC PLEASE skills together. It is most useful as a weekly planning tool rather than a retrospective record: filling it out at the start of the week to schedule pleasant events, mastery activities, and physical self-care in advance, rather than hoping they happen spontaneously. The pattern to monitor is whether any skill category is consistently blank — consistent absence of mastery activities, for example, often predicts low-grade hopelessness that goes unrecognized until it has accumulated.",
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        "text": "The Nightmare Protocol is a DBT skill based on Imagery Rehearsal Therapy: a structured approach to reducing the frequency and distress of recurring nightmares by deliberately changing their content through waking imagery rehearsal. The core principle is that nightmares are learned behaviors — responses conditioned by traumatic or highly distressing experiences — and like other learned behaviors, they can be modified. The protocol involves writing down the recurring nightmare in detail, choosing a changed outcome (any modification that feels tolerable), mentally rehearsing the changed dream repeatedly while awake, and pairing the rehearsal with relaxation. Research shows significant reductions in nightmare frequency following this approach. It is closely related to Cope Ahead in its use of preparatory imagery rehearsal.",
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          "relationRole": "prepare",
          "fit": "primary",
          "strength": 0.9,
          "isPreferred": true
        },
        {
          "situationId": "albtraeume-belastende-naechte",
          "label": "Nightmares or difficult nights",
          "entryType": "prevention",
          "pathSegment": "situations",
          "relationRole": "prepare",
          "fit": "primary",
          "strength": 0.84,
          "isPreferred": true
        },
        {
          "situationId": "neid",
          "label": "Envy",
          "entryType": "emotion",
          "pathSegment": "emotionen",
          "relationRole": "prepare",
          "fit": "secondary",
          "strength": 0.74,
          "isPreferred": true
        },
        {
          "situationId": "schuld",
          "label": "Guilt or guilt feelings",
          "entryType": "emotion",
          "pathSegment": "emotionen",
          "relationRole": "prepare",
          "fit": "secondary",
          "strength": 0.7,
          "isPreferred": true
        },
        {
          "situationId": "interesse",
          "label": "Interest or curiosity",
          "entryType": "emotion",
          "pathSegment": "emotionen",
          "relationRole": "prepare",
          "fit": "secondary",
          "strength": 0.7,
          "isPreferred": true
        }
      ]
    }
  ],
  "situations": [
    {
      "id": "belastung-vorbereiten",
      "label": "Prepare for Stress",
      "shortLabel": "Prepare",
      "entryType": "prevention",
      "isDraft": false,
      "description": "For anticipated stress, relapse prevention or planned difficult situations.",
      "bodySensation": "Anticipatory tension, sleep problems before stressful events, increased excitability in the days before, body is already preparing",
      "impulse": "Over-planning or over-thinking, avoiding the situation, wanting to control all eventualities, using cope-ahead exercise as a safety anchor",
      "intensityNotes": "Preparing for stress has a prophylactic effect and reduces the impact of the crisis. 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": "angst-panik",
      "label": "Fear or panic",
      "shortLabel": "Fear",
      "entryType": "emotion",
      "isDraft": false,
      "description": "For anxiety peaks, near panic, fear of loss of control or massive concern.",
      "bodySensation": "Racing heart, tightness in the chest and throat, shallow breathing, muscle tension, sweating, trembling, dizziness",
      "impulse": "Flee or leave the situation, freeze and freeze, seek and secure control, avoid the next contact",
      "intensityNotes": "Course from chronic background worry to acute panic attack. Physical symptoms increase quickly and subside more slowly. Often wave character.",
      "longDescription": {
        "text": "Anxiety and panic form a continuum in DBT, with chronic background worry at one end and full panic with physiological symptoms at the other. DBT does not treat anxiety as intrinsically pathological — it treats it as a signal whose intensity has become dysregulating. The relevant skill categories are emotion regulation (check-the-facts, opposite action to anxiety, vulnerability reduction), distress tolerance for peak moments, and mindfulness for observing the wave without amplifying it. A key clinical distinction: anxiety justifies avoidance behaviors, which maintain anxiety — a common failure mode when skills are used to suppress rather than process the emotion. The core prescription of opposite action for unjustified anxiety is approach rather than avoidance: actively entering what is feared, not pulling away from it, and doing so repeatedly and all the way until the response decreases."
      },
      "preferredNodeIds": [],
      "conceptLinks": [
        {
          "conceptId": "check-the-facts",
          "relationRole": "understand"
        },
        {
          "conceptId": "emotion-functions",
          "relationRole": "understand"
        },
        {
          "conceptId": "emotions-model",
          "relationRole": "understand"
        },
        {
          "conceptId": "emotion-exposure",
          "relationRole": "understand"
        },
        {
          "conceptId": "accumulating-positive-emotions",
          "relationRole": "understand"
        },
        {
          "conceptId": "please-skills",
          "relationRole": "understand"
        },
        {
          "conceptId": "exercise-check-the-facts-worksheet",
          "relationRole": "apply"
        },
        {
          "conceptId": "exercise-figuring-out-how-to-change-unwanted-emotions",
          "relationRole": "apply"
        },
        {
          "conceptId": "tip-paced-breathing",
          "relationRole": "entry"
        },
        {
          "conceptId": "cope-ahead",
          "relationRole": "prepare"
        },
        {
          "conceptId": "exposure-based-cognitive-rehearsal",
          "relationRole": "apply"
        },
        {
          "conceptId": "improving-the-moment",
          "relationRole": "apply"
        },
        {
          "conceptId": "mindfulness-of-current-emotions",
          "relationRole": "apply"
        },
        {
          "conceptId": "opposite-action",
          "relationRole": "apply"
        }
      ],
      "pathSegment": "emotionen"
    },
    {
      "id": "trauer-verlust",
      "label": "Grief or loss",
      "shortLabel": "Grief",
      "entryType": "emotion",
      "isDraft": false,
      "description": "For reactions of loss, depression or painful sadness.",
      "bodySensation": "Heaviness in the body, fatigue, tightness or pressure in the chest, crying, slow movements, lack of appetite, sleep changes",
      "impulse": "Withdrawal and isolation, pausing and doing nothing, seeking connection to others, focusing on what has been lost, grieving and letting go",
      "intensityNotes": "Course often wavy, not linear. Intensity can increase again after days. Frequent periods of emotional numbness between painful waves. Duration from hours to weeks depending on the loss.",
      "longDescription": {
        "text": "Grief in DBT is treated as a justified emotion that deserves acknowledgment rather than suppression, but one that can become problematic when it persists beyond functional coping. It differs from depression in that it remains linked to a clear loss event and has a wave-like rather than persistent quality. The relevant skill categories are emotion regulation (especially non-judgmental observing), self-compassion, mindfulness, and radical acceptance for irreversible losses. Opposite action for grief involves re-engaging with meaningful activities, not eliminating sadness. A common mistake is treating grief as a problem to be solved rather than a process to be witnessed — which tends to prolong the emotional difficulty rather than reduce it."
      },
      "preferredNodeIds": [],
      "conceptLinks": [
        {
          "conceptId": "exercise-opposite-action-worksheet",
          "relationRole": "apply"
        },
        {
          "conceptId": "exercise-mindfulness-of-current-emotions-worksheet",
          "relationRole": "apply"
        },
        {
          "conceptId": "mindfulness-of-current-emotions",
          "relationRole": "entry"
        },
        {
          "conceptId": "check-the-facts",
          "relationRole": "orient"
        },
        {
          "conceptId": "opposite-action",
          "relationRole": "apply"
        },
        {
          "conceptId": "radical-acceptance",
          "relationRole": "understand"
        },
        {
          "conceptId": "self-compassion",
          "relationRole": "stabilize"
        },
        {
          "conceptId": "loving-kindness",
          "relationRole": "stabilize"
        },
        {
          "conceptId": "emotion-functions",
          "relationRole": "understand"
        },
        {
          "conceptId": "please-skills",
          "relationRole": "prepare"
        }
      ],
      "pathSegment": "emotionen"
    }
  ]
}
