CHAPTER 11 Behavioral Chain Analysis

THE NATURE AND FUNCTIONS OF BEHAVIORAL CHAIN ANALYSIS

THE "BASICS" IN DOING A CHAIN ANALYSIS

CONTRIBUTIONS FROM THE ACCEPTANCE PARADIGM

Be Fully Present

Practicing Nonattachment

No Boundaries, No-Self, Emptiness, and Interbeing

Impermanence

CONTRIBUTIONS FROM THE DIALECTICAL PARADIGM

변증법 기본 가정 세 가지 remind

Reality Is Made Up of Oppositions

Holistic, Systemic Thinking

Change Is Constant; Everything Is in Flux

OTHER TECHNICAL MATTERS IN DOING CHAIN ANALYSIS

CHALLENGING SITUATIONS FOR BEHAVIORAL CHAIN ANALYSIS

  1. First, there is the patient who provides little verbal data with which to work.
    1. 자발적으로 참여하지만 기억력상의 문제를 지녔다고 여겨지는 경우
    2. 고집스럽게 얘기를 꺼내지 않으려는 경우
      1. I will try to name the willful behavior standing in the way and elicit the patient’s help in assessing it.(어떻게?)
    3. 기억의 디테일을 얘기하기 두렵거나 화가 나서 얘기를 하지 않는 경우
      1. 할 수 있는 모든 것을 다 시도해 보며 무엇이 더 나은 반응을 이끌어내는지 관찰함(!)
    4. 정서적 민감성과 반응성이 너무 높은 수준인 경우
      1. In such cases, I typically let go of my plan to do behavioral chain analysis in any detail, do what I can do without causing hyperreactivity, and use in-session strategies for the reduction of the emotional sensitivity.
      2. Usually this begins with my validation of the patient’s emotions as accurately and effectively as possible—which may take a good part of the session.
      3. These are opportunities to prompt, teach, or reinforce emotion regulation skills, mindfulness, and distress tolerance.
    5. 주의력의 문제가 심한 경우
      1. These need to be named and assessed, with a goal of finding solutions.
    6. 큰 그림을 그릴 수 없을 정도로 지나치게 디테일한 부분까지 이야기하는 경우
      1. 환자와 어떻게 하면 이 문제를 해결할 수 있을지 상의하여, 큰 그림을 얻을 수 있는 방향으로 말하도록 격려
    7. 분석 자체를 치료자의 민감성이 떨어지거나 처벌적인 치료자를 만난 결과로 받아들이며 분노하거나 defiance하는 경우
      1. 일상적 언어를 사용하고 분석한다는 느낌을 주지 않도록 노력: One can simply start by saying, “What happened?” Then something like, “How did that happen?” Or, “Tell me about it.” As DBT therapists doing behavioral chain analysis, we can simply try to learn about the story, and in the backs of our own minds we can frame or structure the story in the form of a behavioral chain.