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William’s Story






William lived with his wife in a very small town, where many people had known him personally since he was a young child. He worked as a carpenter (often doing jobs for local residents) and was involved in a very tight-­knit religious community. After several bouts of depression, William began to discover that he probably had post-­traumatic stress disorder related to past abuse by a family member when he was a child. During his periods of depression, he avoided leaving his home, did not attend church functions or activities, and failed to return calls about carpentry jobs. Over time, he became extremely ashamed and anxious, and he avoided people around town, because he was afraid of being judged, criticized, or pitied for his mental health problems.

Even when William’s depression began to lift, he found himself still embarrassed and afraid to see people, and further, when he did see people, he had trouble making small talk and, in particular, being assertive. For example, he often said yes to huge jobs that he knew he didn’t have time for. Then, he would do a less than optimal job or wouldn’t finish the work and would wind up feeling even more anxious and ashamed. William had been so out of practice with social interactions that he needed to learn how to talk to people and also how to manage their demands, say no, and communicate his abilities realistically.

After learning DBT interpersonal effectiveness skills, he began to relearn some of the social skills he had lost, and he gradually started reemerging into the community by getting more involved in his church and reconnecting with others.

Moving Forward

By now, we hope that you have a better understanding of what anxiety is and how it develops, what DBT is and how it might help you deal with anxiety, and the specific kinds of DBT skills we will teach you. Going through this workbook is much like building a new home. First, you need to lay the foundation, and that’s what chapters 1 through 4 have been all about. Next, you need to put all the pieces of the home into place, and that’s what the remaining chapters are all about. As we go forward in this workbook, you will learn ways to apply these DBT skills more specifically to the types of anxiety problems that you struggle with. By the end, we hope you will have a strong, safe bunker of skills to shelter you from your anxiety and keep you safe in the storm.

 

Chapter 5

Stress

Stress often goes hand in hand with anxiety and fear. In fact, these experiences go together so often that many people use the terms “stress” and “anxiety” interchangeably. What you may not know, however, is that even though stress and anxiety are closely related, they are not the same thing, and there are some important differences between these experiences of which you should be aware.


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