DBT Video Text: Pros and Cons

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These are scripts from videos by Dialectical Behavioral Therapy creator Marsha Linehan describing DBT skills. You can purchase the videos from Behavioral Tech LLC.

We have one set of skills left and this is the skill of Pros & Cons. Thinking about the advantages and disadvantages of particular courses of action or doing certain things. So you think about the advantages of doing certain things and the disadvantages of doing them. And you think about the advantages of not doing things. And you think about the disadvantages of not doing things. 

There are three steps in Pros & Cons and we’re going to go through each one of them. So the first step is that you have to actually figure out what’s the behavior that you’re trying to figure out whether you’re going to do it or not. So, if you’re in a crisis and you’re thinking of doing something really destructive, you might think about what is that destructive behavior. Like you’re having an urge to binge eat, drink, use drugs, drive too fast, stay in bed all day, drop out of things you start.

DBT Pros and Cons: a person sits on a bed looking upset

Right now, just for a minute, think through what are the things you do that get you in trouble, make your life go worse. You could just get yourself revved up, mobilized, motivated, on course, stop doing those behaviors, especially when you’re in a crisis, your life would go a whole lot better. So that’s step one. Write those behaviors down. Step two is actually doing the Pros & Cons. The first thing you want to do is get out a piece of paper. Now on the piece of paper, make a grid. On the top, you’re going to want to write ‘Pros’ and ‘Cons’. And then go over to the left side, write ‘Yes’ and ‘No’. So now you’ve got your Pros and Cons grid.

Let’s go through an example. Let’s say you’re a person who’s had a lot of problems with alcohol. In fact, maybe you were an alcoholic at one point in your life. Now, well, you just got fired from your job, life’s really difficult, you don’t really have anything to do, so you start wanting to have a drink. It’s kind of a crisis and you want to have a drink. What are the advantages? Well, you might be thinking, ‘I’ll feel calm immediately. I won’t be in so much pain. I’ll get to experience that really pleasurable buzz, that warm feeling I get as alcohol is going down my throat.’

What do you have to lose? Well, you might think, ‘I’ll hate myself. I’ll have to start over and it’ll be really hard and I’ll feel ashamed.’ So you’ve got the Pros and Cons of drinking.

Now, let’s look at the Pros and Cons of not drinking. What do I have to gain from not drinking? ‘Feel really competent. I can look at my children in the face. I won’t feel hung over tomorrow. I won’t have pain and suffering in the long run.’ Now let’s look at the cons. If you don’t drink, what’s the disadvantage? You’re going to keep on having pain and suffering, at least for the moment. You’ll be more irritable. It’s possible you’ll keep on drinking – you’ll have to start all over. 

Now, you’ve got the Pros & Cons, what do you do next? You’re the only one who can decide; no one can decide this for you. ‘Cause no one can tell you what’s really important to you. But, if drinking’s a problem for you and you know it, then you’re going to have to hope that you’re going to decide that the disadvantages of drinking and the advantages of not drinking far out weigh anything you’ve got to gain from drinking. And my guess is, if you do this honestly, thoroughly, thoughtfully, that’s what’ll happen. 

The secret to a really good Pros & Cons is the first time, do it when you don’t have the urge. Do it when you’re calm, secure, not in a crisis. So that’s step two, you’ve done your Pros & Cons. I’m going to assume that you’ve done it.

What’s step three? Step three is don’t throw that piece of paper out. You want to keep those Pros & Cons because you’re going to need them in a crisis.

Have you ever noticed that sometimes when people get in a crisis it really seems like not only do they not want to get out of the crisis, but actually they kind of want to stay in the crisis. Sometimes people think, ‘If I stay in the crisis, someone else is going to do something. I’m going to stay in the crisis to prove to them how bad it is.’ Or, ‘I’m not getting out. And who’s going to help me?’

Remember that story I was telling you about being in the church and moving around and being sort of miserable the whole time. Well what’s going on? I was trying to get somebody else to do something. It was like, if I stay miserable, he’ll quit talking. Did he?  No. Usually it doesn’t work. I just have to tell you that’s not a road you want to go down.  Lots of people have been down that road. I’ve never seen that road work. The price is just too high. So, do Pros & Cons on whether to use your skills. But if you decide you want to be effective, you want to survive, you want to get through this in one piece, you don’t want to make things worse, these are the skills for you.

This text is the unofficial transcript of Behavioral Tech, LLC.
Chaos to Freedom Skills Training Video. Posted with permission from Behavioral Tech.
Transcribed by Sylvia James, May 15, 2006