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Managing Anxiety through Art Therapy and DBT: Cope Ahead Comics

by Lauren Fallat, LPC LPAT ATR-BC

DBT is an evidence-based cognitive behavioral treatment for a range of mental health conditions, including but not limited to: bipolar disorder, borderline personality disorder (BPD), eating disorders, and post-traumatic stress disorder (PTSD). DBT focuses on helping people to identify and manage their emotions.

One of the most important aspects of DBT is learning how to cope ahead. This involves anticipating difficult situations in the future, identifying potential problems within those situations before they happen and developing a plan to cope effectively. We might plan on coping ahead for situations that trigger feelings of anxiousness, sadness, anger or embarrassment. This can involve anything from planning your day so that you have time for your own self-care, to packing your bag with snacks and water so that you are prepared and energized for the work day ahead.

When you are coping ahead, you are taking control of your life. You are not waiting for difficult situations to happen and then trying to deal with them in a panic. Instead, you are calm and in control, ready to face whatever comes your way.

The following steps can help you create a coping ahead plan:

1. Identify situations that are likely to be difficult for you. These situations might be related to your home life, school life, professional life, and so on. Situations that involve social interactions or potential conflict can also be emotionally triggering. Also consider certain parts of the year, such as holidays and anniversaries that may be difficult especially if they connect with experiences of grief.

2. Develop a plan for how you will deal with these situations. It is important to have your plan be clear, direct and detailed so that anyone could read your instructions for your plan and carry it out in the same way.

3. Practice your plan in advance. This is where role playing and art making can be effective! See below for an art therapy directive that combines cope ahead planning with comic book drawing!

4. Review your plan regularly and make changes as needed. Allow yourself to adapt to different circumstances and change your plan based on details that shift or your own level of comfort or discomfort. While planning for what we expect in our futures may be a worthwhile task, it is also important to recognize that we may need to adapt to changes in course or unanticipated factors, and that’s ok!

For your cope ahead comic drawing:

  1. Identify one problem or concern you have for a specific, realistic situation you might find yourself experiencing in the future. This can be a situation at school, at home, at the gym, grocery store, whatever it may be.

  2. Create a comic strip with the intention of visually depicting the potential future situation. Have at least 3 frames with a beginning, middle and resolution depicted. The resolution or last frame can show how you might solve the problem or cope effectively using strategies that you have identified in your therapy sessions.

  3. Include dialogue! Part of coping ahead is really envisioning yourself in that moment of difficulty and successfully dealing with the stressors. In order to create the clearest picture, it can be helpful to include words that you might say to yourself or others, how you will communicate your emotions or thoughts, and actions you might take. This is a great way to also role play the scenario using the comic as a ‘stage’ for rehearsal.

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