When in a stressful situation, we may feel an urge to say something, to do something, to feel something, to think something. Many times these impulsive urges nudge us towards action, language, feelings or thoughts that are not effective, healthy or helpful in the situation – acting on such impulses simply makes a bad situation worse.
These unhelpful urges might include:
- Yelling at someone
- Using drugs or alcohol
- Eating too much
- Complaining so much that people avoid you
- Retail “therapy” you can’t afford
- Becoming aggressive with another person
- Giving up, shutting down, isolating oneself
- Negative, hopeless thoughts (i.e. “I’ll never mount to anything”; “No one loves me anyway.”)
In Dialectical Behavior Therapy (DBT), developed for individuals with Borderline Personality Disorder, we use a tool called Four Square Pros & Cons to decide whether or not to act on these not so effective urges. This skill gets us to look at a situation in four different ways in order to make a wise-minded decision on how to cope.
In the Four-Square Pros & Cons Exercise, we look at:
- The benefits of acting on our urge.
- The benefits of not acting on our urge.
- The downsides of acting on our urge.
- The downsides of not acting on our urge.
Reviewing the pros and cons helps us to look at a situation from every perspective and identify possible outcomes.
How to Complete a Four Square Pros & Cons List
- At the top of a sheet of paper, write down the impulse you want to review.
- Make a four-square grid of two columns and two rows.
- Above the top right square write “Pros” or “Benefits” and above the top left square write “Cons” or “Costs”.
- To the left of the top row write “Follow the Urge” or “Act on Impulse” and to the left of the bottom row write “Don’t Do It” or “Don’t Act on Impulse.”
- Fill out each quadrant of the worksheet. Think about the costs and benefits you experienced in the past when you practiced the behavior or didn’t.
- Remember to focus on both the short-term and long-term pros and cons.
Sample Four Square Pros & Cons List
The impulse/urge is to: Yell at your co-worker the next time you see him.
|Act on Implulse||1. Will feel good in the moment.||1. Will feel embarrassed later.|
|2. Will feel a rush.||2. Will hurt co-worker’s feelings.|
|3. Will feel in control.||3. Will alienate co-worker.|
|4. Co-worker may leave me alone.||4. Risk loss of self-esteem and sense of self-worth.|
|Don’t Act on Impulse||1. No fight or argument.||1. Don’t get to express anger/dissatisfaction.|
|2. Maintain good working relationship.||2. Don’t get to "make a point" or "win."|
|3. Feel good about curbing impulse.||3. No immediate release or gratification.|
|4. Build trust with co-worker and others.||4. No adrenaline rush.|
By taking the time to look at the situation in depth, we gain a much more measured perspective and often the urge to act impulsively has passed. This works almost every time!
Dialectical Behavior Therapy at Pine Rest
Would you like to learn more DBT skills? We currently offer therapy for adults and teens in Grand Rapids and Traverse City. Call scheduling at 866.852.4001 to make your first appointment. For more information, contact Katherine DeVries (Grand Rapids) at 616.222.3720 or Kym Hansen-Duell (Traverse City) at 231.947.2255.
For Family Members & Friends
Our Borderline Personality Disorder Family and Friends Class is a brief, 4-session educational series designed to increase understanding of the illness and equip family and friends with tools for coping effectively. Participants will learn about the symptoms and causes of BPD as well as coping tools. Weekly sessions will be a combination of education and discussion. Classes are offered in Grand Rapids and Traverse City. Learn more at pinerest.org/bpd or call 616.222.3720 (Grand Rapids) or 231.947.2255 (Traverse City).
Kym Hansen-Duell, LMSW, ACSW is a licensed social worker at the Pine Rest Traverse City Clinic. Kym has a Bachelor of Science in Psychology from Central Michigan University and a Master of Social Work from Grand Valley State University. She is a member of the National Association of Social Workers and the Academy of Certified Social Workers. Kym is available to speak at community events on topics such as ADHD, depression, parenting, family issues and workplace stress