Behavioral Chain Analysis is a valuable tool for people who have BPD because it helps look back and analyze the chain of events that led to a negative outcome. You do it when you are not in crisis and can be objective about the trigger and the resulting behaviour. Nothing happens in a vacuum.

So, if you end up in the hospital because you have taken a drug overdose because you wanted to kill yourself, looking back at the chain of how that transpired can help you enormously. Doing a behavioral chain analysis can also help you figure out what you could have done to interrupt the chain of events that were leading you to spiral out of control by using an alternate DBT skill in its place.

So my last suicidal event looked like this:

Trigger: My boyfriend ghosted me.

Action: I went to the liquor store to buy booze.

DBT skill that would have helped: STOPP or Opposite Action or Radical Acceptance

I came home and made a pitcher of Screwdrivers and proceeded to get drunk.

NEXT: I started to drink all night long.

NEXT: I got drunker and drunker until I became depressed and saw no outlet.

Alcohol is a depressant and I became more and more depressed.

THEN: I went to the grocery store to buy more orange juice for more Screwdrivers.

THEN: I came back home and ground up the pills and placed them in the pitcher of Screwdrivers.

SOON: I began to feel more and more suicidal.

THEN: I sat down and wrote a long suicide note to my children.

EVENTUALLY: I passed out in my living room where a friend later found me and called the ambulance.

The end result was that I ended up in the hospital on the psychiatric floor again. Although it was not the outcome I wanted, it was actually a crucial turning point for me because while I was there I was reintroduced to mindfulness and DBT which eventually led to my recovery.

Had I been able to use any of these DBT skills (Distraction, Self-soothing, STOPP, I could have interrupted the chain of events as they were unfolding and saved myself from another suicidal episode.

Doing a behavioral chain analysis exercise can help you see where you fall down each time and figure out how to put fail safes into place so that you don’t end up going down the rabbit hole again the next time it happens. This is similar to filling out a emergency care plan. But the point of these two exercises is to do them IN ADVANCE when you are thinking clearly and can make rational decisions and choices because by the time you are in crisis, it is too late.