M3: Internal vs. External Events

A big social event is coming up. You are overwhelmed with the thought of how this new group of people will perceive you. Does your tone sound right? Do you play your part well? Do you say all the right things? You are preoccupied with the way you present yourself, and as a result you don't communicate with them authentically. The nervousness that you feel starts growing bigger because of your preoccupation with it. The event ends and you are relieved that the stress and overthinking has ended. This is an example of heightened internal awareness.

Or, maybe you are at the event and are immersed in everything that's happening around you. The sights, the smells, and the conversations. You go along with the events of the night without being aware of how you feel about them. You don't really know how you feel about this social event, and you don't know what your thoughts are on the small talk you make with the others. The social event ends, and you find that you return home angry about something, but you are not sure what. This is an example of heightened external awareness.

Being too internally or too externally aware can lead to problems with regulating your emotions on a day-to-day basis. If you are too aware of your inner experiences, this may amplify the psychological pain or distress you feel. If you are too externally focused, you may consciously or unconsciously ignore your emotions, which can exacerbate any struggles you may be experiencing.

The following mindfulness exercise can help you balance out your internal and external focus, thus helping you reflect and regulate your emotions better on a day-to-day basis.

The point of this DBT skill is to:

• Identify your level of internal versus external awareness;
• Practice focusing more on whichever one you do less;
• Ultimately, creating a balance on the focus of internal and external events.

If you are a person who pays more attention to internal events, then you will practice observing the external events in the environment. On the other hand, if you are predominantly externally oriented, then you will practice shifting your attention to the events (e.g. thoughts, feelings) happening inside you.

Step 1: Are You More Internally or Externally Focused?

Try to think about what you do in a typical situation. Read the statements below and put a check mark next to the ones that apply to you.

I usually pay more attention to:

My thoughts
Emotions
Physical sensations
Urges
Images, memories
--------
What I see around me
Different smells
Sounds around me
People around me
The environment around me

If you checked mostly with the statements on the top half of the list (thoughts, emotions, sensations, etc.) that means that you are predominantly an internally oriented person. In this case, continue with PART A of the second step.

If you checked mostly statements on the bottom half of the list (what you see, hear, the environment, etc.) that means that you are probably a more externally oriented person. Continue with PART B of the second step.

Step 2: Awareness Of Internal Or External Events

PART A: Bringing Awareness To External Events

Try to spend about 10 minutes in total on this exercise.

Start the exercise by sitting comfortably. Try to direct your focus to the environment around you. After paying attention to the environment from a seated position, stand slowly and become aware of the space around you. How big is the room that you are in? How much space does your body take from the room? Move slowly for another minute, breathe deeply and continue focusing on the spatial aspect of the room around you. If your thoughts shift to something else, just gently bring your focus back to the exercise. Next, sit again, and continue the exercise from a seated position.

Bring your awareness to the things you see around you. Is the room well lit or dim? Is it small or spacious? Does the sunshine enter the room or is it lit by a lamp? Look at the colors of the walls. Are they bright-colored or darker? Look at the objects around you. How do they look? Bring your visual attention to the things in front of you, behind you and on your sides. Look up and down. If you get distracted by thoughts, gently and without judgment bring your attention back.

Next, try to bring your attention to the sounds around you. Is the room quiet? Can you hear distant sounds from the street or the other rooms around you? Listen to sounds that are louder, and then try to hear the more quiet ones. If you are in a room that is very quiet, try to hear the background sounds. Listen to sounds that are near you and to the sounds that are further away.

Bring your attention to your sense of smell. Can you sense a certain smell in the space that you are in? Or is there no particular scent to it at all? Maybe you can smell a vague scent from the laundry detergent or your deodorant or perfume. Maybe you can sense the smell of a piece of food that you have in the room, or your cup of coffee. Is there perhaps an unpleasant smell in the room? Be aware of anything that you might feel with your sense of smell.

Try to be aware of the totality of the environment around you. Without prioritizing the different sensations, try to integrate them and be in tune with the external events around you.

Reflect and write down your experience. This journaling of your experience makes all the exercises more impactful. You can print out the worksheet below.

When you find yourself in situations in which your internal awareness is becoming heightened, remember to do this exercise to counterbalance these thoughts/feelings.

PART B: Bringing Awareness To Internal Events

Try to spend about 10 minutes in total on this exercise.

Find a comfortable seated position and bring your awareness to the thoughts that your mind is thinking. Don't get attached to them, just note how they enter and leave your mind. Try not to be reactive to the content of your thoughts. Simply notice them. Maybe you will notice that your mind is particularly fast in coming up with new thoughts. Perhaps you have a slow day or you're a little tired and you don't have as many thoughts. Whether the quality of the thoughts is pleasant or unpleasant, just accept this and non-judgmentally keep being aware of your thinking mind.

Next, try to bring your attention to any emotion that you are feeling. What is the underlying mood that you have today? Are you experiencing any strong emotions? Whether you feel content, calm, happy, or a little sad or anxious, just observe this internal event and accept whatever may occur in you. Maybe you will detect a physical aspect to your emotion. If you feel anxiety, you may have a nervous stomach or sweaty palms. If you feel sad, maybe you will notice that your body feels tired.

Now, bring your attention to any physical sensations or urges that you may feel. How does your body feel today? Is it rested or tired? Can you sense any discomfort or bodily tension? Perhaps you feel refreshed and well rested. Whatever sensation that you might observe in yourself, greet it with acceptance and continue observing the rest of your body. Can you detect any physical need that you might have? Are you sleepy and tired? Are you a little hungry or full? Do you feel any other physical sensations or needs?

Reflect and write down your experience. This journaling of your experience makes all the exercises more impactful. You can print out the worksheet below.

When you find yourself in situations in which your external awareness is becoming heightened, remember to do this exercise to counterbalance these thoughts.

I am not sure that I did the checklist right. How can I know for sure that I am internally or externally oriented?

Think about how you usually react in your day-to-day life. Are you usually aware of most of the things you feel and think while not being that focused on the things around you? That would mean that you are an internally oriented person. On the other hand, if you rarely think about how you feel, what you think or the other internal events that happen inside you, then you are probably an externally-oriented person.

I got equal number of checks on both the internal and external lists. What part of step 2 should I do?

If you got equal number of checks on both lists that might mean one of two things: you either pay approximately equal amount of attention to both the external and internal events, in which case you can choose to do either part first and then next time you can do the other one. For example, the first time you can try part A, and the next time part B. If you are not sure and don't really feel like you are equally oriented towards the internal and external events, then think about it a little more and try to be as honest with yourself as possible. Do the checklist again, there are no wrong or right answers.

How will this exercise help me regulate my emotions?

If you are predominantly oriented towards the internal events, that might mean that when you feel strong emotions you make them even stronger by focusing solely on them. Shifting your focus to the external environment might change your perspective and decrease your level of distress. In contrast, being mostly aware of the external environment might mean that you consciously or unconsciously avoid or ignore your emotions, which can equally contribute to emotional distress. This is why the awareness harmonizing in this exercise can help you better balance your emotions.

If you have any behavioral health questions or concerns, please talk to your healthcare or mental health care provider. This article is supported by peer-reviewed research and information drawn from behavioral health societies and governmental agencies. However, it is not a substitute for professional behavioral health advice, diagnosis, or treatment.