Do you struggle with managing your emotions, building relationships, or achieving your goals? If so, you’re not alone. Many people face challenges in these areas and find it difficult to take control of their lives. However, with the assistance of Dialectical Behavior Therapy (DBT) techniques, you can learn to navigate these challenges and unleash your full potential.
This article explores the different DBT skills and how they can help individuals of all backgrounds and experiences learn to lead happier, healthier lives. So, buckle up and get ready to discover a whole new world of possibilities!
What is Dialectical Behavior Therapy?
Dialectical Behavior Therapy (DBT) is a subset of cognitive-behavioral therapy (CBT) developed in the 1980s by Marsha Linehan, a psychology professor at the University of Washington.
Initially, DBT was an evidence-based treatment method to assist individuals struggling with suicidal thoughts and borderline personality disorder (BPD). Today, DBT has been found to be effective in treating a wide range of mental health illnesses, including anxiety, depression, relationship difficulties, substance use disorders, and eating disorders.
In a study that explored the long-term outcomes of DBT, individuals who had completed 12 months of standard DBT continued to report positive changes for several years after therapy. Analysis of the respondents’ answers to research questions showed that the individuals found DBT to be a life-changing experience. Therapy enhanced their self-development, gave them increased self-control and skills to cope with difficulties, and contributed to enhanced relationships.
Sheritha Chambliss, a psychiatric mental health nurse practitioner and a provider with Grow Therapy, also confirms the effectiveness of DBT in improving the quality of life. She says, “DBT helps in changing one’s mindset, improving distress, emotions, and interpersonal skills. DDT skills also enhance life skills to enable you to live a fulfilling life.”
4 Main DBT Skills
DBT therapy offers a comprehensive toolkit for individuals to unleash their full potential and live a more meaningful life. To this effect, DBT training modules focus on equipping individuals with practical skills to manage their emotions and behaviors effectively. These skills can be grouped into four key areas:
Mindfulness Skills
Mindfulness involves being fully present in the moment and nonjudgmentally observing your thoughts, feelings, and sensations.
In today’s fast-paced and constantly changing world, you’re likely to get caught up in your thoughts and worries, which can lead to stress, anxiety, and dissatisfaction. According to the Centers for Disease Control and Prevention, in 2022, 12.5% of American adults suffered from regular stress-related feelings of anxiety, nervousness, and worry.
Mindfulness skills help you respond to challenging situations with greater wisdom and intention. Mindfulness also allows you to break free from the cycle of rumination and negative thinking. Rumination is the repetitive dwelling on negative thoughts and associated feelings. The repetitive pattern of rumination can lead to anxiety and stress, making things worse.
“Wise Mind” Skill
“Wise Mind” trains you to use input from your “Emotion Mind” and the “Reasonable Mind.” A Wise Mind is the point of intersection between emotion and reason.
Reasonable Mind involves a logical approach to the observable world, situations, and events. When in Reasonable Mind, you can plan and act objectively and according to facts at hand. The downside of Reasonable Mind is that it often excludes emotional input, which can be necessary for making well-rounded decisions.
When in the Emotion Mind, your feelings control your thoughts and actions. Logical thinking becomes hard, facts get distorted, and planning becomes difficult. The intensity of emotions guides your actions. Since emotions guide actions and behavior when in Emotional Mind, you can act impulsively or make ineffective decisions.
Wise Mind is a synthesis of Reasonable Mind and Emotion Mind. In Wise Mind, you can acknowledge and consider your emotions and value your rational thought at the same time. As a result, you can act with wisdom and intuition, considering both the logical and emotional aspects of a situation. This balance allows for well-considered and effective decisions and reactions.
“What” Skills
“What” mindfulness skills teaches you to live your life fully. The skill emphasizes taking control of your mind using three steps as follows:
Observe: Pay attention to emotions, events, and thoughts. You should neither terminate these thoughts and emotions even when they’re painful, nor prolong them even when they’re sweet.
Describe: You learn how to describe the present events, label the ensuing emotions, and identify related thoughts without judgment.
Participate: Immerse yourself into the present activity — act spontaneously and participate without self-consciousness.
“How” Skills
“How skills” are another DBT mindfulness practice that can help you concentrate on the present moment and focus on the intended outcome. These skills emphasize three aspects:
Remaining Non-Judgmental: Avoid viewing a situation as bad or good. The focus should be on the consequences of behavior, not whether you are right or wrong.
One Mindful: This refers to the ability to focus on the current moment and activity. If you get distracted by thoughts or intense feelings, keep coming back to the activity at hand.
Effective: This aspect centers on doing what works for you without worrying about what is right or wrong. The focus should be on the desired outcome.
Interpersonal Effectiveness Skills
Interpersonal effectiveness DBT training module equips you with skills to enhance your relationships and communication with others. Healthy relationships positively impact your mental health. According to research conducted among mothers, those in stable romantic relationships were 2 times less likely to report depression compared to those in unstable relationships.
The following DBT interpersonal effectiveness sub-skills can help you build strong and supportive relationships and build healthy boundaries with the people in your life.
DEAR MAN
DEAR MAN teaches effective communication skills. The training focuses on enabling you to get what you want in an interpersonal context while preserving positive relationships and respect for self. Here is a step-by-step breakdown of the acronym:
D-Describe: This is the first stage that sets up the conversation and lets the other person become aware of the reason you are asking or making a request. Describe your situation in a simple, factual manner without expressing any associated emotions.
For example, if you are angry with your spouse for staying out late, state your case in a straightforward statement. Say: “You promised to come home before six, but you arrived at midnight.”
E-Express: Express your feelings using “I” statements. This shows you are accountable and dissuades the other person from becoming defensive.
For example: “I am very concerned about your security when you stay out so late.”
A-Assert: Ask for what you want clearly and strongly. Avoid beating around the bush, or else the other person might not get what you want.
For Example, you can say: “I would appreciate it if you would notify me every time you are going to stay out late.”
R-Reinforce: Let the other person know why it’s important to grant your request. Make sure they know there’s something in it for them.
Say, for example: ‘I would be so happy and relieved if you did that. It would even make it easier to plan for our dinner together.”
M-(Be) Mindful: Keep your attention on your objectives, and try to stay focused on the conversation even if the other person goes on the defensive. You can use the broken record technique-keep repeating the same thing over and over.
Say, for instance, “I would still like you to inform me beforehand whenever you’re coming home late.”
A-Appear: Confidence on your part makes the other person feel your request isn’t hard to grant and that you’re not easy to turn down. Show confidence by maintaining eye contact, sitting upright, or using a firm tone.
N-Negotiate: Cede some ground if you feel the other person isn’t getting on board with your request. You can do so by making your request more appealing or by offering alternative solutions.
For example: “What if you text or call me when you have a meeting to attend during late hours?”
GIVE Skill
You can layer GIVE skill with DEAR MAN when making requests or trying to achieve your objectives and maintaining a positive relationship with the other person at the same time. GIVE stands for:
G-Gentle: Act respectively or in a gentle manner.
I-Interested: Appear interested and listen.
V-Validate: Express your understanding through words and actions.
E-Easy: Be light, easy, and humorous.
Self-Respect Effectiveness
This DBT sub-skill involves building and keeping respect for you. The skill teaches how to communicate respect for yourself to others.
Self-respect effectiveness uses the acronym FAST, which is broken down as follows:
Be Fair: Validate your emotions as well as the other person’s.
No Apologies: Being over-apologetic erodes your respect and esteem.
Stick to Values: Act with integrity and ensure your actions conform to your values.
Be Truthful: Stick to facts and align what you say with reality.
Distress Tolerance Skills
Important distress tolerance skills in DBT include Self-Soothing, TIPS, and ACCEPTS. It is important to note that these are crisis survival skills meant for short-term, highly stressful situations with the potential for very negative outcomes or consequences. Overusing these skills can hamper your ability to solve problems or change. Overuse can amount to avoidance of building a life worth living and making things worse in the long term.
The bright side is that these skills help you reduce pain to a manageable level or tolerate it in the moment. They help you to manage the current crisis and avoid destructive behavior.
Once the intensity of the pain is lowered, it’s advisable to resort to longer-term skills, like emotion regulation, mindfulness, reality acceptance, and interpersonal effectiveness acceptance skills
Self-Soothing
Self-Soothing skill focuses on doing things that feel pleasant, comforting, and provide relief from stress or pain. This can include activities that impact your senses. Wondering how? Here are some examples:
Vision: Look out at a beautiful sunrise or sunset, a starry night, or a blossoming flower.
Hearing: Listen to your favorite music, the splashing of water, or the melody of singing birds.
Smell: Smell your favorite fragrance, burning wood, or even freshly cut grass.
Taste: Have a bite of your favorite meal.
Touch: Apply lotion on your body, take a long, hot bath, or bask in the sun.
TIP
TIP skill aims at altering your body chemistry quickly to mitigate the effects of overwhelming emotions, thereby controlling your behaviors or reactions.
TIP skill can be broken down into the following tension-reducing activities:
Tip the Temperature: This activity involves tipping the temperature of your face using ice-cold water to induce the human dive reflex to help you calm down emotionally.
However, this activity can lower heart rate very quickly. If you have any heart problems, check with your doctor before using it.
Intense Exercise: This involves engaging yourself in vigorous physical activity to expend energy and calm down emotions. Activities may include running, walking, or jumping.
Paced Breathing: Breath out more slowly than normal. For example, breathe 4 or 5 seconds in, and 7 or 8 seconds out. Do this for about 10 minutes to relieve anxiety, stress, and other intense emotional states.
ACCEPTS
ACCEPTS is an acronym that stands for the steps in a distress tolerance skill that enables you to distance yourself from disturbing emotions. Here is a breakdown of the steps to help get you through distressing situations:
A-Activities: Engage in an activity that’s neutral or opposite to the negative emotion. You can play your favorite game if you’re feeling stressed out.
C-Contributions: Involve yourself in charitable work. You can help a friend or family member, surprise a loved one with a gift, or do something nice for someone else.
C-Comparisons: Compare your feelings to those of others who may be feeling or coping worse than you and consider yourself fortunate. You can watch reality videos about disasters and compare yourself with those less fortunate victims.
E-Emotions: Try reading or watching different emotional movies. You can also listen to emotional music while making sure that each experience creates a different feeling that impacts your emotions differently from the previous experience.
P-Pushing Away: Push away the distressing emotions by leaving them for a while mentally or physically. You can do this by building an imaginary or physical barrier between you and the distressing situation.
T-Thoughts: Distract yourself from ruminating thoughts skillfully by trying to count up to 10 or counting colors you can see outside.
S-Sensations: Create distracting sensations by doing simple, intense activities like squeezing a stiff rubber ball between your hands, listening to loud music, or holding ice in your palms or mouth.
Radical Acceptance
Radical acceptance helps you to accept reality no matter how hard the situation may be. This distress tolerance skill requires that you surrender to the situation mentally, emotionally, and physically.
For example, instead of being very angry and considering all of the reasons you should have been picked for a job or you deserved a position over someone else, recognizing that another candidate was chosen and there is no way to change the decision made.
Emotional Regulation Skills
Emotional regulation involves recognizing, understanding, and effectively managing your emotions.
Emotional regulation skills allow you to take control of your emotions rather than letting them control you. Common emotional regulation skills include:
Identifying and Labeling Emotions
This sub-skill involves recognizing the different emotions that arise within us and giving them a name. By understanding and labeling your emotions, you gain insight into what you are feeling and can take appropriate action to address the feelings.
Opposite Action
Sometimes, your emotions can lead you to engage in unhelpful or destructive behaviors. Opposite action is a skill that encourages you to act in a way that is opposite to your emotional urges.
For example, if you are feeling anger and the urge to lash out, you can practice the opposite action by consciously choosing to respond with kindness and compassion.
Or, if you are feeling depressed and have the urge to lay down and listen to sad music — opposite action may entail listening to more encouraging music and going for a walk.
Problem-Solving
Problem-solving involves addressing the underlying issues or problems that contribute to your emotional distress. Problem-solving skills in DBT therapy focus on identifying and analyzing the problematic situations or people that bring out painful emotions and finding effective solutions.
Who Can Benefit From DBT?
DBT is beneficial to people who experience a wide range of mental problems. People with the following mental health conditions can benefit from DBT therapy:
- Depression
- Anxiety Disorders
- Post-traumatic Stress Disorder (PTSD)
- Substance Use Disorders
- Eating Disorders
- Self-Harm Behaviors
DBT can also be beneficial for individuals who struggle with impulsive behaviors, difficulty regulating emotions, and challenges in relationships.
Trained Psychotherapists conduct DBT in both individual and group therapy settings. In individual therapy settings, clients work with a clinician to address specific issues and develop skills to manage them. In a group therapy setting, clients practice these skills in a collaborative environment and learn from others who are facing similar challenges.
A Word from Grow Therapy
DBT is helpful to people who experience very intense, negative emotions as well as those who want to live a quality, meaningful life. Keep in mind that the sooner you get started with therapy — and stay committed to the process — the sooner you may have an improved quality of life.
Because finding the right DBT therapist may take time and effort, Grow Therapy has come up with a platform to help you find the right therapist within the shortest time possible. Our dedicated team of experts connects you to a qualified and experienced therapist and books a consultation call for you within two days.
