Overview of the DBT skills subsets:
Dialectical Behavior Therapy was developed by Marsha Linehan, PhD, in the early 1990’s. It is a branch of Cognitive Behavior Therapy that involves taking an active participation in changing one's thoughts through the use of specific coping techniques and the practice of mindfulness awareness. DBT is practiced through a toolbox of positive coping skills, divided into four modules, or subsets, used to deal with negative emotions and stressful events.
There are four subsets of DBT skills. These are mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. Briefly, mindfulness involves training your mind to stay in the present moment and to be aware of your surroundings, without dwelling in the past or worrying about the future. Interpersonal effectiveness includes skills to deal with the relationships in your life. Distress tolerance is using skills to deal with intense acute emotions. Finally, after you have used distress tolerance skills to lower your level of distress, the emotion regulation skills subset is used to process and deal with the emotions.
Explanation and Examples of the Distress Tolerance subset:
When you intensely feel any emotions such as sadness, anxiety, envy, jealousy, shame, or guilt, use the Distress Tolerance skills to lower the intensity of your emotion so you can think more clearly. These skills are meant to be used to replace negative coping mechanisms such as binge eating, drinking alcohol, using drugs, or other harmful behaviors.
Examples of Distress Tolerance skills include:
- T. I. P. - This is an acronym that stands for temperature, intense exercise, and progressive muscle relaxation. Changing the temperature in your environment shocks your mind into awareness. By running your hands under cold water, by taking a hot shower, or by stepping outside to feel the weather, you can lower the intensity of your emotions so that you can think clearly about what to do next. Similarly, you can use a bout of intensive exercise to take the edge off of your emotion, or you can use the relaxation technique of progressive muscle relaxation.
- The acronym "Wise mind ACCEPTS" refers to distraction techniques that help momentarily take your mind off of the strong emotion. The key is not to distract and suppress your emotion, but to lower its intensity so that you can then use the emotion regulation skills, explained later in this article. Example distraction activities are doing laundry, cleaning, contributing by helping someone else, or working on a hobby.
- Self-soothing - Using self-soothing activities, such as taking a warm bath, lighting candles, or listening to music, can calm you down and enforce the principle of self-love.
- Pro's and Con's - This represents stopping to think about the consequences of coping negatively with your emotion. This can motivate you to make the right decision regarding coping skills.
- Radical acceptance - Force your mind to radically accept the stressful situation as it is. This is helpful because giving up the fight against your emotion allows you to move on to problem solving how to change it (an emotion regulation skill).
How to use the Emotion Regulation subset:
After you use distress tolerance skills, you will feel more in control of the situation and should feel a lowered intensity of your emotion. You can then use emotion regulation skills to process the emotion and problem solve what to do about it. Draw up a list of ways to solve the problem that is causing you emotional distress. After processing the emotion, you can also use a skill called "opposite-to-emotion action". This is a way to control your emotion. For example, if you feel very sad, force yourself to leave the area where you are and do something enjoyable such as take a walk or go out with friends. You will be surprised at how this can reverse the emotion you are feeling. Another way to regulate your emotions is to make sure you are eating and sleeping well so that you are not as vulnerable to strong emotional reactions in the first place. You can also build confidence, which is very powerful in believing in your ability to deal with your own emotions, by building mastery and coping ahead. Build mastery by completing a goal step-by-step. Cope ahead by drawing up a plan to cope with a situation you are worried about in the future.
How to incorporate Mindfulness:
Based on Buddhist principles, the art of mindfulness can be described as keeping your mind in the present moment. Often, another important part of mindfulness is to exist just as an observer, looking at your surroundings and situation without judgment.
You can add peace to your life by focusing just on the present moment, neither the past nor the future. Then, act as an observer, viewing the moment without judgment, using the following DBT skills:
- Observe: Just Notice
- Describe: Put Words on, just the facts
- Take a non-judgmental stance to view the situation
This will help you to view the situation as it is so that you can think rationally about the situation and focus on what will work to help you, instead of letting your emotional mind run away with you.
Put It All Together:
Using all of these skills together is the most effective way to experience DBT. For further guidance, look into buying one of the many DBT workbooks on the market, or find a DBT-trained therapist in your area.
Sources:
- Ellen Astrachan-Fletcher, PhD and Michael Maslar, PsyD, The Dialectical Behavior Therapy Skills Workbook for Bulimia (California: New Harbinger Publications, Inc., 2009).
- Lenihan, Marsha. Cognitive-Behavioral Treatment of Borderline Personality Disorder. (New York: Guilford Publications, Inc., 1993).
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
Kathleen Sanders - Kathleen Sanders has a BS in Biology and a life-long love of learning about almost any subject. Her particular interests include physical ...
Join the Conversation