Marsha Linehan created Dialectical Behavior Therapy (DPT) around the late 1980s, for those struggling with borderline personality disorder (BPD) and chronic suicidality. DBT has four main branches: emotion regulation, distress tolerance, mindfulness, and interpersonal effectiveness. This article will provide further information about specific skills that have been such a godsend to people like me, who have struggled deeply in their recovery journeys and are utilizing these skills on a daily basis to maintain wellness and stability.
The first branch of DBT I will discuss is mindfulness. Mindfulness practices have been a fundamental part of my recovery journey, often brought up early on, where the goal is to take a non-judgmental stance and allow thoughts and feelings to come and go as they will naturally. Mindfulness is about engaging in the present moment as wholly as possible. Mindfulness is a really good skill to observe what thoughts or feelings come in, passing like clouds in the sky or waves at the beach. Mindfulness is a good grounding technique, and in my day program at Passages, we often start off a few of the groups with a two-minute mindfulness activity which can include: counting the amount of colored objects in the room (say, green things), listening to sounds as two large pair of ears, playing a game where each person has to say a number up until ten but no one can say the same number at the same time or you have to start over again, and more. The biggest thing with mindfulness is that you’ll probably lose focus at some point, and when you do, you practice bringing yourself back to the present moment and focusing on what is currently happening around you, rather than the noise inside your head. Additionally, mindfulness skills include nonjudgmental stance, one-mindfully, effectiveness, describe and observe, amongst others.
The second branch of DBT is emotion regulation. Linehan is a *big* fan of acronyms. So, a lot of her DBT principles operate like those Russian doll sets. The objective of emotion regulation is to learn how to more effectively manage emotions, have awareness of the action urges that are brought up because of them, and how to stay safe in a healthy manner (not resorting to self-harm or drug misuse). One of the emotion regulation skills include "PLEASE," which stands for treating physical illness, eating balanced meals, avoiding drug misuse, and having balanced sleep and exercise. Another skill is "Cope Ahead," which involves imagining the worst possible future situation and you coping with it in an effective and safe manner. And the biggest one that I’m often using is opposite action: when I want to run away from a situation, I act opposite to that and stay instead.
The third branch of DBT is interpersonal effectiveness, with the cornerstone acronyms being DEAR MAN, GIVE, and FAST. DEAR MAN stands for describe, express, assert, reinforce, be mindful, appear confident, and negotiate. DEAR MAN is a good skill to use when you need something from someone, and it’s a helpful skill even if you don’t live with mental health conditions. I’d give an example, but Marsha has probably described it better than me and good old Google is helpful, too. I have used GIVE, which is being gentle, interested, validating, and approaching with an easy manner, and FAST, which is fair, apology-free, sticking to your values, and truthfulness. I often use GIVE when I’m validating another person’s experiences.
Finally, the fourth branch of DBT is distress tolerance skills, which can be used when one is feeling impulsive or tolerating a crisis situation. Self-soothe is a pretty big one from this category that I often use, which applies being kind to yourself and using the five senses to ground yourself back into reality. Pros and cons are also important in understanding what the best possible outcome is in a tricky situation. I’ve made a few pros and cons lists, in regard to my relationship with Luna, for instance. Radical acceptance is another skill, but harder to practice though. It’s about accepting the situation as it is in the current moment, and gradually becoming okay with that. There’s also WISE Mind ACCEPTS with activities, contributing, comparison of others, emotions, pushing away, other thoughts, and intense sensations. The TIP skill would fall under this category, a way of changing your body temperature by holding ice or activating the vagal nerve (if you don’t have any heart problems at least), by bending over half-way, doing intense exercise, and either progressive muscle relaxation or paced breathing.
And honestly, there are a bunch of other DBT skills too that can be of use. The DBT Workbook is a good resource to have. I ordered mine from Amazon, although I have yet to actually fill it out. But that’s been my briefest of overviews of various DBT skills that I hope can be of service for anyone who wants to jump aboard the skills train and apply them to their own lives. It’s genuinely life-saving, once you establish the habit of them.