Dialectic Behavior therapy (DBT) skills are strategies that help with managing painful emotions, staying present, handling difficult situations, and building healthier relationships. Though originally developed to treat Borderline Personality Disorder, DBT can be particularly helpful with people pleasing, boundary setting, overthinking and second guessing.
The Four core modules of DBT are: Mindfulness, Distress Tolerance, Emotion Regulation and Interpersonal Effectiveness
What is mindfulness?
Mindfulness is the core DBT module. It is the act of attending to the present moment without judgment enabling observation of thoughts, feelings and body sensations which grow self-awareness. This provides an opportunity to pause and reflect before reacting.
Mindfulness is the most fascinating skill in my opinion based on research proving how it changes brain structure. It thickens the prefrontal cortex which results in improved focus, executive control and decision making. It reduces the size and reactivity of the amygdala; the brains alarm system. It quiets the Default Mode Network which controls mind wandering and self-critical rumination.
This allows for stress and anxiety to lower. For those who suffer from anxious second guessing and challenges with executive functioning it results in feeling more in control, secure and intuitive. This is particularly useful in helping to distinguish thoughts and feelings from facts. For those who have been recommended psychotropic medication and want a natural approach, mindfulness is a powerful evidenced based behavioral way to reduce symptoms.
What is Distress Tolerance?
Like any form of tolerance such as alcohol or pain tolerance, distress tolerance allows you to handle more of it in larger amounts. Painful emotions and stressful situation often lead to reactive states and behaviors. When we have more distress tolerance, we can navigate triggers without activating the central nervous system and the avoidance/flight or reactive/fight behaviors. Skills that increase distress tolerance are:
STOP: Stop, Take a step back, Observe, Proceed mindfully.
TIPP skills for managing intense physiological arousal.
Self-soothing through the five senses.
Radical acceptance of what cannot immediately be changed.
What are Emotion Regulation skills?
Through mindful exploration we begin to develop a deeper understanding of our emotions and emotional vulnerabilities. This coupled with the emotion regulation skills allows us to respond to our emotions more thoughtfully rather than automatically. Skills that help regulate emotions are:
Identifying and labeling emotions.
Understanding what emotions communicate.
Checking the facts.
Opposite action when an emotional urge is unhelpful.
PLEASE skills to support physical and emotional well-being.
What are Interpersonal Effectiveness skills?
Interpersonal effectiveness skills allow us to become better communicators, establish boundaries, reduce conflict and maintain respect for self and others resulting in healthy relationships.
Skills that improve Interpersonal Effectieness are:
DEAR MAN for asking for needs or expressing concerns.
GIVE for maintaining relationships.
FAST for maintaining self-respect.
Saying no and setting boundaries.
Balancing personal needs with relationship goals.
Who can benefit from learning and applying DBT skills?
DBT can help with anxiety, depression, and ADHD. If you’re not sure what your struggling with but feel that you stuck in an areas of your life such as relationships or emotional and behaviors control these skills will give you a navigation system to get unstuck.
What I love most about being a therapist is witnessing lasting change that helps people build the lives they want. Recently, a client thanked me for the changes she had made in a relationship she once described as toxic; she and her partner are now engaged. I reminded her that I provided the tools, but she did the work. Seeing the difference that putting these skills into practice can make is an incredible gift.
Interested in learning more?
If anything you read resonates or you have any questions and would like to learn more about how DBT might help you please reach out. You can schedule a free consultation through the book now button at the top of the page.