2 DBT Skills Everyone Should Know

Are you interested in learning more about Dialectical Behavior Therapy (DBT)? This unique form of psychotherapy - a variation of Cognitive Behavioral Therapy (CBT), can be used for a wide variety of mental health issues and conditions. 

While DBT was specifically developed for treating individuals who have difficulty managing and regulating their own emotions, (such as with Borderline Personality Disorder), this treatment type has also been proven to be effective for a variety of other conditions, including: 

  1. Borderline personality disorder (BPD)
  2. Self-harm
  3. Suicidal behavior
  4. Post-traumatic stress disorder (PTSD)
  5. Substance use disorder.
  6. Eating disorders such as binge eating disorder and bulimia
  7. Depression
  8. Anxiety

The reason most psychologists and therapists hypothesize that DBT has been so effective in the treatment of these conditions is that each of them is theorized to be associated with a core concern around unhealthy or problematic attempts at controlling intense, negative thoughts and feelings. DBT manages these concerns by helping individuals to find better ways to cope with their emotional highs and lows, which in turn can diminish their symptoms and increase their quality of life. 

If you’re looking to improve your mental health & wellbeing through the use of DBT skills, it’s best to start with an understanding of how DBT works. 

How DBT Works

The goal of DBT is to help you find the balance between acceptance and change - essentially, learning to find peace with yourself and calm amidst challenges, but being willing to change emotions and behaviors that don’t serve you. 

There are four main DBT modules:

  • Mindfulness: Learning to be fully aware and focused in the present.
  • Distress tolerance: Learning to understand and manage your emotions in difficult or stressful situations without turning toward harmful behaviors.
  • Interpersonal effectiveness: Learning to ask for what you want and need and setting boundaries while maintaining respect for yourself and others.
  • Emotion regulation: Learning to understand, be aware of, and control your emotions. 

No matter who you are or what mental health condition you are struggling with, it’s likely you can benefit from an application of specific skills learned throughout these traditional DBT modules. Below are just a few skill elements of specific DBT modules that can make an impact in tangible ways as you learn to apply them. 

DBT Skills Category: Mindfulness 

Have you heard of mindfulness? Mindfulness is a form of meditation that helps you focus on being in the moment, and identifying what you are sensing/feeling in your own body and mind. Mindfulness also implies a lack of judgment toward yourself or your experience, focusing instead on the benefit of being present in your experience and utilizing breathing, meditation, guided imagery, and other techniques to relax your mind and body, which in turn reduces your stress and helps regulate your emotions.  

Most of us are used to spending a significant amount of time obsessing, planning, solving problems, and living in our own negative thoughts. Coasting through our own mind in this way can increase our stress, anxiety, or depression. When we lose touch with our immediate reality, we often drift into an emotionally vulnerable state - which is what mindfulness works to combat. 

Mindfulness (Skill #1): Meditation 

Most people think of meditation in conjunction with yoga or eastern medicine, rather than associating it with simple exercises that can diminish the impact of anyone’s daily stress, anxiety, insomnia, pain, and other mental and physical health conditions. 

At its core, meditation may help you create the balance and acceptance so sought after through DBT therapy, in addition to potentially improving your ability to avoid burnout, improve your sleep habits, focus your attention, and find peace in your day to day life - even amidst constant stressors. 

How to Practice Mindfulness 

The good news is that there are so many ways to incorporate simple meditation exercises into your daily life. Here are just a few:

  1. Slow down: It can be hard to pause in the business of life, but set a reminder or choose a consistent time of day to be still, think about each of your senses (taste, smell, touch, sound, etc) and simply be in the moment. 
  2. Focus on breathing: When emotions begin to overwhelm you, try to find a seat, place both feet flat on the ground or cross your legs, and close your eyes. Focus simply and fully on your breath as it leaves and enters your body. 
  3. Body scan: Lying on your back with your legs straight/flat and arms at your sides, close your eyes and focus on each part of your body from toes to head or head to toes. Move slowly through the awareness of every part of you. 
  4. Walking meditation: Choose a short route, about 20 feet long, and begin walking it slowly, back and forth. Focus on every step and think about the small movements of your hips, feet, toes, hands, and head. 

These and other simple meditation practices can be done just about anywhere, anytime. Outdoors can be the best place to practice mindfulness, but anywhere peaceful and comfortable to you will work. 

If you can, try to practice mindful meditation every day. Over time, this will become part of your daily reality and can be an effortless way to reconnect with yourself. 

DBT Skills Category: Distress Tolerance 

Crisis Survival Strategies 

Distress tolerance as a model of DBT involves a skilled ability to accept, tolerate, and learn from hardship and suffering. 

While some other treatments may focus on avoiding pain and difficulty, distress tolerance actually focuses on handling pain in a much more head-on way, since suffering is an unavoidable part of life. 

There are four main survival strategies involved in the distress tolerance skills solution: distracting, self-soothing, improving the moment, and thinking of pros/cons. 

Distress Tolerance (Skill #2): TIPP

TIPP is a critical distress tolerance skill that can be pivotal during moments where you feel you’re at a breaking point. This acronym - which stands for Temperature, Intense Exercise, Paced Breathing, Paired Muscle Relaxation - can help you self talk off the metaphorical ledge. 

  • Temperature: Anxiety, distress, anger, and other intense emotions can make our bodies feel overheated. Counter this on a physical level by splashing cold water onto your face, eating a popsicle, holding a bag of ice, standing close to your freezer with the door open, or blasting the AC in your car. Cooling your physical body down can help regulate your emotions. 
  • Intense Exercise: Engaging in intense physical activity can match and de-escalate intense emotions. Sprinting a short distance, doing a few quick lengths in the pool, jumping up and down, or hitting some mountain climbers can increase your oxygen levels which helps to diminish stress. 
  • Paced Breathing : Similar to mindfulness, pacing your breathing can help positively impact you by reducing your emotional distress. Box breathing is a great example of paced breathing. In this exercise you’ll hold your breath for four seconds, breathe out for four seconds, and breathe in for four seconds. Do this over and over to reduce your body’s fight/flight response and calm yourself back down. 
  • Paired Muscle Relaxation: Oddly enough, when you tighten your muscles voluntarily and then relax them, the muscle becomes more relaxed than it was before flexing it. This wild exercise can slow your heart rate and increase your oxygen supply. Start by focusing on one muscle group, like your triceps. Tighten them voluntarily and count to five, then let go. 

Learning to leverage these 2 critical sets of skills - mindful meditation and TIPP for distress tolerance - under the DBT module umbrella can help you improve your health and wellbeing as you diminish stress under pressure. 

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