There are definitely all sorts of mental health and self help resources floating around these days, and “mindfulness” has solidly established itself in pop culture. These are all good things, but what do you do when all of those things either stop working, or never worked for you to begin with? Do you struggle to manage stress, anxiety, depression, impulsive behaviors like self injury or other unhealthy coping skills? Allow me to introduce you to: dialectical behavioral therapy skills training or “DBT” for short.
DBT was developed in the late 1980s by Dr. Marsha Linehan for the treatment of borderline personality disorder. Since that time, it’s use has been expanded to treat a variety of mental health concerns: depression, anxiety, eating disorders, stress, and other mood disorders. PsychCentral has a great article that explains the history and basics of DBT.
DBT has five modules or core subjects: Mindfulness, Distress Tolerance, Walking the Middle Path, Emotion Regulation, and Interpersonal Effectiveness.
Mindfulness is the foundation of DBT, and is much more than sitting in the floor on a pillow saying “om… om…” Mindfulness is about becoming more in tune with your experiences and environment and how you respond to each. It is about simplifying, less multitasking, and more effective single tasking. Mindfulness can be practiced by tapping into your spirituality, or it can be practiced by using apps like Calm or Headspace. DBT allows creativity and freedom to practice each skill in a way that works for you!
Distress tolerance is the “next level” of skills in DBT. This focuses on use of some of the good old fashioned “coping skills” everyone talks about in therapy, but also introduces some new skills and more effective ways to implement those tried and true “coping skills.” Everyone experiences distress, but for someone with a personality disorder or other mental health concern, day to day stress can escalate quickly. Distress tolerance teaches recognition and action for things you can change, and tolerance or “coping” with those you cannot.
WALKING THE MIDDLE PATH
Oh boy, this skills is one that EVERYONE could use a little help with (in my humble, licensed professional counselor opinion). Ever met anyone with that “my way or the highway” attitude, or someone who is just NOT capable of “agreeing to disagree.” This might be the skill for them. This is the skill that really dives into the “dialectical” concept. The focus is on developing understanding and acceptance that there is more than one way to see a situation, more than one way to solve a problem, understand that change is the only constant, and honoring the truth on all sides of a conflict without giving up your values or selling out.
For those with mental illness, identifying and understanding emotions can be very challenging. Emotion regulation provides skills to help you identify, understand, accept, and regulate those emotions. Things such as sadness, anger, anxiety, and shame can be horribly debilitating, but they do not have to be! Emotion regulation can help decrease unhealthy coping such as cutting, binge eating, or other impulsive behaviors. It can also be useful to help prevent unhealthy responses to feelings of mania and elation.
Last, and certainly NOT least, is interpersonal effectiveness. These skills are designed to help those with mental health challenges approach relationships with friends and family in more healthy ways. These skills can help you keep and maintain healthy relationships, help you ask for something you want or need, learn how to effectively say no, learn how to solve a problem or resolve a conflict, and learn how to maintain your self respect while doing all these things.
IS DBT RIGHT FOR ME?
Well, could you benefit from any of the above skills or techniques? If the answer is yes, then DBT might be right for you. This summer at Personal Relationships, Inc, I will be facilitating TWO different Dialectical Behavioral Skills Training groups, an adolescent “camp” and a longer skills training group/support group for adults.
The adolescent group will run June 6-29, and will meet on Tuesdays and Thursdays from 10:30-12:30. This is for ages 14-18 (upcoming freshman through upcoming seniors.) Participants will create a coping skills box, as well as put together a binder with skills handouts for use with their outpatient therapists.
The adult group will begin May 15, and will be ongoing on Mondays from 5:30-7:00 pm. Participants will have the option to either complete the skills training (20 sessions total) and “graduate,” or continue to attend the group for support. Clients will use the Linehan workbook, and have the option to either use a DBT Skills Journal or an app to record skills used.