capturing the beautiful calamity of healing in therapy

Why Everyone Can Benefit from DBT

Why Everyone Can Benefit from DBT

When Marsha Linehan developed Dialectical Behavioral Therapy (DBT), it became widely used among practitioners in the treatment of Borderline Personality Disorder, substance use disorders, eating disorders, and mood disorders.

And, yet, DBT skills have universal importance- for just about anyone. While they are effective in treating mental health disorders, they also provide extraordinary benefit for anyone who struggles with overwhelming emotions.

And, isn’t that just about everyone on the planet?

What is DBT? What are DBT Skills?

DBT was developed with four core modules:

  • Distress tolerance- Coping efficiently with painful or stressful events/situations
  • Mindfulness- Experiencing more here-and-now emotions and letting go of judgments and preconceived notions
  • Emotional Regulation- Identifying, observing, and appropriately modulating emotions
  • Interpersonal Effectiveness- Expressing needs, beliefs, and boundaries in a productive and efficient manner

The different skills taught in each of these modules assist with healing, coping, and more appropriate adapting to everyday situations.

Let’s examine each of them.

Distress Tolerance

We all experience varying levels of pain. To hurt is to be human. Unfortunately, in these moments of real or imagined crisis, we may feel overwhelmed with our abilities to cope. And, when we feel overwhelmed, we may act in ways that are harmful to ourselves or others.

Ever acted on an intense emotion only to regret it immediately afterward? This is the meat of distress tolerance.

When we’re struggling with distress tolerance, we may spend a great deal of time worrying or anticipating pain. We may isolate from loved ones, numb ourselves with various substances, or engage in high-risk behaviors. We may react impulsively, rather than with intention and with thoughtfulness. Behavior may just feel out of control and random, done out of compulsion and habit.

If you spend a great deal of time trying to avoid or control pain, you may have issues with distress tolerance. Recharging your emotional batteries helps with overall life management, and learning healthy coping is key.

Suggested coping DBT skills include:

  • Distracting exercises
  • Pleasant activity engagement
  • Radical Acceptance
  • Self-soothing
  • Meditation and positive visualization

Mindfulness

Have you ever meditated? Or, have you ever tried to meditate, but found it unhelpful or even annoying? Just like exercising the body, meditating can take practice, routine, and time for it to be habitual. You may not like meditating the first time you try it (or even the fifth time), but don’t knock the virtues of mindfulness!

It’s one of the most crucial DBT skills for anyone to learn. If we cannot focus on the present moment, we risk losing much of our lives to worrying about the future or agonizing over the past. This definitely isn’t optimal.

If you’re constantly feeling distracted, busy, agitated, anxious, or just “out of touch” with reality, you probably struggle with mindfulness to some degree.

By metaphor, mindfulness refers to taking the time to “smell the roses.” In actual practice, it can refer to essentially doing anything while staying focused, engaged, and accepting of what is presently happening.

Ever lost track of time or even the outside world because you were so engaged in a particular task? Chances are, you were being mindful! It’s healthy for the body, mind, and soul, and it’s one of the most important DBT skills a person can have.

Suggested mindfulness skills include:

  • Focusing on a single sensation
  • Mindful breathing or deep breathing
  • Mindful awareness of emotion
  • Diffusing thoughts (identifying them without giving them attention)

Emotion Regulation

Emotions are natural responses to external and internal stimuli. Emotions, in a nutshell, are what make us human. They define our existence, color our relationships, give us purpose and meaning. We feel all sorts of sensations and feelings throughout the day. All of them are normal, and all of them are welcome.

When learning to regulate, it’s not about the emotion. It’s about how we cope with it.

However, that doesn’t mean emotional regulation is simple. Far from it. Our emotions can feel wild and limitless. They can feel overpowering and overwhelming. Elevated anxiety, sadness, or anger can hinder our ability to participate in daily functioning.

When we feel dictated by our emotions, we are dictated by the constant ebbs and flows of these impulses. We can feel out of control, and that only perpetuates more stress.

DBT skills help with decreasing emotional intensity while increasing individual coping.

Suggested emotion regulation skills include:

  • Identifying (naming) emotions
  • Separating facts from opinions
  • Adhering to appropriate daily care (sleep, nutrition, exercise) schedule
  • Changing negative thoughts
  • Practicing nonjudgmental stances towards emotion
  • Engaging in opposite action

Interpersonal Skills

Healthy relationships are important. We all know that! However, despite our desires, most of us have experienced toxicity and discourse within such dynamics. We’ve tolerated people who have hurt us. We’ve put ourselves in positions to hurt others. We’ve said yes when we mean no or said no when we meant yes. 

Most of us have no idea how to communicate effectively and respectfully in our relationships. Instead, we resort to passive-aggression, aggression, or passivity. These styles of communication move us away from connection and distance us from the people we care about. Instead of expressing ourselves with honest intention, we may resort to lying, manipulating, minimizing, or exaggerating our needs. Talk about ineffective.

DBT skills are built upon increasing individual awareness as well as relational awareness. Knowing how we perceive others- and how they perceive us- is important for solidifying healthy and satisfying dynamics!

Suggested interpersonal skills include:

  • Identifying individual needs
  • Identifying inherent rights
  • Practicing I-statements
  • Increasing assertive communication
  • Negotiating conflicting wants
  • Engaging in active listening

Tying It All Together

The practicality of DBT skills extends beyond severe mental health disorders! The premises of these modules can benefit anyone looking to improve their self-esteem, relationships with others, and overall life coping.

While it’s not my main theoretical orientation, the premises of DBT are a significant part of my therapy toolbox. They provide hope for healing and individual empowerment for change. In therapy, I consider both of these elements as crucial.

After all, we can all benefit from improving how we cope, how we focus on the here-and-now, and how we communicate.