Though DBT (dialectical behavior therapy) is known predominantly as a treatment for borderline personality disorder (BPD), its foundation is pretty simple. The concept of dialectics is used to simultaneously foster change and acceptance. This allows sufferers to accept the present while acknowledging that their future must involve change.
DBT is an empirically based treatment, meaning it is backed by evidence. It is broken down into two major components: skills training and individual therapy.
Skills offer specific solutions to pretty common problems. Though created specifically for those with BPD, it addresses common issues. This means it can actually be used by anyone. DBT teaches clients emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness-skills we can all benefit from. Here are four DBT skills that can help individuals cope with anxiety or stress.
One-mindfully is a skill that suggests that fully engaging in the moment can be a deceptively therapeutic exercise. Often people are living their present lives ruminating about the past or future. This can easily provoke anxiety as we get stuck mulling over what we’ve already done wrong, or what we’re certain to do wrong.
I always try to help clients develop the ability to anchor themselves in the present because that is key to maintaining good mental health. It is all too easy to allow your mind to be hijacked by the past and the future. With this skill, we become aware of our thoughts, feelings, and reactions. We learn to pause and check in before responding. This helps to limit people from reacting which tends to be driven by raw emotion as opposed to responding which is when we are calm and with a set intention.
The idea of cultivating this skill is that this better prepares us to handle future problems. This way we are taking charge of our emotions instead of allowing them to rule us.
The truth is that fully engaging in the present allows us to be better capable of dealing with future challenges as they arise. This can be a foreign concept in cultures, industries, and countries that operate under a “work till you keel over” attitude. Self-care and maintenance are an oft-overlooked, extremely important facet of productivity.
It also helps keep anxiety at bay, by fostering less rumination about the past while allowing us to effectively deal with future problems from a more mentally grounded perspective. It helps avoid burnout and its predecessor: over-extension.
In DBT, the concept of self-soothing refers to our ability to calm emotional turmoil by grounding ourselves by focusing on physical stimuli. This is done by using any number of the five senses: taste, smell, sight, hearing, and touch.
This means there are seemingly endless ways to utilize this skill, dependent upon whatever is the most effective for the individual. It can help anxiety sufferers “get out of” their mind, in order to become grounded in the physical world again.
For example, one could suck on hard candy and analyze the feel and taste. They can also escape through a favorite song or the soft, soothing feel of an animal’s fur.
Because the exercise momentarily replaces rumination and worry, it can be particularly useful for sufferers of anxiety. Taking a break from the rumination can then be utilized to think in a more detached and calm manner. This would hopefully allow the individual to think of more effective ways of addressing whatever is provoking their anxiety, or at give them a momentary vacation from it.
Luckily this skill both helps heed off anticipatory anxiety and deal with the aftermath of an emotionally triggering event.
Radical acceptance can require more effort and is one of the more difficult DBT skills to master. It involves accepting the world exactly as it is, at that moment. Sounds pretty easy right? But what if you’re accepting the death of a loved one, end of a relationship, financial mistake, embarrassing gaffe or catastrophic mistake?
The idea of radical acceptance is not to turn away from these painful experiences but to accept that they’re in fact real and true. Mental effort should, therefore, go into either coming to peace with the experience or changing it. It is embodied in one of my favorite coping mantras, it is what it is.
This can be life-altering for anxiety sufferers who tend to focus on the why and how of the experience, mulling over the disbelief of the circumstances as opposed to how they are going to either accept or extricate themselves from the situation. Often clients come to counseling intently focused on figuring out the WHY. I often state gently it doesn’t matter–not to be dismissive but because the fact is a lot of things in life are inherently meaningless. People act without thinking, life events unfold due to happenstance. Too often clients try to prescribe intent to actions where there is none. A lot of anxiety is grounded in the idea that a better understanding of the situation will somehow make the situation different. This is often only subtly false.
This is because rumination can be seen as a pre-emptive deterrent to being caught unaware of a problem or issue. It can be practiced to pathologically damaging levels, however. This can leave individuals expending truly immense amounts of effort, noticing their situations never seem to actually change.
This skill is about cultivating a non-judgmental perspective where things are neither good or bad. Everything and everyone are simply is as it is. The truth is judging is often a short hand way of stating our preference. It is in our nature to label and judge. And maintaining a non-judgmental stance in the face of stress and anxiety is very difficult, but in doing so will help us to regulate our emotions. Common judgmental words include: right, wrong, good, bad, should, must, unfair, stupid, crazy, awesome, great, terrible, etc.
The fact remains judgments do more harm than good. Passing judgments about people, things, or ourselves shuts those things out of our world and closes the doors to opportunities, growth, and relationships. Staying in a non-judgmental state of mind keeps us open to possibilities and options.
These are four DBT skills that can be life changing for those that commit to them. However, like all therapies, DBT shouldn’t be considered a one-size fix for any problem or individual. Counseling can help you cultivate these skills to be more at peace with yourself and the world around you.