keepcalmDBTonDialectical Behaviour Training, created by Dr. Marsha Linehan and originally for those with Borderline Personality has since been applied very successfully for to loved ones of those with BPD as well as those with NPD and their loved ones. DBT skills are worth learning for anyone, really. They are so effective at helping people, generally, cope with the ever-growing stresses, anxieties, and demands of life generally. I find, when working with my clients, whether they have been diagnosed with BPD or not or are the loved one of someone with BPD that DBT Skills – learning and practicing them until they just become a part of your daily living in ways that so enhance your life experience and relating is highly beneficial to and for everyone.

In my working with clients, sometimes we do take a just DBT approach to working through issues and creating healthy positive change in their lives. Many more of my clients, however, I find, do much better learning DBT Skills if they are integrated/presented and discussed with other modalities as well. Sometimes, clients, find DBT Skills alone, overwhelming, or they feel need for more process. I tailor my approach when working with clients to the needs of each individual client. This has helped so many of my clients to have amazing empowering success in and with healing and recovery and positive healthy quality of life lasting changes.

DBT Skills Training encompasses four main modules:

  1. Distress Tolerance
  2. Mindfulness
  3. Interpersonal Effectiveness
  4. Emotion Regulation

 


All Audios © A.J. Mahari


1) Distress Tolerance: Involves radical acceptance. It also involves practice. Learning the basics of the skills and then practicing them, putting them into action in your life. Along with radical acceptance, the Distress Tolerance Module of DBT Skills training also involves learning to let go of “wilfulness” and learning to adopt a “willing” attitude. When Distress Tolerance is practiced it also involves using the mindfulness skills and other skills in other areas of the DBT skills. In fact, the more skills practice you can learn and integrate, the more effective you will become at tolerating and detaching from what has caused you distress or is still causing you distress or what often may well cause you to feel distressed. Distress tolerance skills are both a way of first learning how to accept what is. To accept what you have control over and what you don’t. To learn to surrender that which is not within your ability to change it, anything felt that is perceived as coming from outside of self or from someone else. This module of DBT Skills training is at the core of how to learn to both accept what is, first of all, and then secondly to learn to change what has been that no longer is helpful to you or healthy for you in your life.

Distress Tolerance Skills  have to do with learning to accept, in a non-judgmental way, both yourself, your current environment and whatever is present in your current situation. Through this module of DBT Skills Training you will learn how to distract yourself, soothe yourself, improving each moment, and think of pros and cons of any feeling or thought or reaction that you may have been mindful enough of to observe and then describe so that you can practice a willing acceptance of what you are feeling and thinking.

2) Mindfulness: Learning this skill and practicing it involves a lot of incredible freeing learning and practice. To begin with, when one starts to learn mindfulness and practice mindfulness one is first asked to observe what is, observe what you are feeling, observe your feelings emotionally, observe your thoughts, without acting on either and then describe what you feel and think, and then keep in mind that no matter what you think or feel at a given time, what is your end goal with regard to a relationship, a job, taking personal responsibility and comporting yourself, despite what you may feel or think in a way that is congruent with your dignity, with self-respect, and self-care.

Mindfulness is a core DBT concept – behind everything encompassed within DBT. Mindfulness is the willingness and ability to pay attention, non-judgmentally, to the present moment. Mindfulness is about living in the here-and-now moment, one moment at a time, experiencing your emotions and feelings fully through your senses in a mindful observing way. Meaning that you will be gaining much more aware perspective of what you have reacted to easily and quickly along with intensely over time that you can now learn that there is no longer a need to react at all in old patterned ways, in the here-and-now. Mindfulness is a foundation for the other skills taught in DBT because it helps people accept and tolerate their powerful emotions. It also helps people when they challenge old negative patterned ways of instantly reacting due to being triggered and emotionally dysregulated to feeling exposed and vulnerable when one is in any type of upsetting situation. The concept of mindfulness and the meditative exercises used to teach it have their roots in traditional Buddhist philosophy and practice.  Learning to practice the DBT Skills does not in anyway mandate, include, or even suggest that you need to believe in any religion or follow anything that has to do with religion. It is important to note the difference that is DBT Skills Training encompassing at its core Buddhist philosophy and not the religious tenets of Buddhism as a religious practice.

3) Interpersonal Effectiveness Skills: Really, a beginning, or continuation, depending upon where in your process you are, of learning to identify and  implement Interpersonal boundaries that will make if possible for you to change what have become entrenched reactionary patterns from the past. In DBT skills training identifying and implementing these emotional boundaries, personal boundaries, – really what amounts to “emotional skin” if you will, are often also a part of assertiveness and interpersonal problem-solving therapy modalities. Along with emotional and practical personal boundaries needed to be implemented between yourself and others are also learning effective strategies for asking for what one needs, how to say no, and coping with interpersonal conflict in ways that don’t continue to be black and white and destructive to maintaining connections with and to others .

The interpersonal effectiveness module focuses on situations where the objective is to change something like  requesting that someone do something that you need help or support with or that you do not want them to continue to do, or to resist changes someone else is trying to make (being able to  say no). The skills taught are intended to maximize the chances that a person’s goals in a specific situation will be met, while at the same time not damaging either the relationship or the person’s self-respect.  Interpersonal effectiveness skills teach you how to live your life relationally in much more healthy and bridge-building ways versus the old patterned black and white “bridge-burning” ways of sudden disconnect when triggered or when feeling not safe or feeling invalidated. Those knee-jerk learned reactions from the past that Interpersonal Effectiveness Skills can help you to no longer need as they no longer are working for you but against you. Meaning that you are being your won worst enemy instead of your own very best friend.

4) Emotion Regulation: Learning that there are three components to your experience, in each here and now moment. They include your Reasonable Mind, Your Emotion Mind and hopefully, you Wise Mind. Emotion regulation is difficult for sensitive people, people with Borderline Personality, unresolved abandonment in their life, Codependence, other so-called personality disorders (ways in which people are acting out their past woundedness and perceiving things from deep within as being done to them by others). Emotion regulation is a powerful and extremely helpful skill to learn. It is connected to radical acceptance and willingness from the Distress Tolerance Module as well as mindfulness, observation, and description and the Interpersonal Effectiveness Skills and being mindful and observant of them in action.

Central to Emotion Regulation are the following:

  • Identifying and labeling emotions
  • Identifying obstacles to changing emotions
  • Reducing vulnerability to emotion mind
  • Increasing positive emotional events
  • Decreasing negative emotional attachment
  • Increasing mindfulness to current emotions
  • Taking opposite action to help you to keep regulating your emotions and not be reactive emotionally to triggers
  • Applying distress tolerance techniques  along with Interpersonal Effectiveness to experience much more balanced and less intense more positive and less negative emotional states


All Ebooks and Audios © A.J. Mahari


Accepting Reality

This concept focuses on learning to accept reality as it is. In recovery it wasn’t until one accepts what was one could gain through enough conscious awareness to begin to assess what is needed or wanted  change that will be so beneficial for one. When those with BPD first learn to accept reality it is often not as one would like it to be. That’s where Linehan’s concept of “radical acceptance” plays such a crucial role in the entire process of accepting reality. Once reality can be accepted mindfully and is not judged, one is already benefitting from less suffering and “turning suffering into manageable pain” as Linehan describes it.

Without this kind of radical acceptance, change isn’t possible. Accepting reality is also about unearthing – becoming aware consciously of so many of the illogical and cognitively distorted interpretations that are the hallmark of the type of thinking patterns that fuel continued negativity and emotional suffering. Remember what you think will drive how you feel and both combined effect how you will behave or what actions you will choose. Often those with BPD aren’t consciously aware – as I talk about in my audios and videos of the difference between how they think and what they feel. It is really how one thinks that most influences how one feels. For many with BPD, however, they have a framework of what I’d call “borderline reality” that is skewed, polarized and influenced by what is a lot of emotional reality that is not in the conscious awareness of those with BPD. It is a triggered emotional and dissociative re-enactment of past painful and/or traumatic experience superimposed quickly through reactivity to unfolding perceptions (often here and now misperceptions) as so much of what people with unresolved abandonment, BPD, or not, still experience is a sense that what happened to them in the past is happening to them again right now.

Letting Go of Emotional Suffering

DBT Skills practice can be very effective in helping those with BPD l(or loved ones and others) learn how to let go of emotional suffering. Emotional suffering that is by and large driven by the highly negative and polarized ways that people with BPD actually think. Letting go of emotional suffering is a choice. For those with BPD it often doesn’t “feel” like it’s that simple, but the truth of that matter is that it is all about learning to make new choices. New choices can be learned after one learns Distress Tolerance, and applies the practice of mindfulness to how one is feeling and what one is thinking in a way that does not see you react to those thoughts or feelings in the patterned ways you have become too used to reacting to what is past painful/traumatic experience and/or perception.

 

Improve the Moment

You can learn through the practice of DBT Skills to improve the moment, one moment at a time. In fact, many people in the active throes of BPD, are so unaware of the here and now moment that is unfolding that this very reality drives a lot of polarized and distorted thinking. When you are being mindful of the moment, one moment at a time, non-judgmentally, so much of the inner chaos and painful tumult that you have often felt in your life will begin to abate. It will feel strange at first, learning to feel much more positive feelings and detaching, healing, breaking out of the patterns of negative painful ways of feeling and thinking.

The Pros and Cons of Tolerating Distress

To the person with BPD the thought that there are pros and cons to tolerating distress may seem a foreign concept at first. However, Linehan explains this concept well, in her DBT Skills books. One has to actually sit down and think about how you experience distress, why you are distressed (and explore this in therapy). It is also helpful to examine what are the perceived benefits of self-harm and the many other “acting in” or “acting out” forms of behaviour that borderlines engage in because they do not know how to tolerate the emotional distress of what Linehan calls “dysregulated emotion”.

Self-Soothing

Self-soothing techniques are important for those with BPD or really anyone,  to learn how to implement. One of the central realities to life in the borderline zone of dysregulated emotions is an inability to soothe oneself. Learning to self-soothe is one of the major cornerstones of recovery and going on to live a life very much worth living with a vast improved quality of life for you to learn to enjoy.

Reducing Vulnerability to Negative Emotion

Those with BPD and many without the diagnosis are vulnerable to negative emotion because so much of the patterned ways that they have learned to think within are polarized and cognitively distorted by layers and layers of defense mechanisms all designed to protect the person with BPD (or person without BPD with unresolved childhood issues such as abandonment) from his/her abandonment trauma. In the active throes of BPD most people with BPD experience negative emotion as a way of life. It stems from (and again it’s not just people with BPD) all-or-nothing, black-and-white polarized thinking that leaves one feeling very reactively hurt, negative and often consciously or subconsciously angry and feeling the need to strongly strike back and be seen and heard – validated. DBT helps people to see that they can validate and self-soothe even in the face of someone else’s not validating them when they realize that it is their own internal feelings and thoughts and how they cope or not with them that makes all the difference.

 

© A.J. Mahari, October 26, 2014 – All rights reserved.

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DBT Skills Can Help Anyone