## DBT Skills **Core principle:** Dialectical Behavior Therapy skills help with emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness. Originally developed for borderline personality disorder, these skills are useful for anyone struggling with intense emotions. ### Four Skill Modules --- ### 1. Distress Tolerance Skills for surviving crisis moments without making things worse. **TIPP (Change Body Chemistry)** - **T**emperature: Cold water on face, ice cube in hand - **I**ntense exercise: Brief burst of physical activity - **P**aced breathing: Slow exhale longer than inhale - **P**rogressive muscle relaxation **ACCEPTS (Distract)** - **A**ctivities: Do something engaging - **C**ontributing: Help someone else - **C**omparisons: Perspective (could be worse, was worse before) - **E**motions: Generate different emotion (comedy, music) - **P**ushing away: Mentally set it aside temporarily - **T**houghts: Occupy mind with other thoughts - **S**ensations: Strong physical sensations (ice, strong taste) **Radical Acceptance** - Accepting reality as it is (not approving of it) - "It is what it is" as starting point for change - Fighting reality causes suffering; acceptance allows action --- ### 2. Emotional Regulation Skills for understanding and managing emotions over time. **Check the Facts** - What triggered the emotion? - What am I interpreting or assuming? - Does my emotional intensity fit the facts? - Is there another way to see this? **Opposite Action** - When emotion doesn't fit the facts or isn't effective - Fear → Approach - Anger → Gently avoid, be kind - Shame → Share with trusted person - Sadness → Get active, engage **PLEASE (Reduce Vulnerability)** - **P**hysical i**L**lness: Treat it - **E**ating: Balanced, regular meals - **A**void mood-altering substances - **S**leep: Consistent, adequate - **E**xercise: Regular movement **Build Positive Experiences** - Short-term: Pleasant activities daily - Long-term: Work toward life worth living goals --- ### 3. Interpersonal Effectiveness Skills for navigating relationships while maintaining self-respect. **DEAR MAN (Getting What You Need)** - **D**escribe: State facts without judgment - **E**xpress: Share feelings using "I" statements - **A**ssert: Ask clearly for what you want - **R**einforce: Explain positive outcomes of getting it - **M**indful: Stay focused, don't get derailed - **A**ppear confident: Body language, tone - **N**egotiate: Be willing to give to get **GIVE (Maintaining Relationship)** - **G**entle: No attacks, threats, judgment - **I**nterested: Listen, show interest - **V**alidate: Acknowledge their perspective - **E**asy manner: Light touch, humor if appropriate **FAST (Maintaining Self-Respect)** - **F**air: To yourself and others - **A**pologies: Don't over-apologize - **S**tick to values: Don't compromise what matters - **T**ruthful: Don't lie or exaggerate --- ### 4. Mindfulness Skills for present-moment awareness and wise action. **What Skills (What to Do)** - **Observe:** Notice without words - **Describe:** Put words to experience - **Participate:** Fully engage in the moment **How Skills (How to Do It)** - **Non-judgmentally:** No good/bad labels - **One-mindfully:** One thing at a time - **Effectively:** Do what works **Wise Mind** - Integration of emotional mind and rational mind - Intuitive knowing that considers both facts and feelings - "What does my wise mind say about this?" --- ### When to Use DBT Skills - Intense emotions that feel overwhelming - Urges to engage in harmful behaviors - Interpersonal conflict - Crisis moments - Chronic emotional dysregulation - Self-harm or suicidal urges (crisis skills) ### DBT Homework Examples - Distress tolerance skill practice during urges - Emotion diary with intensity ratings - DEAR MAN planning for upcoming conversation - Daily mindfulness practice (even 2 minutes) - Opposite action experiment