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