Time to turn off the commute music, name your emotions, practice active listening and ask yourself if it is really worth the pain for a healthier and happier day.
Dialectical Behavior Therapy (DBT) is an effective treatment for PTSD, depression, anxiety, and personality disorders. However, many skills within the treatment can apply to everyone, and I mean everyone, with major benefits to day-to-day life. Here are some suggestions on how to become more engaged, emotionally regulated, and present with four simple ways to practice DBT techniques.
What is DBT?
Dialectical Behavior Therapy is a treatment originally developed by Marsha Linehan in the 1980s-1990s to treat Borderline Personality Disorder. Since that time, research has proven its efficacy with nearly all types of mental health disorders.
Dialectical Behavior Therapy should not be confused with Cognitive Behavioral Therapy (CBT). DBT has four components:
- DBT Individual Therapy – Weekly therapy with a DBT therapist where skills learned in DBT Skills Group are reinforced and significant work is done on commitment to treatment.
- DBT Skills Group – Occurring weekly, this group is more psychoeducational in nature and is run similar to a classroom, where participants are taught skills using a Socratic style method and assigned homework which is reviewed during the following week’s group.
- DBT Phone Coaching – Patients are able to call their therapist during times of crisis to receive help in applying skills they are trying to learn to manage symptoms.
- DBT Consultation Team – Therapists practicing DBT meet weekly to receive support in practicing a difficult, intense treatment and in maintaining competency.
DBT teaches four categories of skills:
- Mindfulness – Developing an awareness of the present moment, without judgment or attachment, in a way that allows you to be more aware of and more effectively manage emotions, thoughts, feelings, etc.
- Emotion Regulation – Improving awareness of emotions, causes, and consequences, in a way that allows us to choose how to manage them and improve the effectiveness of the way that we manage them
- Distress Tolerance – Practicing tolerating, rather than avoiding or changing extreme and/or distressing emotions
- Interpersonal Effectiveness – Learning how to advocate for yourself and improve management of relationships and relationship issues
Clearly the treatment, with so many parts and in depth skills training, is intense. However, as you read more about it, you will inevitably find that anyone can benefit from it. Who hasn’t done something they regret in the heat of the moment? Who hasn’t felt overwhelmed and unsure of what to do? Who hasn’t been so caught up in their head that they miss the turn off the expressway?
Whether you are in intense crisis or an average healthy individual, the knowledge that comes from receiving Dialectical Behavior Therapy can improve your everyday functioning. But if you aren’t someone who is in or hasn’t received DBT treatment, what do you do? How do you get these benefits?
Well, below you can find a few easy ways to start using aspects of DBT skills daily.
- Turn Off The Music During Your Commute
One of my favorite past times is jamming out to my favorite tunes on my way to work. Unfortunately, this is the opposite of what I should be doing. Distraction can be fun, but it also sets us up to miss something important or get caught off guard. What’s the harm, though? Well, a public service announcement might tell you that listening to music during your commute can lead to more car crashes. On the less dramatic side of things, it keeps you from taking in and being mindful of everything that is going on around you (which I guess would also lead to more car crashes).
When you are juggling multiple things at once it inherently means you aren’t doing any one thing as well as you could be if you were only doing one thing at a time. It cuts you off from what is going on around you. If you aren’t aware of what is going on around you, then you aren’t able to effectively deal with it. On the flip side, by committing to whatever you are doing fully, without distractions, you not only improve the way you do it, but you flex and build your Mindfulness muscles. This idea applies to everything from driving to parenting and from washing dishes to shopping. Once you start working on being more mindful in these smaller arenas, you will be able to eventually do it when it matters. To start, though, just practice turning off your music during your commute and just travel.
- Practice Naming Emotions In Everyday Conversation
Everyone has had the experience of being upset but not quite being sure why. Unfortunately, when you don’t know why you’re upset, there is often very little you can do about it. That’s where DBT comes in. One of the best things about DBT is that it encourages patients to improve their ability to be more aware of their emotions, thoughts, behaviors, etc. in such a way that it empowers them to be able to manage more effectively. Sounds pretty complicated but in all actuality it doesn’t have to be. Being able to name your emotions is a great place to start and what better place to practice doing that than in every day conversations? For example, “I’m so happy you came over for dinner!” or “It irritates me when you come home late without calling.
- Listen To The Person You Are Talking To
Sounds easy enough. But how often have you found yourself thinking about what to say before the person has even finished their sentence? We are all guilty of this. Sometimes it’s because the conversation is heated or we are anxious. Either way, it rarely ends well. You usually say something you regret or ultimately wind up not getting what you wanted.
You don’t have to agree with what the person is saying and you don’t have to ultimately change your tune. But actually listening improves your odds of accomplishing your goals in dealing with someone (i.e. improves interpersonal effectiveness). When you actually listen to someone, it increases the likelihood that the other person feels heard and will give you what you want. It also increases the effectiveness of your eventual response because that choice will be based on a more fully informed assessment of the situation.
Conclusion: You should actually listen to the person you are talking to (even if you don’t want to).
- Asking Yourself “Is This Really Worth It?”
Spinning your wheels. It’s a phrase meant to recall images of gerbils hopelessly running in circles in their cage wheel. They aren’t going anywhere, but continue to run none-the-less. When you’re upset, you sometimes find yourself spinning your wheels. Or maybe more appropriately, you find yourself banging your head against a wall being upset about something that isn’t really worth it.
Unfortunately, in the moment, we aren’t always thinking about whether it is worth it. We are usually obsessing over whatever we are upset about and making ourselves miserable in the process. We are tolerating distress poorly.
When we find ourselves here, we almost never actually do anything to make it better. Often times we make it worse and the cycle continues. By ourselves in the moment, it is hard to see the ineffectiveness of this pattern. But one of the easiest ways to try to cut this cycle off at the pass is to, when you notice you are really upset about something, ask yourself: “Is this really worth it?”, “Is anything here actually in my control?”, or “Is my reaction making this situation better for myself?” (hint: the answer is usually no).
Overall, the DBT message is relatively consistent and clear: it is important to take ownership over our lives and we have an inherent ability to effect change for ourselves. Receiving adherent treatment from a certified DBT therapist and/or program is always recommended. But that doesn’t mean that you can’t benefit from some of the concepts without being in or having completed a full course of DBT treatment.
Many of the people I treat with Dialectical Behavior Therapy (DBT) have accidentally referred to it as DIABOLICAL Behavior Therapy. I can’t tell you how many times other therapists at conferences or staff meetings have re-counted a story where a patient has referred to the treatment this way.
When re-telling this type of story, it usually ends with resounding laughter at what is perceived as a Freudian slip. Why, you ask? Well, because while receiving DBT treatment has been known to change your life, it also requires hard work from the person receiving it. DBT may not quite be diabolical or hellish, but it’s certainly not a cakewalk. But these four ways to use DBT daily are certainly a good place to start.
Carla Nasca, Ph.D., is a post-doctoral fellow of the American Foundation for Suicide Prevention in the laboratory of Neuroendocrinology at the Rockefeller University, New York. Dr. Nasca received her B.A. in Molecular Biology and her M.S. in Electrophysiology from the University of Palermo in Italy. She earned her Ph.D. in Neurobiology and Pharmacology from the University Sapienza in Rome, Italy, before moving to The Rockefeller University under the mentorship of Dr. Bruce McEwen.