What is DBT?
Dialectical Behavior Therapy (DBT) was conceived by Dr. Marsha M. Linehan in the late 1980s at the University of Washington. Originally developed to treat borderline personality disorder, DBT has since become a cornerstone in psychological therapy and personal development. By fusing cognitive-behavioral techniques with mindfulness practices rooted in Eastern meditation, DBT offers a unique blend for emotional regulation, effective communication, and self-respect cultivation. Its applications extend far beyond clinical therapy, offering valuable insights for everyday life challenges.
As I said, DBT’s were originally developed for treating individuals with severe emotional dysregulation with conditions such as BPD, but DBT’s principles have proven universally applicable, resonating with a broad audience seeking to enhance their life skills. Its core philosophy emphasizes balancing acceptance and change, empowering individuals to acknowledge their current situation while striving for personal growth.
I was first exposed to DBT’s in the 2010’s as it was applied beyond BPD to people on the spectrum and those with ADHD. It was even offered as a valuable tool for people with varying anxieties providing practical tools for managing symptoms, improving emotional regulation, and generally enhancing quality of life.
I don’t think I’ve spoken to anyone in a therapeutic context in the last 10 years that didn’t at least reference DBT’s as at least part of a person’s vital tool box. I’ve been using DBT’s as part of my toolbox for a great many years and found them very effective.
DBT has Four Modules
Mindfulness:
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Core Concept: Being fully present and engaged in the current moment.
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Application: Practicing non-judgmental observation of one’s thoughts, feelings, and surroundings.
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Goal: Enhances awareness and concentration, fostering acceptance and clarity.
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Distress Tolerance:
- Core Skills: Techniques like distraction, self-soothing, and pros/cons analysis.
- Application: Employing coping strategies during emotional crises.
- Goal: Aims to endure and accept distress without resorting to harmful behaviors.
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Emotion Regulation:
- Core Skills: Identifying and understanding emotions, reducing vulnerability to emotional instability.
- Application: Implementing strategies to change unwanted emotions.
- Goal: Helps in managing intense emotions, leading to increased emotional stability.
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Interpersonal Effectiveness:
- Core Skills: DEAR MAN, GIVE, and FAST.
- Application & Goals: Discussed in detail below.
DEAR MAN, GIVE, FAST: The point of this Post
As I mentioned recently, I’ve been brushing up a bit on these Interpersonal Effectiveness skills of late.
DEAR MAN: This technique is used for effective communication, especially when asking for something or saying no.
The acronym stands for:
- Describe: Factually state the situation.
- Express: Share your feelings and opinions about the situation.
- Assert: Clearly state what you want (or don’t want).
- Reinforce: Explain the positive effects of getting what you want.
- Mindful: Stay focused on your objectives.
- Appear Confident: Use a confident tone and body language.
- Negotiate: Be willing to give and take.
The purpose of DEAR MAN is to communicate your needs effectively and confidently, aiming for a fair and positive outcome.
GIVE: This skill helps maintain relationships through effective communication. It stands for:
- Gentle: Be kind and respectful in interactions.
- Interested: Show interest in the other person’s views.
- Validate: Acknowledge and validate the other person’s feelings and thoughts.
- Easy Manner: Use a light-hearted and easy-going approach.
The aim of GIVE is to address the issue in a way that respects both parties, strengthens the relationship, and finds a mutually agreeable solution.
FAST: This skill is about maintaining self-respect:
- Fair: Be fair to both yourself and the other person.
- (No) Apologies (none, or few): Don’t apologize, absolutely don’t over-apologize, and don’t make apologies when you’re not at fault.
- Stick to Values: Stand by your values and beliefs.
- Truthful: Do not lie or exaggerate.
The objective of FAST is to maintain self-respect and integrity, ensuring your actions align with your values and beliefs, even in challenging social situations.
Do they work?
The short answer is yes. These are tools that work and work well. They require practice, however, and can be challenging to implement in the moment. It’s very helpful to practice these things. A simple Internet search will turn up various examples, scenarios, worksheets, and similar.
Some scenarios you could use to role play, for example, for DEAR MAN might be asking for a raise or addressing a team member’s consistently missed deadlines. GIVE and FAST could be practiced together or on their own and there are a variety of scenarios you could dream up like working on a group project with someone who suggests and unethical approach or, perhaps, you could draw from some interaction in your past that could have gone better.
Like any skill, the effectiveness of DBT techniques increases with consistent practice and integration into daily interactions.
Conclusion
DBT offers a rich set of skills that are not just therapeutic but also practical for everyday life. These skills provide strategies for managing emotions, navigating interpersonal relationships, and maintaining mental well-being. Whether it’s through the mindful practice of being present, the emotion regulation techniques to balance our feelings, or the interpersonal effectiveness skills of DEAR MAN, GIVE, and FAST, DBT equips individuals with the tools to face life’s challenges with resilience and poise.
I’d strongly encourage you, if you don’t already have DBT’s in your tool box, to consider learning more. For those new to DBT, starting with mindfulness practices can be a practical and accessible entry point.
This post is, for me, another opportunity to try to cement these tools in my mind. I’ve been practicing and learning about DBT’s for years and they, along with a variety of other tools, have served me well. But I’m always learning, and always trying to get more comfortable with my tools.
Most of all, I want to share with folks that might not already know about these super useful communication techniques. Some folks may find these sound simple, like things you already know. It’s true, these are somewhat common sense. But even those who understand these things in the abstract can benefit from understanding the formally described structure of DBT’s Interpersonal Effectiveness strategies.
This is but one part of one pillar of DBT’s, there is so much more to to learn in this rich tapestry of therapeutic tools. The standard treatment typically involves a 6 to 12 months of commitment or weekly therapy sessions with on-going practice and homework.
What I’m driving at is DBT’s are You won’t learn much from this post, but if you’re interesting in learning more there are many resources out there for you!