DBT Basics: Questions and Answers about Dialectical Behavior Therapy

I get a lot of calls asking about DBT and though it would be helpful to provide some answers to these common questions. So, without further ado …

What is DBT?

• Dialectical Behavior Therapy is a collection of life skills broken into 4 modules. These skills help to increase awareness, challenge opposing forces, and create change. Mindfulness is the core module, as it is sprinkled into each skill. Here you learn how to increase your awareness of the present moment and simplify varying aspects of life. Distress Tolerance helps you to put up with your distress in order to better manage it. Emotion Regulation provides tools to be more in-tune with the ebbs and flows of emotions, so you are less vulnerable to the intensities. This module also helps you get into the drivers seat, instead of hanging on for an emotional ride. Interpersonal Effectiveness helps you to build healthy relationships, including the relationship you have with yourself. During therapy, you will also keep and complete a daily log to review with your counselor.

Who can benefit from DBT?

• Almost anyone! DBT was originally designed as treatment for individuals with Borderline Personality Disorder, but is now used for so much more. Research continues to show improvements in individuals who self-harm, struggle with suicidal thinking, make impulsive choices, and have difficulty managing emotions and navigating relationships. Most people can also learn to be more present, tolerate pain, challenge cognitive distortions, build a strong sense-of-self, notice irritability before it increased to rage, and let go of judgments that hold you back. A small fraction of the many benefits. I would add that those around you can benefit too, as they will not only notice a change in you, but will also pick up on your new role-modeled behaviors.

How long does it take to learn?

• It depends on where you start and your own definition of having learned something. Many of the skills taught through DBT are lessons that could be read in book or gained during childhood, but were never effectively role-modeled for you. Meaning, everyone wanting to learn DBT will come in at a different level based on life experiences. Reading through the skills is one thing, but practicing, applying, and talking about skill use is where the real learning happens. You will probably find that you are already using many of the skills, but did not have a way to identify your choices and actions. When you are more aware, you will recognize more opportunities to replicate effectiveness.

How will I know it is working?

• Once you accept the process and are ready to understand, PRACTICE, and apply the skills you will begin to notice the difference and eventually use skills without much planning or thought. They become your way of thinking and doing. DBT skills will come to replace the ineffective thoughts and behaviors that were keeping you stuck.

Why is this not taught in Middle School?

• After hearing about DBT and learning the skills, the most common question becomes, “Why is DBT not taught to everyone in middle school?” My response, “Good question!” I believe DBT could be such a benefit at early agaes. Learning these skills, with peers in a structured environment, could set children up with greater resources for success throughout their life.

CLICK HERE for more information about individual DBT at SouthView Counseling

- Nikki Gorman, MA, LPCC

Fight Procrastination: Break Down Tasks to Complete Them with Less Anxiety

Avoidance and procrastination

As I sit and make my week's To-Do List, I am completely aware that I use these lists as a form of procrastination. I can make a list of tasks to complete, organize, color code, and put on the calendar. It sounds productive, right!? Wrong. What you might have guessed, is that I already did this yesterday. I am using this form of being "productive" to avoid just sitting down and completing the tasks. I might look busy and motivated, but am not fooling anyone, especially not myself.

So, why do it? The answer is simple ... avoidance and procrastination. Sometimes we get ourselves into a habit of organizing and preparing instead of actually doing. While part of this is derived from habit, the other part is also anxiety. Even the smallest task can seem major when it is pushed off and carried over from day-to-day. 

Break it down and commit

When tasks start to feel too big to tackle, then it is time to break them down and commit to completing the smaller steps. Start with One-Thing-At-A-Time!! Follow your usual routine of making and organizing a To-Do List, but this time do it with intent and less anxiety. Make a list of things you want to accomplish, then pick just one thing, and hide the list for later. Now, break that one thing down into many small tasks and focus on just the first item again. Pick a day and time to complete the first small step towards your larger goal. When you finish the first step, make sure to cross it off the list, not only because you deserve that feeling of gratification, but your brain will also release a shot of dopamine and increase motivation to get more done. Win-Win!! 

Tony has struggled with procrastination his entire life. He avoids completing homework until the night before, his closet has become his bedroom floor, and his apartment is a disaster zone. When he looks around at the mess, he feels overwhelmed and discouraged. "It's been like this all summer," he thinks. "Let's be honest, I'm never going to clean it and just need to accept that I am a messy person."  

Ouch! Tony is having a HUGE distortion by identifying himself with his mess. This thought process will keep him down, instead of provide him with encouragement. Tony decides to bring it up in therapy and works to create a smaller lists of things he wants to clean. He chooses to start by focusing on just the laundry. He makes a list of steps to complete the laundry and makes a goal to focus on the first small task. Grab a basket and walk around collecting all the dirty clothes. That's it, that's his homework for the week! This doesn't clean the clothes or clean his apartment, but it is a start and more than he has been doing. Afterwards, he feels like that was pretty easy and proud of himself for setting a goal and completing it. Tony can't wait to tell his counselor of his success. Tony will be more likely to complete the next step, because he had a positive experience. Nice job, Tony!

Be mindful

Throughout the day be mindful of things you have completed, NOT your dreaded To-Do List. This will help you to stay motivated and build a sense of confidence that you are someone who gets things done! Yes, you!

 - Nikki Gorman, MA, LPCC