Choosing DBT Skills

In response to my emotional meltdown in The Silent Rejection, someone asked me what DBT would have me do in this situation.  It seemed more appropriate to make a separate post than to ramble on and on in a comment.

I was in so much pain at the time I wrote the previous post, that the first step would have been to use Distress Tolerance skills.  There are a lot of options, but the ones I’d have leaned on first would have been Self-Soothe and ACCEPTS.  Self-Soothe is about using the five senses to comfort yourself.  I consider coloring to be a part of Self-Soothe, but it also could be part of ACCEPTS.  ACCEPTS is about distracting oneself from the situation that is causing distress.  Each letter stands for a method of distraction:

Activities:  anything you can participate in from reading a book to playing a sport
Contributions:  doing something to help others such as helping someone move or volunteering at a soup kitchen
Comparisons:  sometimes called “Count your blessings”, this is about being thankful for what you have that others don’t, or that you didn’t have in the past
Emotions:  doing something to elicit different emotions, such as watching a comedy or reading a joke book
Pushing away:  getting the thought out of your head, often via visualization; in group we use a conveyor belt on which we imagine putting our thoughts and watching them slip away
Thoughts:  thinking about other topics; I tend to use puzzles or trivia, or recite a pattern such as the Fibonacci sequence
Sensations:  a kind of extreme twist on Self-Soothe – you use the five senses, but instead of comforting they are more shocking, such as a hot shower or holding an ice cube while it melts

Another Distress Tolerance skill that might have been helpful is Keeping It In Perspective.  It’s about recognizing that the situation is probably not the worst thing that’s ever happened to you, and even if it is, you can use the techniques you learned from other struggles to help get through this one.

After calming down, the emotion still needs to be dealt with and that could be done via Emotional Regulation skills.  I discussed some of these in Upcoming DBT Graduation.  I would have sort of been using Feeling Not Acting already if I used Self-Soothe and ACCEPTS, but another step is to use Ride the Wave and allow myself to feel the intensity of the emotion without acting upon it.

Since this situation was about a conflict with others, there’s probably something helpful in the Interpersonal Effectiveness module.  I think I would use Relationship Assumptions, which states that all parties are doing the best they know how in the relationship, and that even though you didn’t create all the problems, you have to do what you can to solve them.  It helps to recognize that these people didn’t mean to hurt me.  They don’t know that they did, and if I want to feel comfortable with them in the future I need to address the issue and let them know how I feel.

That said, there’s also a skill called Radical Acceptance.  It’s about accepting a situation as it is and recognizing that you can’t change the situation.  Nothing I can say or do now is going to make this hurt and humiliation unhappen.  It’s impossible to get what I want in this situation.  Radical Acceptance says that accepting the situation, even though I don’t like it, will prevent pain from developing into suffering.

Of course there are dozens of skills and ways to apply them.  Other people might have selected an entirely different course of action in the same situation, and their chosen skills might have worked even better for them.

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3 thoughts on “Choosing DBT Skills

  1. Thank you so much for writing this. It’s very helpful! I was gonna reblog but I noticed you don’t have a reblog button. What’s the best way to share your stuff on my blog? Thank you :)

    Like

    • Oh yeah, I disabled reblogging. Don’t really care for how it looks to have part of my post appear on someone else’s blog. Happy to have you share a link though, maybe with a brief explanation of what you liked about the post.

      It’s funny – now that I’m soon to be leaving DBT group I seem to be writing more about the skills.

      Liked by 1 person

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