‘Breathe in for two, hold for two, breathe out for two, and hold for two.’ Have you ever done that? Have you ever taken in a few deep breaths to help you avoid an unwanted reaction to a difficult situation? Yes?! It’s quite possible you’re using DBT (Dialectical Behavior Therapy) skills without even realizing. That’s the beauty of DBT. The skills that are taught can be done in home, at work, at school, wherever they are needed. All the tools needed are easily accessible. As a residential team member I am continuously coaching DBT with the students, and then answering to the statement, “this wouldn’t be normal to do outside of treatment.” Sure, asking a boss if you can use “Dear Man” to get your needs met might cause a little confusion. However, learning the skills and practicing them can be effective in all aspects of life. I do it everyday and want to share my favorite DBT skills to use at home.
My five favorite DBT skills to use at home:
Distress Tolerance: TIPP
It is sometimes difficult to come home after a long day at work and realize I still have to do dishes, or laundry, walk the dog, bathe and feed my son, respond to emails, and ask my husband how his day was. Before I know it my distress is in full swing, and now nothing is going to get done. The idea behind distress tolerance isn’t to completely get rid of the distress. Naturally, that to do list is going to be stressful. With a distress tolerance skill, it will help lessen the level of distress so that the tasks at hand can be completed while maintaining sanity. I use TIPP most often, it is used when emotional arousal is high and the brain is struggling to process information. TIPP stands for:
T = Temperature
Using something cold to decrease heart rate automatically such as splashing your face with water, or holding ice cubes in your hand.
I = Intense exercise
Increasing your heart rate for a short amount of time (10-15 minutes) is a way to again, automatically change the body’s reaction.
P = Paced breathing
Slow your breathing and breathe in for 4 and out for 6-8 seconds. Do this for a couple minutes to bring down emotional arousal.
P = Progressive muscle relaxation
Tense and relax each muscle group from head to toe.
Distress Tolerance: ACCEPTING REALITY
Sounds simple, sure accept what you can’t change. However, that doesn’t help the emotion that comes with realities that are hard. Despite the level of severity, this skill can be used to accept things that cannot change. At times, it could be the never-ending load of laundry and for some, it could be the loss of a parent or loved one. As a parent, there comes a time where you may have to accept that you have a daughter in treatment, or that she is need of treatment. Part of accepting reality is knowing there are still choices. You can accept it, find a way to solve the problem, work to change how you feel about the problem, be miserable in the situation, or make it worse. All are choices. Thinking through those choices can help you do a self-check to assess the problem and determine what to do about it.
Emotional Regulation: PLEASE
Emotions are often hard to understand and can be unwanted and unpleasant. However, some emotions are helpful by allowing yourself to explore a situation and how you feel within it. The skill, PLEASE, is helpful for you when you can’t seem to distinguish between anxiety, feeling overwhelmed, sadness, or loss. While none of these may be pleasant, working through and exploring sadness or loss is going to lead to a healthier mindset. The acronym PLEASE describes the following skills to help take care of yourself, which in turn will help regulate emotions.
Treat PhysicaL illness: It is important to treat physical problems, take prescribed medication, and see a physician if necessary.
Balance Eating: Eat balanced. Be sure to eat enough to sustain your body. Try to avoid foods that will negatively play into emotions.
Avoid mood-altering drugs: Stay off drugs that are not prescribed, and don’t abuse prescription medication.
Balance Sleep: It helps to stay on a regular schedule and to sleep enough to feel rested. This can vary from person to person.
Get Exercise: Getting a small amount of exercise each day is important. Start small and work your way up.
Walking the middle path: DIALECTICS
Dialectics help to create understanding in situations where conflict is typically present. By understanding dialectics you can see that in any situation there is more than one way to solve a problem, that two things that may seem completely opposite can both be true, and the one constant thing is change. Focusing on the language in a conversation can help create a middle path understanding. Opposed to using the word BUT, replacing it with AND. This will validate the other person as well as allow you to express your position. Sometimes these conversations can be with yourself while you may be faced with personal conflict. Saying, ”I can do this AND it is going to be hard” versus “I can do this BUT it is going to be hard” can create a feeling of more openness and possibility.
Mindfulness: HOW and WHAT Skills
There are a lot of different ways to practice mindfulness. Each person is different in what works for them. I personally do well with paced breathing. Regardless of the mindfulness that you prefer, there are ‘how’ and ‘what’ skills that will help you practice mindfulness more effectively:
- Observe: inside and outside yourself, notice the experience, let thoughts and feelings happen.
- Describe: label what you observe, i.e., I feel scared, my chest is tight, my heart is racing.
- Participate: engage in the moment fully, even if this means experiencing hard emotions.
- Don’t Judge: notice, don’t evaluate. Stick to observations, without labels of good or bad. When a judgment arises, replace them with descriptions.
- Stay Focused: concentrate your mind so that past, present, and future distractions don’t get in your way.
- Do What Works: be effective, do what is effective for you in your current situation. Don’t allow emotions to control your behavior.
I shared only five skills out of the many, and while they are my top five, they might not be yours. If they don’t work for you, they aren’t the only option. My hope is that with exploring the skills in DBT you realize how possible and helpful they are. Work to find your TOP 5 DBT Skills.