Dialectical Behavior Therapy Skills for Health

What is Dialectical Behaviour Therapy?

Dialectical behavior therapy (DBT) was originally created by Dr. Marsha Linehan (1993a) to help people who were struggling with borderline personality disorder. It was designed to teach people practical skills to improve their lives, and research showed that it was very successful. The Linehan Institute is a great resource to learn more about DBT.

Now DBT is also being used to help people who are struggling with a wide variety of other problems, including Depression and Anxiety. The common factor in all of these illnesses is overwhelming emotions.

DBT helps me cope with Depression and Anxiety. But it also helps me cope with the overwhelming emotions that come with Type I Diabetes and Celiac Disease.

My psychiatrist introduced me to DBT when she diagnosed me as having chronic Depression and Anxiety. The more I learned about DBT skills and how to use them to cope with the symptoms of Depression and Anxiety, I realized I could apply the skills to help me cope with my Type 1 Diabetes and Celiac Disease.

4 DBT Skills Groups

• Distress tolerance skills help me distract from painful situations when I can't cope with them, and then relax and soothe myself.
• Mindfulness skills help me stay focused on what's happening in the present moment, concentrate, and make healthier choices as a result.
• Emotional regulation skills help me identify and name my feelings, and then learn how to tolerate them without getting overwhelmed.
• Interpersonal effectiveness skills give me the tools to improve my relationships, ask for what I want in an effective way, say no, and establish appropriate boundaries, in a respectful, healthy way.

Next, I am going to share 2 examples of distress tolerance skills I use. This page is a sampler of DBT skills. My hope is to spark your interest in DBT.

How I Practice DBT Skills

Use coping thoughts as a distress tolerance skill

When my thoughts are self-critical, I can probably feel bad about myself and engage in behaviors that make me feel worse. However, thoughts can also have a positive effect too, especially in a distressing situation. Sometimes a few supportive words in the form of a coping thought are all the help I need to accomplish a task, feel better, or get through a tough situation. When my emotions are overwhelming, I tell myself:

• "My feelings are uncomfortable right now, but eventually they'll go away."
• It's ok to feel sad, anxious, or afraid sometimes."

Using coping thoughts can help me endure and cope with overwhelming emotions until I am able to come up with a plan to deal with them in a healthy, effective way, such as talking with my psychiatrist. Using coping thoughts is like an effective temporary fix for complex symptoms of Depression and Anxiety.

Self-soothe as a distress tolerance skill

Learning how to soothe myself is very important because it can make both my mind and my body feel better. Then I will be able to cope with a difficult situation in a more effective way. For example, I use my sense of touch to soothe myself when my blood sugars are too high. It helps me to relax and then have more energy to deal with the high blood sugar levels. It helps me to manage my overwhelming feeling of guilt for a having high blood sugar reading. Here are 3 ways I self-sooth:

• I hug my husband. If I can't hug my husband, I hug my pillow.
• I touch the leaves of the plant in my living room. The leaves are soft.
• I take a long shower or bath. Or I use a hot towel on my face.
• I wear my most comfortable clothes. If I am at home, pjs are my favourite choice.

Self-soothing is a skill that does not come easily to me when I am in the middle of a difficult situation. In the past, I expected other people to do it for me or I felt guilty to self-sooth in the middle of a crisis. Now, I am learning to take care of myself in the midst of a problem.

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