Putting together different DBT-Skills

I will try to clarify some emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness skills that I hope might be useful.

Mindfulness practices:

These are daily and for low levels of distress. You can try them in high distress but may find that unless you’ve been practicing them regularly they may be inaccessible.

We start with selecting a joyful, peaceful, powerful, in love, or safe moment to focus on. Even if the moment had a down side we can hold both realities or truths at the same time (a dialectic), alternating focus back and forth. We’re searching for a full body experience of the moment. It is the both the same as, but the opposite of, thinking about a stressful moment and that feeling flooding back.

This is a mindfulness practice that, once a couple of potent memories have been identified, can be practiced in 10-15 second periods throughout the day. You wait till the body feeling of the emotion returns to know you’re done.

Another practice that helps straighten out our thoughts is “Everything is perfect” on inhale and “As it is” on exhale; give yourself full permission to mutter “Even if I don’t like it” – I’ll write more on non-judgment later but this practice is at the heart of it.

Distress tolerance practice:

When a moment hits hard it is time for TIP!
Temperature: Increase heat for depression and cold for anxiety or anger
Intensive: a 20 second burst of activity, jumping jacks etc.
Pressure: Palms up push on the bottom of your table, hug yourself tightly, put a coffee table type book on your chest laying down

If still not calm decide if your head is spinning or you feel agitated physically:

Spinning mind: Do the ABCs – pick a topic (cities, names, cars…) and go through the alphabet matching (i.e., Audi, BMW, Chevy, Dodge…) sounds easy but quite complex – if you can’t match a word/letter skip it rather than frustrating yourself

Agitation: hold an ice cube till it melts; inhale to a beat of 4 or 5, exhale to a beat of 6 or 7; repeat two more times to restabilize your system

Now, you’re ready for a ‘chain analysis’. Stop, note the distress and ask yourself when was the last time I felt better/stable/good…..

From that point track events and reactions, how quickly or slowly, overwhelm set in. Where there any actions that I can consider changing in the future without judging my reactions/actions in the past; for instance, sometimes the immediate impulse to behave worsens the situation rather than improves it. (This can be an empowering process if non-judgment is practiced)

The most important part of the exercise is to restore the feeling of sanity. When a chain analysis is done it should make perfect sense to me why I feel as bad as I do.

Emotional Regulation and Interpersonal Effectiveness practice:

Opposite action, opposite action, opposite action for down regulating an emotion. For instance, someone disappoints or irritates me. I may thank them for being involved with me as a friend; gratitude is the best antidote for anger. I will find a better more peaceful time to address their behavior. Knowing I have an action plan is empowering; knowing why I’m choosing to do what I am doing is also empowering; practice smiling inside because there is a secret plan the other person does not know about that is going to help me get my way/point across/etc.

Rather than being defensive to criticism practice listening, reflecting back what was said and see if you got it right, thank them for their concern and point of view and tell them you’ll think about what they said. Go to a trusted friend or therapist and ask for help in determining how accurate the perceptions are 2%? 50%? 97%? Maybe they see a ‘blind spot’ if so you can thank them again; if not then if you want you can tell them there is likely some truth to it but you don’t see it.

Jon Ubick copyright 2013

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