10 Weeks of DBT

Dialectical Behavioral Therapy is a science-based therapy created by Marsha Linehan, PhD. that has been proven effective in teaching individuals struggling with behavioral disorders and PTSD skills to improve their quality of life. These skills are divided into four categories: interpersonal effectiveness, mindfulness, distress tolerance, and emotion regulation. DBT was developed in the 1980s, and though DBT is spreading quickly, many people still don't know much—if anything—about DBT therapy.

After struggling for years with depression, and getting diagnosed with Borderline Personality Disorder when I was 18, I was encouraged to try out DBT. Every week I had a one-on-one session with my therapist, and a two hour long session in group therapy. In the beginning, DBT therapy was a huge commitment and I began to worry that it wasn't worth it, but when I started to integrate the skills into my day to day life, my perception of DBT changed completely. After completing that first year of DBT, I signed up for an advanced DBT course called DBT-ACES. I believe that DBT saved me, and gave me the opportunity to take ahold of my life, set goals, and implement a new set of skills to help me mindfully, and effectively navigate my life. Because DBT was so effective for me, I feel that it is my duty to share the DBT skills I have learned with others.

Below is a list of DBT skills and DBT-inspired practices to implement over a period of 10 weeks for anyone interested in getting a taste of DBT therapy.

Week 1: Reduce Vulnerability by Taking Care of Your Needs

Are you reducing vulnerability factors by eating well and staying hydrated? Sometimes we just need to step back and recognize whether or not we're taking care of our physiological needs. If you struggle to drink water on a regular basis, try following a water drinking schedule for one week. Start with drinking 1 glass when you first wake up, 1 glass before each meal, and 1 glass before bed. If it helps, set alarms on your phone to remind you when it's time for a glass. If you also struggle with finding good times to eat, try create an eating schedule. One thing many people struggle with is eating out or on the go. It may feel tedious at first, but try to get in the habit of packing healthy lunches and snacks to take with you. This will help you save money too!

Week 2: Self-Soothe with a Mini Vacation

We all have setbacks from time to time that we have to recover from. Whether it's a bad grade on a paper or a missed deadline at work, often times we'll experience shame or sadness from our setback. We must not let those emotions swallow us. If you come across a setback, maybe it means it's time to pave the way for a breakthrough by practicing some self care. First, take a step back and look at the situation. Are you stressed? Do you need to take a break? Maybe the best way to move forward is to allow yourself a mini vacation from whatever the problem is that you're trying to tackle. Taking a mini vacation can help reduce irritability and stress so you can return to your task focused and rejuvenated. Maybe your mini vacation is a day hike, maybe a day at the spa, or maybe your schedule and budget is tight and your mini vacation is relaxing at home watching your favorite movie. Whatever it is, make sure it's something that will feel good and refreshing to YOU. After self-soothing with a mini vacation, use your fresh and relaxed state of mind to take a second attempt at the task at hand. Just remember, don't get too carried away on your mini vacation that you begin to procrastinate!

Week 3: Practice Mindfullness with Observe and Describe

Sometimes we forget the importance of living in the moment. If you often find your mind racing, and you're thinking too much about the past and the future, try and focus on the present. There are many ways and many senses we can use to do this. This week, use Observe and Describe skill to observe and describe what's happening around you. Maybe you're walking somewhere and you notice the trees around you. What do they look like? How are the leaves shaped and what colors are they? Pay attention to detail. Maybe it starts raining. How do the raindrops feel? Can you see them? Maybe it's a nice smell you're observing, or maybe you hear birds calling and traffic rushing by. Observe and Describe calms your mind, keeps you in the moment, and improves your ability to focus. It's also a good mindfulness skill to practice when you're feeling stressed out and/or worried. There are many ways we can practice living in the moment. Again, pay attention to detail and live in the present.

Week 4: Practice Reducing Judgements

This week try and focus on being mindful of your judgmental thoughts. We all have them, some of us are more critical of ourselves, while some of us are more critical of others. This week try to focus specifically on the judgmental thoughts you have about yourself. First identify it. What is the thought? What has led you to think that about yourself? Check the facts. Did something happen to make you think that thought about yourself or are you just feeling bad about yourself? If you're feeling frustrated about an action you committed, try and reframe your judgmental thought to gently express disappointment in the action, rather than yourself. If your judgmental thought comes from poor self-esteem, or you're used to criticizing yourself just to criticize, think about how you can think more positively of yourself. Compliment and praise yourself to combat those judgmental thoughts and criticisms. In order to be happy, we must be happy with ourselves, and sometimes judgmental thoughts can get in the way of that. Focus on nonjudgmental this week, and treat yourself with respect and compassion.

Week 5: Opposite to Emotion Action

Is there an emotion getting you down, and making it a challenging for you to do the things you want to do? It's good to process your emotions wholly, without ignoring or exaggerating them, but if it's lasting too long and getting in the way of your happiness, try practicing Opposite to Emotion Action. Here's how it works: If you're feeling sad and your urge is to isolate yourself and stay in, practice Opposite to Emotion Action by making a plan, leaving your home, seeing a friend or two and throwing yourself in to the moment. Similarly, if you're feeling anxious and your urge is to to hide away and avoid reaching out to others, try practicing Opposite to Emotion Action by approaching someone new, or by meeting with a group, or going to an event like a show or a party. Opposite to Emotion Action requires Willingness and your full Participation so it could help to practice Willingness and a Cope Ahead by visualizing the and mentally walking through event you're worried about beforehand.

Week 6: Build Friendships

If you are someone who finds building friendships to be a difficult and anxious process, challenge yourself to build new and fulfilling friendships this year. A good way to start is to identify and make a list of your values. When you feel like you're finished with that, make another list of activities you would like to do with other people. Be it singing, walking, dining, drawing or visiting a museum—finding an activity to do with a new potential friend could take off some of the stress of coming up with things to do and say. When you've finished your list, reach out to your potential friend with open suggestions of when and where to hangout, and do a cope ahead by imagining a play-by-play of the day to reduce anxiety. On the day you hang out, make sure to participate fully and reduce anxiety by letting the wave pass and/or practicing opposite to emotion action. Remember, if the plan doesn't work or your potential friend cancels, it's most likely not "you." Check the facts. Maybe something came up, or they already had obligations that day.

Week 7: Find Your Wise-Mind

I believe that Wise Mind is one of the most important skills to learn in DBT, so I'm going to repost one of the first posts I made explaining the concept of Wise Mind with an example of when it's good to put your Wise Mind in use. Wise Mind is a wonderful mindfulness skill about achieving balance between emotion mind and reasonable mind. When I'm in Wise Mind, I feel serenity both in my mind and my body. A good time to find Wise Mind, is when you feel like you are about to take an impulsive action. For instance, consider a scenario where someone has upset you and instantly you want to send an angry text. Instead of sending that text, ask yourself: Am I in Wise Mind? If the answer is no, use skills like Check The Facts or STOP skill to take a step back, until you feel like you're in a good state to respond, or not respond depending on what makes the most sense to your Wise Mind.

Week 8: Build Mastery

If you're feeling down, and incapable of achieving your goals, try using Build Mastery. Set a goal, and follow this goal with little, challenging but manageable action steps. Maybe you want to make a piece of artwork you're proud of but you're feeling unmotivated. Start by setting a day, or time span that you want to complete this project. Once you have your time frame, organize it to fit into your schedule. Maybe you plan to work on your art project for 30 minutes a day, for one week. Or maybe you want to work on it for 1 hour, three times in the week. Whatever makes sense to you! When you feel like you've solidified your action steps, ask yourself if there's a 50% chance you'll be able to complete this goal. If 50% seems too low, try stepping back and making your goal a little bit more reasonable. If 50% seems too high, modify your goal to be more challenging. If you organize and plan your action steps, it will be more likely to achieve Build Mastery. You'll likely feel accomplished, motivated and competent afterwards! If you're feeling really low and unmotivated, you can still set small goals and achieve Build Mastery. Maybe you're struggling to get out of bed, and your goal is to do one load of laundry, or call a friend. It doesn't have to be a big goal, as long as there's a 50% chance that you can complete it, and you give yourself the proper praise afterwards for Building Mastery.

Week 9: DEARMAN

You are your own best advocate. When obstacles arise, sometimes you need to advocate for your needs. Whether you're struggling with an illness and need to take time off from school, or you're dealing with a family loss, or you need to make a change in your work schedule—whatever it is, learning how to get those needs met will benefit you. First put yourself in Wise Mind. Figure out exactly what it is you need, and whether your request is reasonable. Then Cope Ahead by practicing DEARMAN. DEARMAN stands for Describe, Express, Assert, Reinforce, (stay) Mindful, Appear Confident, and Negotiate. Here's an example: Say you've been struggling with some health issues and you need to ask for an extension on a paper. After accessing whether or not your request is reasonable, Cope Ahead by planning out how you're going to ask for your objective. Start with Describe by describing to your teacher what it is you need, stay straight to the point. Express the importance of your request by explaining how you've been feeling and what your symptoms have been. Stay balanced; articulate the importance of your request without allowing your emotions to take over the dialogue. Assert your needs without being aggressive or over-bearing. Reinforce your teacher, tell them how much you would appreciate the extension and how it'll help you to do better in their class. Stay Mindful, remember to check whether or not you're in Wise Mind throughout the request. Appear Confident that your request is valid, and important. Finally, make room for Negotiations. If your teacher can't give you an extension as long as you anticipated, settle for a shorter extension. Sometimes you just have to meet another person half way, and that's okay. This is a very important and simultaneously very challenging skill, but don't let that discourage you. Good luck!

Week 10: Create an Ambition

I encourage you to take this week to brainstorm and write up an ambition. If you already have an ambition you follow, go back and take a look at it. Does it still ring true? Sometimes our goals and aspirations change over time and you may have some editing to do. If you haven't written out an ambition and you have no idea what I'm talking about—let me explain. In DBT-ACES therapy, we construct an ambition that we take steps towards each week. It's a little plan on a little piece of paper or maybe on a poster, or a note on your phone with a list of goals you want to achieve. For example: I want to have a degree in sociology, I want to have a pet dog, an apartment I can live comfortably in, and close friends I can trust. OR: I want to be financially independent, practice mindfulness daily, and go running three days a week. Your ambition is YOURS. Personalize it, make sure it's the ambition that you want. After you've written it out, you can begin to take action steps towards it! Good luck.

After these 10 weeks, if you find that these skills are helping improve your mental health, giving you hope, or inspiring you to live the life you want to live, consider looking into DBT as a regular practice. It just may be the toolkit you need to manage your mental health.

(For more information about DBT, click here.)