Dialectical behaviour therapy (DBT) aims to teach people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve their relationships with others.
Introduction
Dialectical Behavioural Therapy (DBT) was initially designed to improve impulse control issues and emotional regulation problems in clinical settings and is often considered a subtype of Cognitive Behavioural Therapy (a popular psychotherapy umbrella term), due to their many overlapping domains. While initially used predominantly for people experiencing borderline personality conditions, the skills taught in DBT have also been extracted and used to help people improve their general mental health and well-being.
The core principle driving DBT practices is the philosophy of dialectics which understands and acknowledges the fact that various conflicts, tensions, and disagreements between our thoughts, feelings, behaviours, and the world around us occurs continuously; and that to achieve peace and optimum mental health, we need to balance, resolve, or deal with them effectively. By viewing the world in shades of grey, DBT seeks to shift extreme emotions, thoughts, and behaviours to more neutral alternatives, and in doing so, allowing us to lead more effective lives with any given environment.
Hence the various skills and exercises covered below will help us achieve this greater control and mastery over our thoughts, feelings, and behaviours, bettering the way we navigate the world and relationships in our lives. The critical focus throughout will be on attaining and sustaining psychological equilibrium (i.e., a state of balance).
At this point, it needs to be made clear that the exercises and skills found in this guide are not a substitution or replacement for formal mental health support and you should seek help from a mental health professional if you are experiencing mental distress. We hope to achieve with this guide the imparting of DBT inspired exercises and skills that are easy to apply, require little to no advanced understanding of DBT's principles, and do not need professional guidance to utilise.
Here are simple to use exercises to boost your psychological well-being.
1. Mindfulness
The core of mindfulness is a strong awareness of our thoughts, emotions, behaviours, relationships, environments, and how they relate to one another. It is about mastering our mind and how we relate to our experiences with the world, and not allow them to control us. Here are some mindfulness exercises you can utilise to become more in-tune with yourself.
Mindful Breathing: Unlike regular breathing, we want to focus on how the air enters, circulates, and finally exits our body. Count each breath from 1 as it enters, to 10 or whatever number is most comfortable for you as it exits. Use some form of a mantra if necessary, to aid your concentration. Repeat this for at least 5 minutes.
Favourite Song: Focusing on your attention to the music you enjoy can be very useful for cultivating mindfulness. Listen to the melody, the lyrics and their meaning, pay attention to the different instruments, single out instruments and notice how they stand out from the rest. See if you can identify any new aspects of the song.
Interconnection: Think and ponder over how interconnected the world is. From the surface you are standing upon, to how they connect you far away to the people in your life, to how they further link you to places you enjoy going to, or to the broader environment/universe.
2. Distress-Inspired Exercises
When we are in distress, we sometimes forget the broader picture and focus on coping strategies which may work in the short-term but be detrimental later on. Identifying and planning potentially distressing situations in our lives can be useful in staying one step ahead and minimising potential discomfort before they become worse. Here are some tips for doing so.
Grounding: Take a deep breath, and list five things you can see, describe them in detail. What are four things you can feel, how do they make you feel? Name three things you hear with as much detail as possible. What are two things you can smell, are they pleasant or unpleasant? Name one taste, engage your senses and describe it.
Acceptance: During distressing times, there may often be no other choice except to find away to accept the situations or emotions that cause pain, allowing us to release the psychological resources required to move forward. Acceptance does not mean we enjoy, agree, or even like the situation or thought that is causing us distress, but it allows us to regain control and find a way to proceed. Refine your attitude towards acceptance by learning to let go of the day to day inconveniences which may irritate or annoy us (e.g., waiting in line, people being late, spilling your drink, etc.); or practice giving yourself permission to feel negative emotions (e.g., telling yourself it is okay to feel sad).
Willingness: While facing a distressing situation, asking yourself what you would be willing to do to end the suffering, solve the problem, or sacrifice will help you to discover your levels of tolerance for such situations. You can then adjust your expectations on how willing you are to perform specific actions to reduce the distress. Conducting a cost-benefit analysis of each option can help reveal which option you are most willing to partake in.
3. Emotion Regulation
Emotions are a part of our daily lives and can be challenging to manage at times, but being able to control or exert mastery over them can reduce the impact of negative ones, and enhance the positive ones. Here are some tips to go about regulating your feelings better.
Building Positive Experiences: Identify certain barriers that may prevent you from taking part in positive experiences within your life. List strategies to overcome these barriers. Next, create a list of activities and routines that you feel have previously brought positivity into your life. Break down these activities to see if there is any way to make them more impactful or easier to integrate within your life. The key to building positive experiences is balance, and finding what works for you.
Continuum Mindset: Instead of viewing emotions as black and white or extremes, it could be more effective to view them on a continuum. For example, for a feeling such as sad a continuum could be as such - unhappy > sad > blue > depressed > despondent > hopeless > bleak. We are not restricted to being either sad or happy, and there could be different shades of each emotion. This perspective will help us better manage the intensity of various emotions which surface in our lives.
Self-care: Emotions are easily influenced by various factors and caring for our physical health by keeping fit, having proper meals, resting enough, and avoiding drugs/alcohol can be vital to ensuring good emotional health. Identifying barriers and resources to support this self-care process is also crucial.
4. Interpersonal Effectiveness (Pt. 1)
Relationships with people is a cornerstone of human existence. There is no escaping our basic need to interact with others, but distressing and negative situations can challenge this. Learning how to do so can be daunting, but here are two simple guiding frameworks to utilise.
FAST: The acronym stands for
Fair - when relating to others, we need to ensure that we are fair in our treatment of them, that we do not swing between being extremely kind or abusive. Remain respectful and aware of our emotions to not lash out at others
Apologies not needed - apologies are important if you have done something wrong or have hurt somebody; but you do not need to apologise for having your own thoughts, opinions, values, and beliefs. Apologising excessively can also make the gesture seem less authentic.
Stick to values - using your values and beliefs in life as a guide can help ground you, allowing others to know how to interact with you. Understanding which values are non-negotiable, and also seek to resolve any conflict of values in an objective way.
Truth and accountability - be honest and accountable with yourself and in the way you interact with others. It its also important to note that honesty can be harmful when others are concerned, so it is important to be tactful when doing so. But in general, being accountable and honest is an effective way to interact with others.
4. Interpersonal Effectiveness (Pt. 2)
GIVE: The acronym stands for
Genuine - being “real” and authentic in approaching others is crucial as it demonstrates respect and openness. This is less a skill and more of an attitude that needs to be adopted.
Interested - listen carefully when others speak, ask more questions to find out details and avoid a problem-solving mentality when talking to others. Be aware of your nonverbal communication by maintaining good eye contact, not using a mobile device, and keeping your posture open and relaxed.
Validate - acknowledging how others feel, think, believe, or experience is important in demonstrating a non-judgmental attitude. Doing so does not require you to necessarily agree or accept what they are sharing as it is okay to hold differing views or opinions.
Easy manner - being unaggressive, non- judgmental, and open-minded around others creates a sense of comfort, allowing for them to feel safer in our presence. Doing so allows for relationships to develop more easily.
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