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This site is not doing the detail on these, though it is tying together much of the content (which is in common with other therapies) throughout the site. A key point is to not use this as self-help but to use profesional guidance and supervision.
DBT combines standard cognitive-behavioral techniques for emotion regulation and reality-testing with concepts of distress tolerance, acceptance, and mindful awareness largely derived from Buddhist meditative practice.
TWO COMPONENTS
It has two components:
Individual - The therapist and patient discuss issues that come up during the week (recorded on diary cards) and follow a treatment target hierarchy (prioritized and interrelated).
Self-injurious and suicidal behaviors take first priority.
Second in priority are behaviors which, while not directly harmful to self or others, interfere with the
course of treatment. These behaviors are known as therapy-interfering behaviors.
Third in priority are quality of life issues and working towards improving one's life generally.
During the individual therapy, the therapist and patient work towards improving skill use. Often, a "skills group" is discussed and obstacles to acting skillfully are addressed.
Group - A group ordinarily meets once weekly for two to two-and-a-half hours and learns to use specific skills that are broken down into four skill modules: core mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance.
DBT does lots of mnemonics for the steps in each type of action (behavior) required.
"WHAT" AND "HOW" SKILLS
These include, as in all mindfulness exercises that involve paying attention but describing:
Observing objectively, without judgment
Staying "one-minded", where one focuses on one thing without getting distracted into emotion.
With an emphasis on effectiveness (i.e. "what works" rather than a "good/bad" orientation)
The training and practice of doing this is good for setting up a good mind routine, but it is more effective to do this in writing if one wants to carry a particular situation/problem through to solution.
DISTRESS/FRUSTRATION TOLERANCE
In a bit of an "accepting reality" (as in Buddhism and in all paths to happiness) approach, one learns to accept distress as an occurrence in life that must be accepted and tolerated rather than immediately escaped from. DBT emphasizes staying with the distress for a time and learning to bear pain skillfully. One allows the distress without judging it or oneself, not approving of it or disapproving of it. In that objectiveness, one can make good decisions about what the impact is and what strategy to use to get the desired result instead.
This kicks one out of "destruction emotional reactivity" and adding fuel to the fire with additional distressing statements (self evaluations and/or exaggerating threats).
The "accepting" is the opposite of what the Buddha says that we human beings normally do, as explained in Suffering And Struggle.
TACTICS TO DISTRACT
Rather than continue on a negative upon negative hyping of the distress conversation they use this process to distract:
A mnemonic ACCEPTS, with the steps.
SELF-SOOTHE
Also, besides distracting, as with all therapies and the recommendations on this site, they encourage the learning of and the practice of self-soothing - which is behaving in a way that is comforting, nurturing, kind and gentle with oneself. See Self-Nurturing, Self-Soothing.
BREAK, BRAKE
Universally in the disciplines, we are taught to take a break from the intensity and from feeding the negative emotion monster. It is called by various names, but all include
1. Stopping
2. Breathing deeply, focussing on breathing
LEARNING EMOTION REGULATION
This is addressed because they consider their "borderline personality disorder" patients to be too emotionally intense and sensitive (they work themselves upward into a frenzy) so they, as probably all of us, need to learn to regulat their emotions, their urges, and behaviors that are reflexive rather than chosen in equanimity.
EMPHASIS ON REGULATING EVERYTHING AROUND EMOTION
As in the idea of keeping the body and mind in the highest functioning mode (in homeostasis, which is a key emphasis on this site) so recommendations are made for physical health, eating, sleep, exercising, breaking away from using mood-altering substances.
'EFFECTIVENESS"
There is an emphasis toward doing what is effective, no matter how you feel - and not letting emotions (mere body chemicals) run oneself into fruitless thinking and behavior. there is an emphasis on practical problem solving, rather than just cycling in emotional spirals.
They have helpful mnenomics for interpersonal activity of DEARMAN and GIVE.
These cards list the skills for reference and have a format for tracking what is needed to see your behaviors, emotions, etc. Impressive monitoring and feedback technique.
CHAIN ANALYSIS
Chain analysis is a form of functional analysis of behavior but with increased focus on sequential events that form the behavior chain. It has strong roots in behavioral psychology in particular applied behavior analysis concept of chaining. On this site, we emphasize knowing what the causal chain is so that you can intervene at the most effective spot if possible. People tend to have "magical" thinking or to believe there is a mysterious force that all of a sudden causes them to leap forward or to be pounced upon, but once one is aware that there is a full sequence that leads to each and every thing they begin to learn to intervene more effectively.
AS WITH ALL THERAPIES AND GOING TO CARNEGIE HALL
One must practice, practice, practice. But since one will react inappropriately in the moment, all are encouraged to go back through and review what occurred and then to visualize and "practice", after the fact, what would best have been done/thought to get the new desired result. Sufficient practice, using methods that may take 5-7 minutes, will enable one to have more automatic and appropriate responses to situations - and ones that will happen within a small instant of time, a few seconds at most, where the practiced response rules - and life becomes much, much better.
USEFUL SYSTEMS
FlashCards - Mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness
USE THIS SITE, AT LEAST
The throroughness and referenceablity of this site is outstanding: DBT Self-Help.
AND YOU SHOULD HAVE READ THESE
The Miracle of Mindfulness by Thich Nhat Hahn
Skills Training Manual for Treating Borderline Personality Disorder by Marsha M. Linehan
Cognitive Behavioral Treatment of Borderline Personality Disorder by Marsha M. Linehan, 1993
And, for more understanding,
Also recommended with The Miracle Of Mindfulness:
Wherever You Go, There You Are: Mindfulness Meditation In Everyday Life, Jon Kabat-Zinn (Video)
The Joy Of Living: Unlocking the Secret and Science of Happiness, Yongey Mingyur Rinpoche (one of my favorite books)
Additional videos:
