Hey! Here, every week for the first 16 weeks of the blog, we'll add some tips from Marsha Linehan's wonderful invention, Dialectical Behavior Therapy (adapted for adolescents by Alec Miller) If you're in or a graduate of DBT and don't see a skill here that you like (from the module I'm posting about) eMail it to us at selfinjuryanonymus@aol.com, and you just might see it here! Enjoy!
TARGET BEHAVIOR: A QUICK NOTE
There are three "Targets" in DBT. The term "target" is used to refer to things that interefere with your return to a more "normal" life (whatever that is)
Target 1 (T1)
This is the behavior that brought you to DBT in the first place. It may be drug/alcohol use, self-harm, eating disorders, whatever. We don't say exactly what it is for a few reasons: to make it easier to apply DBT to all issues that are DBT worthy, and to not call attention to the behavior, trigger someone else, and for privacy.
Target 2 (T2)
Target 2 doesn't really exzist in this setting. In face-to-face therapy, a T2 would be not attending a session, not practicing the skill during the week for homework, not doing your diary card (an emotion log, basically). T2 is anything that interferes with treatment but does not really cause physical harm to anyone.
Target 3 (T3)
This is anything that interferes with your quality of life. For example, I was originally placed in DBT for self-injury. I then developed Eating Disorder NOS, which would be a T3 because it was not what brought me to DBT. If someone who is in DBT for Anorexia and then starts using pot, the drug would be a T3. T3s can become T1 if they significantly harm an individual.
MINDFULNESS
Mindfulness is about taking control of your mind. It is two things: Full Awareness (being aware of how you are feeling at this very moment in time, physically and emotionally) and Attentional Control (staying focused on one thing at a time) there are three states of mind in DBT mindfulness: Emotional Mind, when one acts just based on their emotions, Reasonable Mind, when one acts on facts, and the coveted hybrid of the two, Wise Mind. Wise Mind is when one can act in accordance to their emotions but at the same time use their knowledge of the facts that go along with engaging in a behavior and come to a rational decision for themselves. Note that rational does not always mean what society deems right. How does one acheive Wise Mind??? There are six steps:
- Observe: Just notice the experience in the present moment. Don't push away or judge your emotions, experience them.
- Describe: Label what you observed in the step above with words. ex: "I feel sad." or "This orange is moldy". Remember to only describe. DON'T JUDGE! This is key.
- Participate: Lose yourself in the experience. Don't be self-conscience or dwell on yesterday or worry about the future. The present is a gift so enjoy it.
- Don't Judge: As we said before, this is key. Don't evaluate things as good or bad. they simply are. Replace statements like "You're an asshole" with an "I Feel" statement, like "I feel pissed off when you do that."The person may indeed be an asshole, but calling that to their attention won't help the situation. Most importantly, don't judge your judging!
- Stay Focused: Do one thing at a time. Leave the distractions elsewhere. Concentrate your mind and live in the moment.
- Do What Works: Don't let the emotions control your behavior. Play by the rules and act as skillfully as you can! Do what you need to acheive your goals. Remember to let go of the negative feelings that just make things worse.
So, to practice using these skills, lie down or sit in a comfortable position. Choose one thought to observe, like your breath or the cute kid who sits next to you in math. Keep it a positive thing. Close your eyes and think about your thing. When your thoughts stray, realize this and redirect your energy to your object. Do this for at least thirty seconds, or more if you like.
DISTRESS TOLLERANCE
Here are the band-aid skills of DBT. These are the ones that help you white-knucle through the pain you're in at the moment. Why should you try to get through it? Well, pain is a part of life and it cannot be avoided, if you don't deal with the pain you may act impulisvely, and most importantly, when you act impulsively you coan end up hurting yourself and loved ones.
So here's your basic survival skills:
Distract with "Wise Mind Accepts"
Aectivitis
- Distract yourself! Talk to someone, entertain yourself with media or engage in hobbys. Try writing in a journal. This blog is my Activity to avoid my T1s
Contributuing
- Help others with the Activities you do (like we try to here). Have a free hugs day. Send some snail mail. Make the world a better place to be!
Comparisions
- Look at those less fourtunate! There's always someone (unfourtunatly) who has it worse. Or, if that makes you feel guilty about feeling upset in the first place, immagine or remember a time when things didn't suck ass as much as they do now.
Emotions
- Change how you feel! Insetad of ruminating on things, do something that will evoke the oposite emotion of the one you're feeling now.
Pushing Away
- If something's triggering you, leave the situation. Note that sometimes these are things that need to get done (like homework) and that you'll return to it after a set period of time, or when you're less vulnerable to the trigger. But don't put off things you need to do. It'll only make itself worse. Put the pain in a fire and burn it, just don't let the smoke get in your eyes.
Thoughts
- Change the way you're thinking. Count as high as you can in as many different languages as you can. It's okay if all you remember is "ich, ni, san". Do some math (as crazy as that seems) In short, do something that doesn't take emotion to do. Take a vacation to Reasonable Mind, and throw your towel on the sand to soak up the sun.
Sensations
- Make yourself feel. Maybe snap a rubberband, wash your hands in very hot or firgid water, attack a stressball, or even touch yourself (yes, that is exactly what I mean...have fun) Be careful not to over do it lest you end up with another T1
Self-Soothe
Vision
- Look at something that makes you happy like pictures of baby pandas. Be a stalker and people watch random people do stupid shit.
Hearing
- Crank up the tuneage! Blast some awesome music, or even play your own if you're a gifted virtuoso (or even if you're not!) Listen to the crickets or birds. Download an app or go to a site that plays ambient noise.
Smell
- Go smell the roses! Find your favorite smell and immerse yourself in it.
Taste
- OMNOMNOM! Much on something tasty. Don't over do it! (Not recomended for those with eating disorders!)
Touch
- Yes, we're back at touch. You know what that means. For a more PG version, put on some comfy clothes or wrap yourself in a blanket. Personally, I like the feel of satin.
Movement
- Stretch yourself out! Dance to what you're feeling inside. It doesn't have to look good. I'm not the slightest bit graceful, yet I love to move my body with emotions.
All of these have their downsides-you have to do them the right way. For example, if you want to distract yourself from T1 by watching a movie, Black Swan probably isn't the best choice, or if you're writing in a journal, don't just get yourself more worked up about the things that are bothering you.
FINDING THE MIDDLE PATH
EMOTION REGULATION
INTERPERSONAL EFFECTIVENESS