18Apr

How to Stay in Control in the Face of Uncertainty—DBT Skills for Daily Life

In the wake of an international crisis, the Coronavirus pandemic has seemingly changed the world as we know it—overnight. Furthermore, the current social and political climate surrounding this crisis has caused many of us to experience feelings of unease, uncertainty, and a full range of emotions that we can’t make sense of. In the face of challenges such as this, it can be easy to feel that we are no longer in the driver seat in life, unable to regain power over our emotions and no means of coping with circumstances beyond our control.

However, fortunately, there are interventions available to help those of us who need strategies for managing our emotions and finding healthy ways to stay connected with our supports. Dialectical Behavioral Therapy, or DBT, is a therapeutic approach aimed at providing strategies for handling difficult emotions. DBT has traditionally been a go-to treatment approach for individuals with borderline personality disorder, depression, substance abuse, and eating disorders. However, I personally regard the skills emphasized in DBT interventions as useful to the general public as a whole. After all, who among us has not been faced with life challenges that cause us to experience intense or otherwise overwhelming emotions? I have assisted a wide range of clients with learning to develop and implement DBT skills in their daily life, both adults and children alike, with much improvement.

DBT principles are typically divided into four main skills areas, including: Mindfulness, Distress Tolerance, Interpersonal Effectiveness, and Emotional Regulation. Each skills area is designed to provide a variety of unique tools to add to one’s toolbox, accessible during times of difficulty, which allow for positive and productive coping. These four skills areas aim to allow one to strategize ways to challenge overwhelming or irrational thoughts and emotions, while also providing space for acceptance of thoughts and behaviors in situations where change is particularly difficult. Let’s take a look at each skills area and explore some potential strategies for putting these skills into practice.

Mindfulness

Mindfulness emphasizes aware of and acceptance of whatever is happening in the present moment, by challenging ourselves to not wander into the past or future. Being mindful pushes us to immerse ourselves in the present moment, simply noticing what responses come up for us and learning to sit with our thoughts and feelings. Remaining mindful in challenging times can help you learn to notice and accept your thoughts and feelings without judgement—such as labeling something as good, bad, etc.

In the context of DBT strategies, mindfulness is divided between what we specifically draw our attention to in the moment, and the specific skills we utilize in order to remain mindful.

Where to focus our attention:
• the present
• your emotions, thoughts, and bodily sensations
• working to divide our thoughts from emotions and/or bodily sensations

What we DO to be mindful:
• balancing rational thoughts with emotions
• utilizing radical acceptance to learn to tolerate aspects of yourself, and accept these as challenges
• taking effective action based upon rational thought and present awareness
• using mindfulness skills regularly and consistently

Some examples of DBT mindfulness strategies include:

*Mindful eating
*Guided meditation
*Body scan exercises

Distress tolerance

While mindfulness can go a long way, it isn’t always easy to use in moments of significant distress. In these times, we rely on skills aimed at allowing us to handle especially challenging moments. Relying on distress tolerance skills can help us to push through really tough times without resorting to self-destructive or otherwise harmful coping strategies. In times of crisis, you might use some of your own, “go-to” coping strategies to help you deal with your emotions. However, for many of us some of these strategies, such as social withdrawal or avoidance, don’t offer much help. While it may allow us to stay afloat for the moment, these types of coping strategies often pull us deeper into despair. For some people, falling deeper into overwhelming feelings can bring on self-destructive or otherwise harmful coping strategies, such as self-harm, alcohol or drug use, or disordered eating behaviors.

Distress tolerance skills can help you:
• find helpful distractions that allow you to become calm enough to deal with the situation or emotion
• self-soothe by relaxing and engaging the senses to find relief
• find ways to improve the moment despite pain or difficulty
• compare coping strategies by weighing options

Some examples of distress tolerance skills include:

*Creating art
*Gratitude journaling
*Engage the senses by holding a melting ice cube in your hand, or submerge or splash your face with cold water
*Read a book
*Write
*Play an instrument

Interpersonal effectiveness

In times of stress, we can experience Intense emotions and rapid mood changes that are influenced by things that are out of our control. Being able to identify how you feel and gaining awareness of what you want is an important part of fostering fulfilling relationships. Interpersonal effectiveness skills can help you to find clarity in these areas. Interpersonal effectiveness skills entail: listening skills, social skills, and assertiveness training.

These skills include:
• learning strategies for effectively asking for what you want and take steps to get it
• developing strategies for working through conflict and challenges in relationships
• developing a deeper sense of self-respect and acceptance

Some examples of interpersonal effectiveness skills include:

*Active listening
*Responsibility
*Dependability
*Leadership skills
*Flexibility

Emotion regulation

The final skills area refers to emotional regulation, or our ability to manage our emotions in an effective manner. When life brings on challenges, sometimes you may feel like there’s no way to get in control of your emotions. However, there are effective strategies that can offer help when feeling overcome by our feelings. Emotion regulation skills help you learn to deal with our immediate emotional reactions, before they erupt into a series of additional building emotional reactions. For example, a primary emotion of anger or sadness might build and develop into feelings of guilt, worthlessness, anxiety, and depression.

Emotion regulation skills teach you to:
• recognize emotions in the moment
• move beyond barriers to emotions that have positive effects
• be more mindful of emotions without judging them
• avoid giving into emotional urges and losing control
• solve problems in helpful, healthy ways

Some examples of emotion regulation skills include:

*Taking care of your mind, body, and spirit
*Allow time for fun and relaxation
*Foster healthy relationships
*Find ways to accept or embrace vulnerability

These four DBT skills areas are implemented in a variety of therapeutic ways, including: individual therapy, group therapy, skills training, and coaching. If you find yourself struggling to manage your thoughts and feelings in the wake of the current pandemic or are beginning to feel unable to cope with life stressors or events that cause you to feel overwhelmed help is available. Please contact Life Enhancement Counseling Services today at 407-443-8862 to schedule an appointment with one of our experienced Orlando mental health counselors.

Sources:

Healthline (2019.) Dialectical behavioral therapy (DBT). Retrieved from https://www.healthline.com/health/dbt

Positive Psychology (2019). 22 mindfulness exercises, techniques, and activities for adults. Retrieved from https://positivepsychology.com/mindfulness-exercises-techniques-activities/

ABOUT THE AUTHOR

Clare Bohm