Intro to DBT mindfulness

DBT (Dialectical Behavior Therapy) is a therapy designed to improve emotion regulation and distress tolerance through mindfulness, skill building, and acceptance. Marsha Linehan introduced the therapy early on, and it grew as a sort of cousin to cognitive behavior therapy and bridged the waves of psychology theory from strict behavior change to incorporating mindfulness and acceptance. It is a powerful modality with a lot to offer. The foundation of DBT is in the core mindfulness skills, which I’ll discuss here. These are a set of skills I teach almost all clients, pretty early on in treatment. If you would like to learn more about DBT, I recommend checking out www.dbtskillscoaching.com. Dr. Hall offers training courses as well as a robust list of podcast episodes to complement this brief overview of DBT-specific mindfulness.

It begins with three What Skills. This refers to “what” you want to do, in order to increase your mindfulness. The first what skill is observe. This means to notice what is going on inside and around you. Body sensations, thoughts, environmental factors. Pay attention to all the things happening. Next is describe. This means to put words on the observations you have made. What specific body sensations are you experiencing? What do see and hear and feel in and around you? Attune to your five senses. Last, participate. Engage in what is going on in your current moment. Do not wish for things to be different, or deny what is actually happening. Participate fully in the moment.

The second set of mindfulness skills are called the How Skills. These are the three skills used while applying the what skills. When you observe, describe, or participate, you want to do it one-mindfully, non-judgmentally, and effectively. One-mindfully refers to eliminating distractions. Be fully in the moment, doing one thing at a time. Focus on what is happening just in that moment. Do all of this without judgment. This might be the hardest of all, as we are so primed for judgment all the time. We want things to be different than how they are. We deem emotions and events as right or wrong, good or bad. Of course, there are ways to make distinctions that are useful, but we struggle more when we get judgy about things. It is more skillful to describe as painful or comfortable, difficult or easy, rather than good or bad. The third and last how skills is effectively. In DBT, this means doing precisely what works. No more or less, but exactly what the situation calls for. Go to work when you’re scheduled, ask for help when you need it. Do what works, in spite of urges to the contrary.

These fundamental skills are applied throughout DBT to help individuals detach from intense emotions and continue to make decisions in ways that are helpful rather than damaging to their lives and relationships. People are encouraged to apply the How skills one at a time: first observe, then describe, then participate. As each of these is enacted, all the What skills are applied concurrently. As you observe, do it one-mindfully, non-judgmentally, and effectively. Same goes for describe and participate. As you apply these skills, you will feel more mastery over your emotional landscape, and more contentment in your life.