DBT Intro: Dialects, States of Mind
Over the next several weeks I will be covering a series of concepts and skills on this blog used in Dialectical Behavioral Therapy (DBT). My hope is that they will be especially helpful right now as we are all trying to navigate our pandemically altered lives. Whether you are struggling with the anxiety of so much uncertainty, the stress of being a working parent with kids now at home 24/7, or the loneliness of social distancing, DBT offers simple and practical tools to help us respond intentionally versus reactively our difficult internal and external experiences.
DBT skills are divided into the following 4 modules, each with differing, but overlapping goals:
Mindfulness🡪 skills aimed at increasing our awareness of our internal and external present moment experience and relating to it in an accepting and nonjudgmental way
Emotion Regulation🡪 skills aimed at reducing negative emotions and increasing positive emotions
Distress Tolerance🡪 skills aimed at tolerating crises and intense painful emotions as to not act in a way that makes the situation worse
Interpersonal Effectiveness🡪 skills aimed at interacting in ways that are more likely to get our needs met within relationships.
Thus, if you are (like me) interested in engaging with your life with more presence and acceptance, learning how to respond to your emotional experiences in healthy ways, and/or interacting more effectively within your relationships, I am hopeful that learning and practicing these skills will help you create some positive changes.
We will begin with the Mindfulness module next as it sets the foundation for all DBT skills. This is because if we are unaware of what is going on for us, we will not know how to respond in the most effective way (or choose the most effective skill). But before getting into mindfulness, I think it is useful to first cover some fundamental concepts that underly DBT and the purpose of the skills.
In both my personal life and my work as a therapist, one of the most influential concepts in DBT has been that of “dialects.” The term dialect refers to two seemingly contradictory or opposing ideas, thoughts, emotions, urges, etc. Our minds can very easily fall into dichotomous or black and white thinking, which can end up creating a fertile ground for conflict (either internally or within our relationships) if we are needing to find the “right” way to think or feel. Instead, DBT encourages us to focus on and embrace what is valid about both sides of any dialect. For example, maybe you are a working parent right now and are struggling with something along the lines of “I wish my kids were going back to school in the fall, but I should be appreciating the extra time with them.” Instead of trying to figure out if you should be feeling stressed or grateful, DBT asks us to hold space for both emotions to be valid.
The DBT skills are aimed at balancing the underlying dialect of acceptance and change in therapy and in life. The importance of this balance is evident if we look at how focusing on only one side of the dialect creates problems. For example, if acceptance is the only right answer, then there is no work towards improvement or growth, and we can end up feeling stagnant and stuck. On the other hand, if change is the only right answer, then how do we respond to the parts of our lives that are not within our control to change? Or if we only see the value in changing/improving ourselves, then we can end up judging or shaming ourselves for being where and who we are right now.
Thus, the need for acceptance and change are both true, and the DBT skills offer strategies oriented towards both. While the skills are focused on change and acceptance, this is just one example of countless dialects operating in our lives. Learning to see the value of both sides of any contradictory opinion, feeling, thought, etc. can be applied and help with so many of our other internal and relational struggles.
An easy and concrete first step to try to apply this to your life and increase your capacity for dialectical thinking is to notice any time you are using the word “but” and substitute it with “and.” Here are some examples of (big and small) ways in which I am doing this in my life:
I feel excited and nervous about applying for my pre-doctoral internship this fall
I am grateful for the opportunities that living in Seattle provides and I miss my Montana home
My partner needs space to zone-out with a tv show when stressed and that is hard when I am wanting to connect
I want it to be summer forever and I am looking forward to the nights being colder to sleep
I am doing the best that I can to create structure to my days and I can do better to be more consistent
In learning and practicing the skills over the next several weeks, I encourage you to embrace the seemingly contradictory attitude of “I am doing the best that I can andI can do better.” This is especially important right now amidst the variety of ways the pandemic may be impacting your life (e.g. feeling isolated/lonely, increased parenting demands, anxiety around all of the uncertainty and unknowns about the future, etc.). We are all doing the best that we can to navigate our newly pandemic world, and we can all make changes to navigate it better.
States of Mind
The last thing I will cover this week is another important dialectical concept in DBT, the seemingly contradictory “rational” and “emotional” states of mind that are both inherently part of being human. Our rational mind thinks and makes choices based on logic and facts while our emotional mind operates based on how we “feel” in the moment. When we are hijacked by our emotion mind, we may find ourselves engaging in behaviors that are reactive (e.g. yelling at your kids or partner, avoiding something that makes you anxious, staying in bed all day if feeling depressed, etc.). The goal of the DBT skills is to find balance and integration of both our rational and emotional mind so that we can make intentional (vs. reactive) choices from “wise” mind.
Wise mind helps us to access the value in both reason and emotion, thereby allowing for optimal decisions. For example, say it’s been raining for the last week and the sun is finally out. Your friends invite you down to the beach for a large BBQ party. Emotion mind may be thinking “I’ve been so lonely and cooped up this last week, I’m going to go.” Reason mind may be thinking “given the current state of COVID-19, going to the gathering increases risk of exposure to myself and other people…..I shouldn’t go.” Wise mind has the capacity to integrate the facts (necessity of social distancing) with the emotions (loneliness/need for connection and fresh air) of the situation and make a choice that honors both (e.g. wearing masks and going for a walk with a friend or two).
An important first step to increasing our capacity to respond to life from wise mind involves practicing and cultivating the skill of mindfulness. Next week we will begin the Mindfulness module, but until then I encourage you to start to notice when and how emotion mind and rational mind are driving your behaviors in either helpful or unhelpful ways.