The Dialectical Behavior Therapy Skills Workbook

As the title of this post might imply, I am now in possession of a workbook.  I subscribe to Psychology Today, and September’s issue did a spread on Borderline Personality Disorder called “The Kings and Queens of Chaos”.  The article on BPD was okay.  It’s hard to go beyond the surface of any personality disorder because even within the disorder there is a spectrum of functionality.  For instance, there isn’t just one type of narcissist.  On the narcissistic personality spectrum, one might find the Phallic Narcissist who does behave differently than the classic narcissist who behaves differently than the narcissist with borderline tendencies or the narcissist with sadistic tendencies.  The same applies to those diagnosed with BPD.  The high-functioning BPD can be a highly successful person in their job but experience great difficulty in interpersonal relationships.  This is where the article in PT misrepresents the disorder.  Most BPDs I’ve known have been very driven women with narcissistic tendencies.  They have a certain set of skills, find a niche, and experience success in their chosen career.  They can be volatile at work often described as perfectionistic, the Office Bitch, or scary, but they get the job done.  Why? Because their identity is tied to their ability to do well in the one place where they can and do feel successful–the workplace.  PT implied that BPs have a hard time holding down jobs because of their lability, and I was actually irked.  It’s an entire misrepresentation of a diagnosis.  This misinformation will also give people a sense of false security like one guy I know.

He is successful in his job.  He has numerous degrees one of which is a PhD in psychology although he is not a practicing clinical psychologist.  He used to email me about his wife, and if she didn’t fit the bill for for having BPD, then Joan Crawford wasn’t Mommy Dearest.  Some of her behavior was off the charts, and I was astounded that he wasn’t putting the pieces together.  He told me that he discussed his wife with a friend, who was a practicing clinical psychologist.  He indicated that his wife did indeed sound like a borderline.  My friend’s response? But, she’s so good at her job! Marsha Linehan, the creator of Dialectical Behavior Therapy and pioneer in the field of treatment for BPD, was herself diagnosed with BPD.  Clearly, one can be successful in their career, make contributions to society, and get better with such a diagnosis.  This isn’t really why I wanted to write this post.

Within PT’s article on BPD was another article on the most successful form of treatment for it–Dialectical Behavior Therapy commonly known as DBT.  While DBT is commonly known to some, it seems to be a bit rarer in the field at large.  I haven’t come across that many practitioners.  I am hopeful that this is going to change because, as the article stated, DBT just might be what everyone needs.  DBT is not talk therapy.  DBT is a kind a therapeutic approach that equips people for life because, let’s face it, pathologies are on the rise.  People are more depressed and anxious now than they ever have been.  Affairs are on the rise, narcissism and loneliness are increasing as are addictions.  The human body is simply not fit for the 21st century.  Post-modernity is taking a toll, and most of us are overdrawn.  This is where DBT steps in.

So, what is it exactly? Basically, DBT teaches four skills:

  1. Distress tolerance
  2. Mindfulness
  3. Emotional regulation
  4. Interpersonal effectiveness

Who doesn’t need this? There isn’t one person I know who doesn’t need help with distress tolerance.  What does that mean exactly? Put very simply, you feel distressed, how will you handle it? Our culture today is saturated with escapism.  If i’m upset by something in my circumstances, there are exits everywhere.  I do not have to stick around and work on my own resiliency.  I can get a dopamine hit through any number of venues both virtual and real.  What’s more, it’s encouraged! “You need a break!” We are told this over and over again.  Distress tolerance, therefore, teaches resiliency which is exactly what is needed.  On the flip side, if you come from an abusive background, your distress tolerance is often distorted.  You might not know what not to tolerate because you were forced to tolerate too much.  If you watched your drunk father beat up your mother every Saturday night for years, then you might not know that an emotionally abusive spouse is not to be tolerated.

Mindfulness is something that I love while at the same time something that challenges me.  I am the Queen of Perseveration.  “Hello, my name is MJ.  I perseverate.”  I don’t do this all the time, but when I get going I won’t stop until I’ve Thelma and Louised myself over a mental cliff.  It usually starts with a feeling.  A bad one.  That bad feeling will bring forth a memory from times past when I felt the same way.  An entire gestalt memory recall event will occur, and my mind will bring forth every single time I ever felt this way.  A memory train will form, the events forming cars, the cars linking together, the emotional pain becoming the steam locomotive, my perseveration tying me to the tracks, and the whistle blows! Full steam ahead! I am run over again and again by every painful memory until I’m weeping and shrouded in negativity.  There are train tracks in my mind from these events ready and waiting for the next time the Memory Train pulls into town.  Mindfulness training, however, dismantles that train.  It teaches us not to focus on past events or look anxiously to the future.  It teaches you to let go of negative thinking and judgments as well.

Emotional regulation is a vastly important skill, and emotional regulation is something everyone struggles with at one time or another.  It’s really about becoming aware of what you are feeling, observing your emotions while not becoming overwhelmed by them.  It’s also about not reacting in destructive ways due to a lack of emotional modulation.

Lastly, interpersonal effectiveness “gives you new tools to express your beliefs and needs, set limits, and negotiate solutions to problems–all while protecting your relationships and treating others with respect.” (p 2)  How’s that for a goal? Who doesn’t need that skill?

On some level, I feel like I have these skills, but I see that I could grow immensely in all of them.  This is why I bought the workbook.  It costs $15.  You can do it alone.  You could do it with a friend.  You could do it with a therapist.  But, I think the point is that it’s worth doing even if your only goal is to become a better person.  By the way, there’s one for anxiety, too! Just thought I’d tease you a bit.

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Resources:

Dialectical Behavior Therapy Skills Workbook for Anxiety: Breaking Free from Worry, Panic, PTSD and Other Anxiety Symptoms

Dialectical Behavior Therapy Skills Workbook for Bulimia: Using DBT to Regain Control and Break Control Over Your Life

Dialectical Behavior Therapy Skills Workbook for Bipolar Disorder: Using DBT to Regain Control of Your Emotions and Your Life

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15 thoughts on “The Dialectical Behavior Therapy Skills Workbook

  1. I am getting this book and we are so going through it together. Um…well…if that’s okay with you.

    I read that same article in PT and then hid the issue from my husband so he couldn’t read the article and say, “You’re wrong, my mom doesn’t do this, she doesn’t have BPD.” Why? Because the article didn’t talk about the waif and the hermit and their issues and these are the traits most prominent in my mother in law.

    I agree with you that everyone coudl benefit from DBT. Everyone. I can see where it would be beneficial for me, for my husband, for co-workers, family members, people I meet on the street. Who wouldn’t benefit from distress tolerance, mindfulness, emotional regulation, and interpersonal effectiveness?

  2. Pingback: Practicing The Skills | Out of the Mire

  3. Pingback: Distress Tolerance and Radical Acceptance | Out of the Mire

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