About DBT Continued

March 26th, 2024
therapist talking to patient
Thank you all for getting into the DBT skills with me. Another excellent way is to join one of our therapists in a DBT skills group where she will educate a group of adults in learning these very things I’m sharing with you here. Sometimes the in person education is much more helpful; reach out to our office to join that group.

Let’s continue by referencing the website where I was able to get a lot of this information; other than being trained in DBT the DBT Mega Bundle from https://shineandthrivetherapy.com/products/dbt-mega-bundle has been a huge resource in helping get this information to you all. They have an excellent workbook and flashcards that help make the information more accessible. 

I missed one of the important components of DBT having skipped over what it means to think dialectically. In essence it is the ability to consider all sides of something and remembering that opposites can be true at the same time. In dialectical thinking we are moving from either or mentality like I am not doing my best because I still can be better. 
Example: I am angry AND I can be respectful. 
I hate what they did AND I still love them. 
I want to change AND I’m afraid of change. 
I am capable AND I need support.
This way of thinking has the ability to bring the mind more peace as two opposing thoughts can both be true. We can both need help AND want to work on our own without having to choose either or. 
Here is a brief YouTube video explanation of dialectical thinking: https://www.youtube.com/watch?v=XFRMHBwHmTk
Distress Tolerance is the next group of knowledge for today. We may only get to begin it and more to come next time. It is learning to tolerate the emotional pain and distress we experience through using coping skills that will work. Distress Tolerance also is working on accepting reality as it is so pain does not turn to suffering. 
When considering distress it’s important to be aware of your specific stress symptoms. Stress symptoms can be broken down into physical; emotional/cognitive; and behavioral categories. Physical symptoms can include: headaches, back pain, nausea, sweating, stomach pain. Emotional/cognitive can include: worry, difficulty concentrating, anger, memory problems, brain fog. Behavioral symptoms can include: constant racing thoughts, teeth grinding, substance use, procrastination, relationship issues, picking at nails and skin. There can be many other symptoms. This list is only to give you an idea of how in the moment before and during a stressful situation your mind and body can respond to stress. Some long-term consequences of stress are: anxiety disorders, depression, sleep disorders, and a weakened immune system among many others. 
Coping behaviors we may fall to in regards to trying to cope with the stress are: negative self-talk, picking and biting at skin or nails, smoking, yelling at family and friends, emotional eating, avoiding social situations family and friends. Again there are more, this is an idea to gauge if you have turned to coping in ways that would not be most effective over time. 
Before moving on to one great distress tolerance skill I’d like to share my personal opinion that because your coping has not been the most effective or healthy it does not mean you have failed. In high stress times or chronic almost unending stress you have found ways to survive and keep going. That is amazing. These skills are only to help you find more long term effective ways of supporting yourself or a loved one. 

HALT Skill

Halt before engaging in impulsive, self-destructive, thoughtless behaviors and see if you are: 
HUNGRY – get something nutritious and drink some water.
ANGRY – can impact our ability to stay in Wise Mind and throw us off balance. 
LONELY – reach out to others you care about; have an interaction with someone who brings you joy.
TIRED – sleep is important; crucial to stability in mood and mental health. 
Here is a brief video that gives more instruction on HALT: 
Come back next time and we will be continuing distress tolerance. Thanks!
Written by Katie Walter