DBT Peer Connections

Building Hope, Community and Skillful Means


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Respecting Emotion & Regulating Emotion: An Introduction to Checking the Facts

Emotions are like a sixth sense because like sight, sound, taste, touch, and smell, they give us important information about our environment that we need to survive. What makes emotions so special is that they help us to act quickly when logical thought is too slow for us to engage in problem-solving. (See Situations below.) However, for people who may be unusually emotionally reactive, sensitive, or have learned to judge or invalidate their emotional sixth sense from culture, values, gender roles, parents, family, loved ones, etc., emotions may not always cause the expected effective response. Therefore, dialectical behavior therapy came up with the skill checking the facts to help us figure out if our emotional responses fit the facts and intensity of a situation and whether an unwanted or distressing emotion needs skills toward accepting and changing or skills toward accepting and tolerating.

Situations When Emotions May Be More Effective Than Problem Solving

  • A person walks in front of your car; fear of hurting someone else or yourself causes you to slam on the breaks and veer away from the person without thinking about it. The result is fear saved your life and the life of the person who walked in front of your car.
  • The garbage in your kitchen is piling up; the rotting food and stench is so disgusting you so much you immediately take it out to the dumpster instead of thinking about whether or not you should go on strike and stop taking out the garbage altogether to get your roommates to do their part. Disgust makes sure you do not unnecessarily expose yourself to dangerous bacteria, viruses, parasites, and other disease-causing things that exist in garbage.
  • In a department store, a man twice your size, with huge muscles, and a survival knife strapped to his waist threatens to spank your crying child who just said “F-you!” when you told her she could not have the toy she wanted. You get angry and step between your child and the person, and warn him that if he touches your child, he will be sorry. Anger causes you to protect your child when thinking about it might prevent you from taking on someone who could easily clobber you.

Emotions That Are More Intense Are More Convincing

Although emotions give us valuable information we need to thrive and survive, if we are not mindful of the facts that cause them, we may mistakenly believe that they are always telling us the truth. However, when we check the facts of emotional responses, we can dialectically challenge their intensity through a clear behavioral practice that helps offset dilemmas emotionally intense people often face.

For example, Joe may be emotionally sensitive based on his biology, which causes him to be more reactive and experience emotions more intensely and for a longer duration than most people. Therefore, when prompted by an emotion, it may overwhelm his logical mind so that he automatically believes his emotions are telling him the truth. Every one of us has probably in our life had an emotion feel so intense, we unquestionably believed it to be true. “I just had this gut feeling, that she was lying to me.” The feeling drives the assumption. Checking the facts tests the assumption’s reliability. In dialectical behavior therapy, we realize that wise mind is neither logical or emotional but a synthesis.

The following is a scenario where emotional intensity that is misleading leads to problem behaviors associated with panic disorder and agoraphobia. Robin had a heart attack 10 years ago while in line at a grocery store. Now every time she goes to the store and has to wait in line, she has a panic attack and leaves before she gets to the register. The fear and anxiety are so intense she believes that staying in line is going to lead to catastrophe. Therefore, she responds to it by running away from the danger. Since she had a heart attack in a store line, her fear makes sense because the fear has a cause. However, the fact that her fear is valid does not necessarily mean that her response to the fear is valid too.

To figure out whether Robin’s response to fear is valid, we need to check the facts surrounding it. With fear, we know it is valid when our life or that of one of we care are about is threatened. (See flow charts below.) So let us check the facts. What causes heart attacks? “Most heart attacks happen when a blood vessel supplying part of the heart becomes blocked. When that part of the heart stops getting enough blood and oxygen, it can be damaged, causing a heart attack. Usually, the blockage is caused by a fatty material (plaque) that builds up on the inside of blood vessels and a blood clot.” (Craig, 2011) So now that we know the facts about what causes heart attacks Robin can go about assessing if the cause of heart attacks correlates with her fear of having a heart attack in a store.

In dialectical behavior therapy skills training, there is a very clear process. “Check the facts and analyze clearly whether your feared outcomes are likely. Observe what is really going on, and ask wise mind whether your feared outcomes constitute a true catastrophe. Cope ahead can be useful for getting better at handling situations that you know precipitate judgmentalness in you.” (Linehan, 2015, p. 159) So if Robin wants to apply this to her own situation. Here is a line of questioning she may use to check the facts. Does standing in store lines cause heart attacks? No. If Robin is going to have a heart attack, will leaving the store before she gets to the register prevent it? No. And if Robin is at risk for another heart attack what are the odds that it will happen again right at the moment she is standing in line at a store? Her odds are probably pretty slim. So, the conclusion is that Robin’s fear makes perfect sense given her past experience and her response of running out of the store before she can get to the register is not valid because checking the facts, it becomes clear there is no real danger. From this point, Robin may proceed to constructing whatever cope ahead strategy suits her dialectical behavior skills knowledge and preference so that next time she is in a store line she may try something different instead of running out of the store when fear arises.  The key is that change transpires through acceptance. When we accept that every behavior has a cause and look for the cause instead of giving into urges to judge or blame, change becomes more possible.

Communicating Emotional Pain: Do You Have to See It to Believe It?

All emotions have a cause and therefore contain validity. When we do not validate or acknowledge emotions, they usually increase in intensity, which likewise may lead to problematic behaviors. Yet when a person’s emotional expression escalates, we often respond by judging the person’s emotions and not listening to them. As such the person’s emotions increase because their expression is not being acknowledged or accepted.

To illustrate the function, let us say that instead of communicating emotion, you were at work and a fire started on the floor you were on, while your co-workers, on the floor above you, had no idea. Your goal is to let your co-workers know about the fire so you can effectively respond and evacuate. If your co-workers did not acknowledge that they believed you or took your message seriously, would you shrug your shoulders and go your own way or would you increase your intensity of communication by raising your voice, becoming more animated, intense? Would you question what you knew to be true about the fire because others did not believe you even though you saw the fire with your own eyes, felt the heat on your skin, filled your nostrils with sulphuric burn of it smoke? Would you trust your own senses more than the social order of majority rules?

Most people would not doubt their senses no matter how fervent or many others might object, and, as such, would likewise intensify their assertion regarding the fire, escalating the message until, at last, it was received. This is the same with communicating emotional suffering. When a person says she feels miserable and the confidant responds by saying, “you have nothing to be miserable about,” or “other people have it a lot tougher than you do,” or “you are always so dramatic about everything,” or “you need to learn to appreciate what you have,” or “Chin up. Life is rough,” or “Get over it,” it is saying to the person needing support that she really does not need support because her pain, is in fact, not real. So while the person in misery may be reaching out for support, instead what she gets is an argument, more distress, and the burden of proof that her misery is true. Finally, after she has pleaded, begged, argued, and still meets disbelief and skepticism, she realizes that words are not enough to communicate her emotional pain, so moves to actions.

When we see a wound, we do not doubt that it causes pain, but the cause of painful of emotions is not something we can see like a scratch or a cut because the wound evolves from personal experience, which cannot be conveyed to others through sight. As such, to validate emotional experience is to trust that emotion, by its nature, is not a thing easily employed in deceit and manipulation because it acts faster than intentional behavior. In other words, when a person has an intense, extreme emotional response, it is rarely, if ever inspired bu ulterior motives. Therefore, it is more reasonable to conclude that self-harm and suicidal behavior are not really acts of manipulation, but rather dysfunctional means to communicate suffering to oneself and others. More simply, it is easier to communicate and accept suffering caused by physical injury than it is to communicate and accept suffering caused by emotional pain. Dialectical behavior therapy’s position is that in the case of emotional pain, you do not have to see it to believe it. You only have to be willing to trust that when someone tells you she is suffering; she is telling you the truth.

Suicidal Behavior Is an Attempt to Communicate Not Manipulate

However, learning to hurt oneself is rarely a result of motivated effort. It is not like learning to read which requires conscious focus and determination. Usually, it is an impulsive act that emerges impulsively when all else has failed. The pattern becomes established when, at last, after the person has inflicted physical harm upon herself, she receives the soothing support she wants, needs.

People who are repeatedly suicidal often get accused of being manipulative because threats or actions toward suicide lead loved ones to act in caring, compassionate way. If a person says he feels manipulated by suicidal behavior. Is he not likewise saying, “I did not want to be emotionally supportive, and she made me do it. She manipulated me into being gentle and compassionate when I really wanted to tell her to quit feeling sorry for herself.” It seems to me the problem is not necessarily that the suicidal person is manipulative or that the loved one is callous and insensitive, it is a fundamental issue of supply and demand. The suicidal person demands more emotional support than a loved one may be able or willing to give. It does not mean either person is bad or flawed. It just means there is a need for balance that is not being met, and judging those involved rarely leads to a reasonable, satisfying, or effective solution.

The Sixth Sense: Exploring Emotions & Myths

In American culture, exerting control over emotional expression is highly valued. And when we are unable to keep our emotions from being expressed, we feel we must apologize for it. How many of you have cried in front of others and not apologized for it afterward? One of the skills I am using to overcome emotional self-invalidation is the DBT skill, no apologies. While the behaviors that follow my emotions may, at times, call for an apology. Emotions are not the problem. It is the response to the emotion that is the problem. Emotions are physiological sensations, not intentional actions. So, here we have a real and true sixth sense that has yet to be acknowledged widely as such.

When emotions are unwanted or unusually intense, accepting, respecting, allowing the experience, instead of judging, suppressing, or denying is the key to overcoming distress. In dialectical behavior therapy, emotions receive the same nonjudgmental regard the other five human senses do. In fact, it emphasizes an intentional effort to distinguish a person’s emotional experience from a person’s emotional response to synthesize the dialectical perspective needed to change extreme behaviors. This is where the dialectical behavioral skill check the facts is particularly useful. By building knowledge of how emotions function one-mindfully, nonjudgmentally, effectively, observing each our own emotional experience, we may combine that experience with logic to access our wise mind.

The following flowcharts show how to check the facts of emotions and offer a variety of solutions that show how to synthesize acceptance and change that is the premise of all strategies and skills employed in dialectical behavior therapy.

References

Craig, Karen Jean. (2011). Heart attack.(Patient Education Series)(Disease/Disorder overview). Nursing, 41(12), 54.

Linehan, M. (2015). DBT skills training manual (Second ed.). New York: The Guilford Press, 159.

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DBT Skills: Working with Primary & Secondary Emotions

The easiest way to figure out whether you are experiencing a primary or secondary emotion is to ask whether the emotion and its intensity fit the facts of the situation. If your emotion fits the facts it is usually a primary emotion, if it does not fit the facts it is usually a secondary emotion. Use the following flowchart and subsequent tables to help you figure out what emotion regulation skills to use for primary and secondary emotional responses.

  1. What is the emotion I am experiencing?

  1. Is my emotion a primary (fits facts) or a secondary emotion (does not fit the facts)?
  2. What solution will I use to solve the problem?
  3. Was the solution effective after applying it?
  4. What do I think caused the solution to be effective or not?

Check the Facts

Opposite Action

Fear

Fear fits the facts when:

  • Your life or that of someone you care about is threatened
  • Your health or that of someone you care about is threatened
  • Your well-being or that of someone you care about is threatened
The Opposite Action for Fear is:

  • Do what you are afraid of doing over and over again
  • APPROACH events, places, tasks, activities, people you are afraid of.

Do things to give yourself a sense of CONTROL and MASTERY over your fears.

Anger

Anger fits the facts when:

  • An important goal is blocked
  • You or someone you care about is attacked or hurt
  • You or someone you care about is insulted or threatened
The Opposite Action for Anger is:

  • Gently AVOID person you are angry with (rather than attacking)
  • Take a TIME-OUT and breath in and out deeply and slowly
  • Do something a little bit NICE (rather than mean or insulting

Do the OPPOSITE of other angry action urges

Disgust

Disgust fits the facts when:

  • Something you are in contact with could contaminate you
  • Somebody whom you deeply dislike is touching you or loved one
  • You are around a person or group whose behavior or thinking could seriously damage or harmfully influence you or the group you are part of
The Opposite Action for Disgust is:

  • MOVE CLOSE. Eat, drink, stand near, or embrace what you found disgusting.

Be KIND to those you feel contempt for; step into the other person’s shoes

Envy

Envy fits the facts when:

  • Another person or group gets or has things you don’t have that you want or need
The Opposite Action for Envy is:

  • Inhibit destroying what the other person has
  • Do the OPPOSITE of envious action urges
  • COUNT YOUR BLESSINGS

Make a list of the things you are thankful for

Jealousy

Jealousy fits the facts when:

  • A relationship or thing in your life is very important and desired by you
  • An important relationship or thing in your life is in danger of being damaged or lost
  • Someone is threatening to take a relationship or thing important in your life away from you
The Opposite Action for Jealousy is:

  • LET GO of controlling others’ actions

SHARE what and who you have in your life

Love

Love fits the facts when:

  • Who or what is loved does things or has qualities that you value or admire
  • Loving the person, animal or object enhances the quality of your life or of those you care
  • Loving the person, animal or object increases your chances of attaining your own personal goals
The Opposite Action for Love is:

  • AVOID the person, animal or object you love
  • DISTRACT from thoughts of the person animal or object
  • REMIND yourself of the “cons” of loving

Do the OPPOSITE of other loving action urges

sadness

Sadness fits the facts when:

  • You have lost something or someone irretrievably
  • Things are not the way you wanted or expected and hoped them to be.
The Opposite Action for Sadness is:

  • Get ACTIVE; approach, do not avoid.

Do things that make you FEEL COMPETENT and self-confident. 

Shame

Shame fits the facts when:

  • You will be rejected by a person or group you care about if characteristics of yourself or your behavior are made public
The Opposite Action for Shame is:

when your behavior does not violate your own moral values

  • Make your personal issues PUBLIC with people who won’t reject you
  • Engage in behavior that sets off shame OVER AND OVER in public
  • Do the OPPOSITE of other shame action urges

When your behavior
does
violate your own moral values

  • APOLOGIZE publically
  • REPAIR the transgression
  • MAKE THINGS BETTER; or work to prevent or repair similar harm for others
  • COMMIT to avoiding that mistake in the future

ACCEPT the consequences gracefully

Guilt

Guilt fits the facts when:

  • Your behavior violates your own values or moral code
The Opposite Action for Guilt is:

When you WILL NOT
be
rejected if found out

  • Make your personal characteristics PUBLIC with people who won’t reject you
  • Engage in behavior that sets off gu1lt OVER AND OVER AND OVER in public

When you WILL
be rejected if found out

  • HIDE or USE SKILLFUL MEANS if you want to stay in the group
  • Join a NEW GROUP that fits your values

Do what makes you feel guilty OVER AND OVER with your new group


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Interpersonal Effectiveness: DEAR MAN GIVE FAST Skills At A Glance

DEAR MAN: Using Objective effectiveness

  • Describe the problem factually and without judgment
  • Express your feelings about the problem. Emphasize  “I feel” instead of “You make me feel” statements
  • Assert yourself by stating exactly what it is you want as simply and clearly as possible
  • Reinforce getting what you want by describing why the other person would benefit from helping you
  • Mindful attention to own biases, intense feelings, invalidating others/self & urges to engage in problematic actions.
  • Appear Confident by using eye contact skillfully, paying attention to body language, and tone of voice
  • Negotiate terms by being willing to make a compromise, having a plan B ready to offer as an alternative

GIVE: Using Relationship Effectiveness

  • Gentle manner even if you are angry. Strive to treat people with a degree of respect that reflects kindness
  • Interested  in others points. Pay attention to others ideas and show you are listening by nodding, eye contact, etc.
  • Validate others thoughts/feelings/statement. Reflect back what others say without parroting & check facts
  • Easy Manner in communicating. Maintain awareness to body posture; tone, volume and speed of voice; and smile

FAST: Self-respect effectiveness

  • Fair in interpretations/negotiations. Strive to come to solutions that are mutually beneficial and ethical
  • Apologies (no Apologies) Do not apologize for disagreeing if doing so contradicts your values.
  • Stick to values by figuring out what your personal values are and not giving them up to appease others.
  • Truthful communication, striving for honesty and authenticity in what and how you communicate with others.


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Dialectical Behavior Therapy Smartphone Applications Review

With the advent of digital information and the world-wide web, the world of psychotherapy and society in general continues to look for new and useful ways to incorporate digital technologies into our everyday lives. Here the focus is specific to smart phone applications (Android, iOS7, etc.) that aim to incorporate aspects of dialectical behavior therapy (DBT).

To date, a variety of said applications can be downloaded for free and/or for a modest price on the market (either by web, iTunes, and/or Google Play) and new ones are certainly on the way. Each app presented and discussed below includes download links, developer’s summarized descriptions verbatim, and my personal review notes following (highlighted in red, bold type).

This list means to provide a general overview of available applications with user notes and is provided purely for your reference. User’s are informed to use the listed applications at their own discretion and are aware that the information provided herein does not mean to replace therapy provided by qualified mental health professionals.

Rachel Gill aka Pinki Tuscaderro
DBT Peer Connections Founder

A Pilot Study of the DBT Coach: An Interactive Mobile Phone Application for Individuals With Borderline Personality Disorder and Substance Use Disorder
Shireen L. Rizvi, Linda A. Dimeff, Julie Skutch, David Carroll Parsons, Marsha M. Linehan – Dialectical behavior therapy (DBT) has received strong empirical support and is practiced widely as a treatment for borderline personality disorder (BPD) and BPD with comorbid substance use disorders (BPD-SUD). Therapeutic success in DBT requires that individuals generalize newly acquired skills to their natural environment. However, there have been only a limited number of options available to achieve this end. The primary goal of this research was to develop and test the feasibility of the DBT Coach, a software application for a smartphone, designed specifically to enhance generalization of a specific DBT skill (opposite action) among individuals with BPD-SUD

*Note: The link above refers readers to the scientific research literature for this application. Currently the app is not available for public consumption.

Optimism
FREE (Windows, Mac OSX, iPhone, Web)

Optimism apps are self-tracking applications, designed to help you increase your understanding of all the things that affect your mental health. The apps act as a springboard to detect patterns in your health and develop strategies to proactively manage depression, bipolar disorder, and other mental health conditions.

*Note: This seems to be the most flexible FREE software for managing a Dialectical Behavior Therapy (DBT) Diary Card and skills tracking digitally in that it provides synchronization across devices and the web, offers graphical interface for viewing skills/target behaviors over time (Fig. B), provides a customizable reminder function, and has clinician management option to allow for collaboration and/or sharing reports (Fig. C) that may be sent to self, therapist, etc. according to user preference. In my case, I have a weekly report sent at 7pm the night before my individual session to my therapist so she may have my diary card on hand before I arrive for therapy.

However, there is a catch to using this software as a diary card. The interface must be manually configured with DBT specific data elements provided and arranged according to your own preference. This took me some time to figure out through trial and error. I contacted the developer about creating a function for saving/distributing user templates, which may be included in future updates. This software is recommended for advanced computer/mobile application users. However, the good news is that all my hard work is summed up in the screenshot below. (Fig. A) which will surely cut your set up time to a minimum.

OPTIMISM SOFTWARE DBT DIARY CARD SETUP INSTRUCTIONS:

  1. Go to https://www.optimismonline.com/register.php and register with the website. This allows you to fill in your diary card, receive reminder notifications, and synchronize your data across devices. For example, I can fill in my card on my computer, synchronize data, then open the app on my iPhone and the data I entered through my computer will show up on my iPhone/iPad. (Android version is under development, according to the developer.
  2. Go to http://www.findingoptimism.com/ and download the software for your computer (Windows, Mac OSX) to your desktop or other related folder.
  3. Open newly installed software from your programs start menu (Windows) or applications folder (Mac)
  4. In the main screen, click the CUSTOM button in the CORE DATA, then STAY WELL STRATEGIES, TRIGGERS,  and SYMPTOMS, respectively renaming each section and customizing data according to screenshot below (FIGURE A) from my software configuration.
  5. After your software is configured, Point to title bar option FILE then click ONLINE SYNC.
  6. Click next to skip through the ONLINE SYNC introduction screen.
  7. Login to the Optimism server using your USERNAME and PASSWORD that you created when registering with the Optimism Software website. (See step 1).
  8. Select UPLOAD date from this software to the online database.
  9. Click CONTINUE. Congratulations your DBT diary card is now set up and ready for tracking.
  10. OPTIONAL: If you have an iPhone/iPad, go to https://itunes.apple.com/us/app/optimism/id352262677?mt=8 and download the app from iTunes and sign in using the information you provided for registration. (See step 1)

FIGURE A.

 

FIGURE B.

Optimism Software Charts Screen Shot

FIGURE C. 

optimism report Screenshot for DBT diary card configuration

 

A Simple & Free DBT Skills Diary Card App

Free (iPhone only)

A Diary Log for each day with 28 skills. – A Description of Each Skill if you Forget – Examples of Each Skill – A record keeping system that tracks your highest number of days you have ever logged in a row as well as your current streak. – Statistical information based on 1 day, 7 days, 28 days, or ALL records. – A daily log. – A Notification reminder that you can set to remind you daily at a specific time – Ability to share this app through Facebook, Twitter, E-Mail, or Text Message. – Beautiful photos and artwork – Add your own music to the DBT Skills Diary Card. – Full Version Users: You can now send PDF files with your diary card stats + notes via email, or print to your AirPrint. Email your therapist/counselor with just a few taps!

*Note: This is a great, simple to use DBT diary card. You fill out as the app asks you a series of questions, those who buy the full version have more options to track and manage data. This is a user friendly, great app for those are new to mobile apps or beta testing gurus.

Breathe2Relax
FREE (iPhone and Android)

is a portable stress management tool, which provides detailed information on the effects of stress on the body and instructions and practice exercises to help users learn the stress management skill called diaphragmatic breathing. Breathing exercises have been documented to decrease the body’s ‘fight-or-flight’ (stress) response, and help with mood stabilization, anger control, and anxiety management. Breathe2Relax can be used as a stand-alone stress reduction tool, or can be used in tandem with clinical care directed by a healthcare worker

*Note: This is a must have FREE mobile app for anyone with a smartphone who wants to help manage their stress. As a DBT related app, this software will help you build mindfulness to breath by providing you guided breathing instruction with visual graphics and audio that you can customize to the second according to your own inhale/exhale cycle. This app is highly recommended for those with anxiety, Panic and/or PTSD related symptoms

Bowls – Authentic Tibetan Singing Bowls
FREE (iPhone Only)

Swirl your fingers slowly around the edges of the bowls to create beautiful meditative harmonic tones. Tap the bowls, gongs, bells, and tingsha cymbals to add depth and variety to your music. NEW Feature! Record and save your masterpieces and play them back while relaxing or meditating to bring peace to your mind, body and soul. Use this app for meditation, music, relaxation, and personal well-being.

*Note: In DBT group skills training, sessions typically begin with a mindfulness practice that ideally utilize a tibetan singing bowl that is tapped 3 times to signal the start of a mindfulness practice and 1 time to signal the end of a mindfulness practice. This application is great for those who are leading mindfulness practices and are looking for a FREE, digital alternative to purchasing an expensive Tibetan singing bowl. The audio is excellent and nearly indistinguishable from the authentic bowl sound.

Mindfulness Bell
FREE (iPhone and Android)rings periodically during the day, to give you the opportunity to hold on for a moment and consider what you are currently doing, and in what state of mind you are while you are doing it. According to the Zen Buddhist teacher Thich Nhat Hanh, this is an effective means of developing mindfulness.


*Note This is a great FREE application for building mindfulness. I like to set the timer to go off randomly and periodically through the day to remind me to take a mindful moment to be present and breathe deeply. The audio is high quality.

DBT Review
FREE (iPhone only)
Manage your emotions and improve your relationships with DBT Review, a personal-use DBT tool. This app was designed as a learning adjunct for people learning DBT or working with a DBT therapist. The four categories of skills are covered. The app is based on Marsha Linehan’s “Cognitive-Behavioral Treatment for Borderline Personality Disorder” (1993). This app is not recommended for anyone unfamiliar with DBT skills and is not a substitute for therapy.


Note: This is a FREE DBT skills review application for those who are in the process of skills training and are still building your descriptive knowledge of individual skills. Although not as comprehensive as DBT Self-help, this is a decent FREE alternative.

 

DBT Diary
$4.99 (iPhone and Android)
helps you keep a diary of your daily urges, emotions and skills used. One of the challenges of keeping a diary it is easy to forget the exact details of events when you are filling out your diary at night or before a therapy session. The DBT Diary app solves this problem by helping you keep a detailed, accurate diary throughout the day, at the exact time of each event, wherever you are, by using your mobile device.


Note: This is a DBT diary card application that offers comprehensive data tracking. However, the interface is not all that user friendly. If you are willing to take the time to customize your software, I recommend using Optimism, which is much more flexible and has many more options for tracking/sharing/managing target behaviors/DBT skills use.

DBT Diary Card and Skills Coach
$4.99 (iPhone and Android)
What DBT Diary Card has to offer – Skills. LOTS of them. It can be your quick reference to your skills so that you don’t have to carry around your book or binder. Every skill is described in readable language to help you understand them easily and it’s all just a quick tap away – Emotions. All the “basic” emotions are presented, again with descriptions and explanations a quick tap away – Behaviors. The most troublesome are pre-loaded – Coaching. If you know you need to use a skill but can’t think of which one or can’t remember how to choose, use the app. The coaching can be your virtual therapist. – Complete customizability. Are you working on something different or do you have a different understanding of a particular skill or emotion? Change it. It’s that easy. You are not wedded to the way it’s presented in the app. It’s all completely customizable – 911 skills. Put your emergency skills a tap away. – Email.

Note: I have not personally used this application, so have no additional info to offer other than the developer’s provided description above. If you have used this application, please share your review with readers in the comments section.

DBT Self-help
$8.99 (iPhone and Android)
is a tool that helps you manage overwhelming emotions, break destructive impulsive behaviors, navigate relationships and cultivate mindfulness. It contains skill descriptions complete with rationale and practice tips that will enable you to develop and practice the needed skills. The skills are based upon the principles and skills taught in Dialectical Behavioral Therapy skill classes. The app can be used in conjunction with psychotherapy or as a standalone self-help intervention as the skills can be implemented into many situations and settings.

Note: This is a comprehensive DBT skills review application for those who are in the process of skills training and are still building your descriptive knowledge of individual skills.

DBT 911
FREE (Android only)
With this app, you will quickly get a random distress tolerance skill to do. In addition, for each module, Mindfulness, Emotional Control, Manage relationships, and Distress tolerance, are the skills represented and tutorials for these. Contains over 150 different suggestions on skill exercises. There is also the opportunity to create your own crisis list so you will always have it with you. An optional module for validation has been added as desired by participants. The application is designed in collaboration with the participants in DBT treatment. Dbt112 can never replace professional help, but can serve as a tool for DBT training.

*Note: This application provides reference to DBT skills. This app offers minimal information although it could be made more useful with some added effort from the developer. If you are looking for a DBT reference tool that is FREE and are not big on comprehensiveness, this app is for you.

DBT: Interpersonal Relationship Tools
$4.99 (iPhone only)
Build a D.E.A.R.M.A.N. using the DEARMAN builder on the spot! All the help you need to instantly make one on the spot. Save the DEARMAN’s you make along with priorities and load them up whenever you want! – An Intensity Calculator to help you figure out exactly how you should ask for what you want, or say no to others. – An Interpersonal Myth Checklist. Over time, keep track of how the myths you have in your head change! – A Validation Quiz. Do you know how to give validation to yourself and others? Use this quiz to get quick feedback on different scenarios so you learn how to give validation right away! – Troubleshooting to help you when you try to get what you want, but still can’t! – Beautiful Photography.

Note: This is a good app for those of you texters with fast fingers and it would be a useful app for people who are good at typing if it were a desktop application. The tool as afar as it references DBT skills, does a good job of stayiung in line with the skills learned in the Interpersonal Effectiveness Skills module. The downside is that the interface lacks automation and requires mostly text entries, which can be tedious on mobile devices. If you want to keep your interpersonal skills at arms reach at all times though it is worth the five dollars.

DBT Emotion Regulation Tools
$7.99 (iPhone only)

With Eight DBT Tools: Understand My Emotion, Emotional Myth Checklist: Short Term Happiness Tool, Long Term Happiness Tool, Observe & Describe Emotions, Opposite Action Calculator, Values & Priorities, Manage Extreme Emotions, Tips to use on the spot, and a number for the National Suicide Prevention Hotline.

Note: I have not personally used this application, so have no additional info to offer other than the developer’s provided description above. If you have used this application, please share your review with readers in the comment section.

Core Mindfulness Skills: DBT Peer Connections Skills Training Videos

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In the introductory video, viewers become oriented to DBT. In this first official episode of skills training, the viewer learns about mindfulness as it relates to a specific set of skills taught in dialectical behavior therapy. These are the first skills taught in DBT skills trainings group and are an essential first step to building DBT skills mastery.

I Love People with BPD!

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I don’t think changing the name of borderline personality disorder is going to end stigma. What we really need to do is to get others to just start loving people who have borderline personality disorder.  –Marsha LinehanI Love People with BPD!


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An Introduction to Dialectical Thinking According to DBT

Dialectical Thinking Diagram by Rachel Gill

To say that something is right or wrong is a moral judgment, a subjectively realized opinion. In other words, what may be right to you may be wrong to me and vice verse. For this reason, a primary objective in dialectical thinking is to eliminate unnecessary judgments. However, this is not to say that judging has no purpose.

To the contrary, judgments are a necessary means to human survival. Every day we make important judgments that help shape the course of our future like putting on a seat-belt before driving or waiting for the proper signal before entering a crosswalk. Rather, what dialectics is targeting in the context of judgments is an inflexibility of mind, black and white thinking.

In dialectical thinking, there is a conscious intent to build awareness to one’s own and others personal judgments. Through this state of awareness, one becomes able to realize, acknowledge, and then radically accept all points of view. To accept does not necessarily mean to agree with but rather to let go of all resistance to reality as it is.

Instead of tying oneself up in the misery of what one thinks life should or should not be, the wise mind realizes that life is just as it is regardless of how it causes one to feel. Although emotions are important and powerful, they may likewise convince us our beliefs and judgments are somehow greater or less than reality, this may be because our morals and values are things we tend to feel strongly about.

Therefore, rather than committing to judge oneself and others in a divisive or self-defeating manner, through the process of mindfulness, dialectical thinking, and reality acceptance, one not only reduces his or her psychological suffering, but opens the mind to the possibility of change. This balance of acceptance and change is a synthesis of wise mind and defines what it means to be dialectical.