When a DBT Skill Works

This was also published on The Mighty: What Happened When I Used a Skill I Learned in Dialectical Behavioral Therapy

I’ve been in DBT for several months now, and am just finishing my first round through the modules. Though I’ve seen some progress with how I handle extreme emotions, progress has felt slow or even nonexistent at times. This is frustrating because I want to feel better as fast as possible, which is perhaps unrealistic when you are trying to change deeply ingrained thought and behavior patterns.

DBT’s Standpoint on Blame

DBT contends that a patient can’t fail the therapy, so I know it isn’t my fault DBT hasn’t “worked” yet. Still, DBT also says that even though we are trying our hardest, we can always try harder. Got to love those dialectics, right? So, as much as I want to push the blame completely off myself, which is valid, I must also acknowledge that I can put more effort into practicing skills if I want the full benefits of DBT.

Giving DBT 110%

Every so often, I’m able to do this. I put 110% into picking and applying a skill to a situation. Just the other day, I was emotionally overwhelmed after attending a meeting related to my thesis and receiving a stressful text. As soon as I got home, I pulled out my DBT workbook, used the self-soothe skill, followed the instructions to write a DEARMAN as a response to the text, and then used opposite action to study for the GRE, which I had been avoiding.

And what happens these times I really commit to DBT? Nine times out of ten, using the skills works beautifully. The interaction over text went smoothly. I studied what I was avoiding, plus a little extra. I handled the situation effectively, was more in control of my emotions, and generally felt better.

The Difficulty of Using Skills

So, why don’t I do this more often if it works? For one thing, it’s incredibly difficult. Throwing yourself completely into a skill requires a lot of energy, plus a fair amount of hope. There is no guarantee a skill will work, so trying requires being vulnerable. Logically, I know I have a better chance of feeling better if I try at a skill than if I do nothing, but that doesn’t necessarily make it easier. After all, not using skills is what I’ve been practicing for most of my life.

Reinforcing Skill Usage

The best way to increase skill use though, is to strongly reinforce when it happens. This can mean whatever would be gratifying to you. My favorite rewards are simple: candy and time to read. I also make sure to tell my therapist about successes. Her validation and praise are strong reinforcers. For someone else, a reward could mean shopping or watching a movie. Positive reinforcement is a powerful tool. Whatever works for you, use that.

Beyond these external rewards, one last crucial reinforcer is taking time to feel proud of yourself. If you gave 110% using a skill, whether or not it worked, take a few minutes to appreciate that and practice self-compassion. External reinforcers are great, but you also deserve to pat yourself on the back from time to time. That can make all the difference in choosing to help yourself by using a skill again.

Morgan

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