DBT skills: self-help for borderlines
If you're a tulip, don't try to be a rose. Go find a tulip garden. All of my clients are tulips, and they're trying to be roses. It doesn't work.
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(Marsha Linehan, founder of DBT)
DBT Skills according to Marsha Linehan
Skills describe skills that effectively help to reduce states of tension . In crisis situations they help to reduce destructive behavior such as self-harm or binge eating. Affected people learn to deal better and harmlessly with tension.
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For the exercises to be effective, they must be used regularly - ideally in relaxed states. In the event of a high level of tension, it can be used immediately because it is stored in the brain.
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The DBT works on a scale of tension that helps decide which exercises to use:
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0 - 30% no to low tension (skills to improve mindfulness)
30 - 70% medium to high tension (e.g. skills for dealing with feelings)
70 - 100% high voltage (stress tolerance skills)
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Emotions and Borderline Personality Disorder: Skills Help
Feelings are responsible for high tension. They secured and safeguard our survival - fear, anger, shame or joy all serve a specific purpose and are neither good nor bad.
They influence our thinking and here it is important how we deal with emotions. For example, fear can trigger an escape reflex, but we do not need to pursue it when we are in a safe environment. Skills help us to classify and evaluate feelings better and to react more calmly.
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In the next section I describe the 5 skills modules of dialectical behavioral therapy (DBT) closer: Try for yourself what is most effective and try to practice regularly. Through mindfulness you will learn to recognize early warning signs of high voltage and self-harming behavior and thus to prevent them.
In the 1st module of the 5 skills modules, those affected learn inner mindfulness, on which the other modules are based . All modules are:
DBT Skills according to Marsha Linehan: Dealing with borderlines
If you have a problem, you have the following options:
Solve the problem: change , avoid or leave the situation - interpersonal skills
Finding a better way of dealing with the problem - dealing with feelings
Accept the problem - inside Mindfulness and Stress Tolerance
Keep feeling bad - No! Apply the skills :)
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Every feeling, every action has a reason - even if our behavior is sometimes incomprehensible, there are reasons why we have learned to act like this. It's easier to criticize and crush us for it. However, we can also learn to act and actively shape our lives: If we positively change the triggers that trigger our behavior.
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Situation analysis: step by step through the borderline chain
In this step you describe your specific problem behavior , how for example exploding in anger. Proceed as follows:
Reconstruct the situation in which you exploded - be very specific (e.g. instead of clearly defining bad feelings: sadness, self-hatred). Describe exactly what you said, done, felt and the intensity of those feelings.
What situation started the chain reaction that caused you to explode?
Which impulse, which thought triggered the problem behavior?
Why were you vulnerable at that point? (e.g. physical illness, poor sleep, influence of medication or intoxicants, stress, feeling sad / angry, etc.)
Describe everything exactly so that an actor could use it to play a play.
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Example: I sat down and wanted to be quiet. I felt stressed and annoyed because I didn't know what training to do. Erika entered the room, obviously in a bad mood and aggressive, she began to provoke the person sitting next to me.
I felt that I had to step in and de-escalate. In that moment I lost touch with myself and was with the others. I immediately got angry and aggressive, but still tried to be calm. Then Erika screamed very condescending things, I turned around and yelled at her to shut up. At the same moment I was so disappointed in myself because I went nuts again and everyone was staring at me in shock.
Borderline DBT Stress tolerance skills: from 70% tension
You use these skills when you are in high tension . You distract yourself with strong - but not hurtful - stimuli. This is how you learn to endure this tension and to reduce it again. By using it, you will stop the aggravation and manage to end the condition faster. Stress tolerance skills are divided into :
Action-related skills:
do something actively, e.g. B. Running, swimming, dancing
social activities, e.g. B. taking care of someone, playing chess with someone
Change feelings, e.g. B. watch a comedy when you are sad
Body-related skills:
Focus on breathing, e.g. B. Breathing exercises according to instructions
targeted relaxation exercises, e.g. B. Jacobsen, Autogenic Training
Thought-related skills:
compare with people who are worse off
Brain "flick-flacks", e.g. B. Name fruit from A to Z, always subtract 5 from 100
Visiting a place of well-being in your mind
Sensory skills - consciously focusing on sensory perception:
see consciously, e.g. B. how water flows, concentration games
to taste consciously, e.g. B. chew spicy candies, chilli peppers
feel consciously, e.g. B. Head in cold water, hedgehog ball or rubber band on the hand
listen consciously, e.g. B. Favorite song, encouraging music
smell consciously, e.g. B. hot spices, Japanese medicinal plant oil
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So that you have it "to hand" immediately in a crisis, I recommend that you make an emergency kit .
DBT Skills Borderline: Inner Mindfulness - Tension 0-30%
Behind the idea of inner mindfulness lies the fact that people with borderline personality disorder mostly devalue, criticize and picture disasters . You are in a negative spiral about yourself, situations and emotions. Just because of these thoughts, their tension constantly increases, which leads to destructive attempts at solutions such as self-harm.
With inner mindfulness you learn to observe how you deal with yourself and to stop bad mechanisms at an early stage . The acceptance of what is creates space for change. This also includes radical acceptance, e.g. B. "I am angry and that's okay too" (instead of devaluing myself immediately and increasing the anger). Through inner mindfulness you learn to be in control and to feel yourself without being flooded with emotions and thoughts.
The following skills help here:
What-Skills: What Do I Do?
Observe: what is happening in me, what am I doing?
Describe: Describe from moment to moment what happened in order to understand what was going on
Participate: In the "here and now" being fully focused on one thing through awareness - in this state of concentration one cannot devalue oneself at the same time
How-Skills: How Do I Do It?
Free of evaluation: People with borderline tend to evaluate very quickly and usually more negatively - this is about accepting too factually and neutrally: what is is neither bad nor good.
Concentrated: In order to stay fully in the present, we have to recognize and stop evaluation early on.
Effective: Doing the right things at the right time - what is possible now?
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Concrete exercises - we experience mindfulness through our sense organs
Do the exercises very consciously and slowly - you will notice how you relax through concentration.
see: "explore" the environment - look down / up, sideways, straight ahead. What do you see? Is something new or different? Which color predominates?
hearing: listening in the forest - what exactly am I hearing? How close or far are which noises, sounds and tones? Which are loud, what do I hear very quietly? Is it a lot of noise?
smell: the smell of a coffee bean - what do I smell and how do I describe this smell? (earthy, intense, pleasant etc.) ​
taste: sucking hot candy - what do I taste on my tongue? Where can I taste it on my tongue? How do I describe the taste? (fruity, hot, pleasant etc.)
feel: the wet grass - how did the wet grass feel on my feet? What is the ambient temperature? What do I feel when I walk consciously? How is my breath
DBT skills borderline: dealing with feelings - tension level 30% - 70%
What to do if I feel very tense? The important thing is: every feeling has a justification , even if you cannot assign it at first. Notice it mindfully and try to describe it. Is it appropriate for the situation? It always helped me think about my best friend and how he would react. If my reaction was too intense - compared to my "healthy" friend, I used skills to weaken it.
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Example of DBT skills dealing with feelings:
Situation A: You discover a bear in the forest and feel fear. Check whether someone you trust would also feel fear - probably they would! Thus the feeling is appropriate and you can act according to the feeling.
Situation B: You discover a beetle in the forest and feel fear. Check to see if someone you trusted would also experience fear - probably not. So you should n't pursue the impulse to act like escape or seek protection .
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But how do you deal with fear?
Through the skills dealing with feelings you will learn to weaken feelings by:
opposite action: actively deal with the action and stay instead of flying. In this way you can experience that the beetle won't hurt you.
Opposite posture: Assume an upright and proud posture instead of making yourself small.
Opposite thinking: Check if the beetle could really be a threat. Do a reality check - what is the risk that the bug will put you in danger?
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The goal for borderline sufferers is in this area
Observing and describing feelings and understanding their effects
minimize emotional vulnerability
Reducing emotional suffering
Make space for positive feelings
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How do I perceive feelings? By observing, describing and specifically naming , those affected get to know their emotions. In the next step, they should assign which feelings and respective actions are appropriate and which are not.
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By doing this, those affected by borderline personality disorder learn to deal with their feelings more consciously . They learn to understand what is going on in them. It is important to realize that the feeling is only part and not everything.
An example: I told my therapist that everything was bad, I didn't want to live anymore - she asks: Can you see that this is a part that is not doing well at the moment? In addition, there is still your joie de vivre, your creative part, etc. So I didn't just learn to see black and white. If I felt bad, I learned to say to myself: Part of me is not doing well today. And that's okay. (Application of radical acceptance )
So I learned not to fall so deep and not to sit in the hole for so long. The following sentence can also help here: I am not the feeling - I have a feeling.
DBT Skills for Borderline Disorder to Self-Esteem
Borderline people often put themselves down very badly and suffer from very low self-esteem. They should learn that they too are worth something and important. By having a better attitude towards yourself, you will take better care of yourself and take care of yourself. Healthy self-confidence and self-acceptance are a very important step towards a happier life.
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The aim is to treat yourself fairly and to learn to look at yourself lovingly. People with borderline are ashamed and punish themselves very often and very intensely because of their history. The distorted body perception often makes them feel ugly, and the loss of control over their feelings makes them unreasonable. In this module, those affected learn to accept what is and to be more friendly and loving with themselves .
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The exercises include developing awareness of your own thoughts: How do I treat myself, when and why? (Identify triggers) Then you pay attention to what would be good, what is good and reinforce these things . An important step in this is: Recognize beliefs (e.g. I hate myself and want to die) and change them (e.g. it is good that I am born and I accept that).
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DBT skills for borderline interpersonal relationships
The aim of this module is:
Building good relationships and ending destructive ones (e.g. resolving conflicts before they get too big, strengthening good relationships)
Finding a "middle ground" (e.g. creating and maintaining an even balance)
communicate what is needed (e.g. get others to take you seriously; show clear boundaries)
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This includes the following framework conditions:
Clarify priorities: will the relationship help me? Is it good for me to keep the relationship? Can I keep my self-respect while doing this?
Representing wishes and rights effectively
Shape the relationship so that it is positive and others are comfortable around you
Maintaining self-respect: Behave in a way that allows you to maintain self-respect
Intensity: Decide how close and intense you want to shape the relationship and your limits
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People with borderline personality disorder also have needs and these often neglect them. The aim is to learn to feel your own needs again and to stand up for them. At the same time, those affected should recognize their own destructive behavior early enough to avoid it. Social competence and thus relationships with others should thereby be strengthened .
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Sources for DBT skills on borderline:
https://www.mentalhealthcrowd.de/dbt-und-achtsamkeit/ (accessed on: October 12, 21, 8:30 a.m.)
http://www.blumenwiesen.org/dbt.html (Accessed on: October 12, 21, 8:34 a.m.)
https://www.parkland-klinik.de/fileadmin/Parkland-Klink/Mediathek_pdf-Dateien/Parkland-Klinik__PLK-Flyer-Skills_zur_Krisenbewaeltigung.pdf (Accessed on: October 12, 21, 9:12 a.m.)
Bohus, M., Wolf, M. (2011). Interactive skills training for borderline patients. Manual for the CD-ROM for therapeutic work. 1. corrected reprint. Schattauer.
Brähler, Ch. (2020). New ways out of loneliness: With self-compassion to more connectedness. Irisiana.
Germer, Ch. (2015). The Mindful Path to Self-Compassion: How to Get Rid of Destructive Thoughts and Feelings. 1st edition. Arbor.
Neff, K. (2012). Self-compassion. How to reconcile with our weaknesses and become best friends to ourselves. 11th edition. Kailash.
Neff, K., Germer, Ch. (2019). Self-compassion - the exercise book: A proven way to self-acceptance, inner strength and friendship with yourself. New edition. Arbor.
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