DBT Skills Training – Mindfulness

Dialectical Behavior Therapy Treating Borderline Personality Disorder

Dialectical Behavior Therapy (DBT) is a type of psychotherapy developed by psychologist Marsha Linehan for the treatment of Borderline Personality Disorder (BPD). While Dialectical Behavior Therapy (DBT) skills were primarily developed for people diagnosed with Borderline Personality Disorder (BPD), the skills may be useful in the treatment of various mental health disorders in which clients struggle with poor coping and problematic emotional regulation.

Mindfulness Based Treatment

Dialectical Behavior Therapy (DBT) utilizes behavior therapy principles in conjunction with Eastern philosophical practices of mindfulness meditation. A client of Dialectical Behavior Therapy (DBT) has specific behavioral goals, which are achieved by utilizing skills to handle emotional and cognitive dysfunction.

A general goal of Dialectical Behavior Therapy (DBT) is to learn skills that will change behavioral, emotional and cognitive patterns that are associated with the client’s problematic living and cause distress. One of the hallmarks of Dialectical Behavior Therapy (DBT) is to set specific behavioral goals, namely to decrease the following: interpersonal chaos, labile moods (depression, anger), impulsiveness and confusion about oneself. Additionally, the following behaviors are to increase when utilizing Dialectical Behavior Therapy (DBT) skills: interpersonal effectiveness, emotional regulation, distress tolerance and mindfulness. Dialectical Behavior Therapy (DBT) involves group therapy, individual therapy, family sessions as needed and crisis intervention.

Mindfulness DBT Skills

Mindfulness is one of the Dialectical Behavior Therapy (DBT) skills. Marsha Linehan explains the theory behind mindfulness as useful tool by identifying the differences between what she names “reasonable mind,” “emotional mind,” and “wise mind.”

Reasonable Mind

Reasonable mind is identified as the scientific and analytical part of your mind, which is often useful, though there may be times when it is not as useful. For example, reasonable mind maybe useful when one is paying bills or planning her schedule, but may not be useful if one is watching a play through reasonable mind and unable to enjoy the play because she thinks “this could never happen in real life.”

Emotional Mind

Emotional mind is the creative part of one’s mind. Interpersonal communication occurs through emotional mind. Emotional mind may be beneficial in certain aspects of interpersonal relationships, such as empathizing or writing a love sonnet; although, emotional mind may not, however be useful when budgeting one’s finances because emotional mind could lead someone to carelessly shop without considering the losses. Emotional mind may be largely affected by sleep deprivation or low blood sugar.

Wise Mind

According to Marcia Linehan, wise mind is an integration of reasonable mind and emotional mind, the intuitive mind taking experiences in as a whole, using both mind and body. Mindfulness-based skills in Dialectical Behavior Therapy (DBT) attempt to foster the client’s use of wise mind.

Dialectical Behavior Therapy (DBT) teaches mindfulness meditation skills as the “what” skills, meeting clients are taught to identify and notice “what” is occurring in each moment. The first part of mindfulness taught in Dialectical Behavior Therapy (DBT) is to observe one’s experience. Clients are taught to just notice their experiences, without judging the experience in any way. They are taught to not react to the experience, just notice it. Clients are taught to control their attention by paying attention to each moment and not clinging or pushing away anything. Clients are taught to remain alert to every thought, feeling and sensation that occurs in their body without judging it. There are taught to watch their thoughts come and go, notice each feeling rise and fall like leaves in an ocean. They are taught to notice there are physiological sensations in each moment. Dialectical Behavior Therapy (DBT) teaches clients to notice their senses and what is entering their body through their eyes, ears, nose, skin and mouth.

The next step taught in Dialectical Behavior Therapy (DBT) with regard to mindfulness meditation skills involve the client describing, without evaluation or judgment, the experience. The client is to describe the feeling that he has inside, the physiological sensation, the thought that entered his mind or the behavior that he has engaged in. The experience should be put into words, such as, “I am having a thought” or “I am having a feeling.”

The final part of meditation that is taught in Dialectical Behavior Therapy (DBT) involves participating in one’s experience. This step involves completely forgetting yourself and becoming one with your experience. Ruminating is to be let go and the client is taught to completely be immersed in the moment. The client is taught to act intuitively from wise mind and actively practice accepting the situation as it is, changing harmful situations and changing harmful reactions to situations.

Clients are taught to identify situations where they used wise mind, emotional mind or reasonable mind. Wise mind is the ideal state of mind, when you are using your best instinct and gut feeling. Clients give examples of when they used wise mind in the recent or remote past. They then do the same for emotional mind and reasonable mind. Reasonable mind involves thinking and logic and emotional mind involves feelings like anger, happy or emotional experiences like listening to music.

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