From Distress Tolerance to Interpersonal Effectiveness: A Guide to DBT Skills for Anxiety

Anxiety is a common mental health condition that can interfere with daily life, relationships, and overall well-being. While there are many different approaches to treating anxiety, one particularly effective therapy is Dialectical Behavior Therapy (DBT). DBT is a type of cognitive-behavioural therapy that focuses on helping individuals develop practical skills for managing difficult emotions, regulating behaviour, and improving interpersonal relationships.

In this blog post, we’ll explore some of the key DBT skills for managing anxiety, including distress tolerance, mindfulness, emotion regulation, and interpersonal effectiveness. We’ll provide an overview of each skill set and examples of specific skills that individuals can practice in their daily lives. While these skills can be helpful on their own, it’s important to note that learning them is best done through DBT therapy and peer group participation. By working with a trained therapist and a supportive community, individuals can develop these skills and apply them to their daily lives, leading to a happier and more fulfilling life.

Definition of Anxiety

Anxiety is a natural emotional response to stress, characterized by feelings of unease, worry, and apprehension. While some level of anxiety is normal and can even be helpful in certain situations, excessive anxiety can interfere with daily life, relationships, and overall well-being.

Overview of DBT (Dialectical Behavior Therapy)

DBT, or Dialectical Behavior Therapy, is a cognitive-behavioural therapy initially developed to treat individuals with Borderline Personality Disorder. However, DBT has also been found to be effective in treating a wide range of mental health conditions, including anxiety.

DBT focuses on helping individuals develop skills for managing difficult emotions, regulating behaviour, and improving interpersonal relationships. It combines elements of mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.

How DBT can help with anxiety

DBT can help individuals with anxiety by providing them with practical skills to manage their symptoms at the moment and strategies to address the underlying causes of their anxiety. By learning how to tolerate distress, regulate emotions, and communicate effectively with others, individuals can reduce their anxiety and improve their overall quality of life.

Description of distress tolerance

Distress tolerance skills are DBT skills that help individuals tolerate intense emotional distress without resorting to harmful or self-destructive behaviours. These skills are particularly helpful for individuals with anxiety, as anxiety can often cause intense feelings of distress and discomfort.

Examples of distress tolerance skills

1. Self-Soothe – This skill involves engaging in activities that provide comfort and relaxation, such as taking a warm bath, listening to soothing music, or practicing deep breathing exercises.
2. TIPP Skills – TIPP stands for Temperature, Intense exercise, Paced breathing, and Progressive muscle relaxation. These skills are designed to help individuals quickly reduce their emotional distress in the moment.
3. Distract with ACCEPTS – This skill involves using distraction techniques to shift attention away from distressing thoughts or emotions. Examples of distraction techniques include reading a book, watching a movie, or playing a game.
4. Radical Acceptance – This skill involves accepting and acknowledging the reality of a situation, even if it is not what we want or would choose. Radical acceptance can help individuals let go of feelings of anger, frustration, or disappointment and focus on moving forward.

Mindfulness Skills

Description of mindfulness

Mindfulness is the practice of being present in the moment and observing our thoughts and emotions without judgment. It can help individuals with anxiety by increasing their awareness of their thoughts and emotions and helping them respond more effectively.

Examples of mindfulness skills

1. One-mindfully – This skill involves focusing all our attention on one task or activity without distraction. This can help individuals with anxiety to stay grounded and reduce overwhelming feelings.
2. Observing – This skill involves observing our thoughts and emotions without judgment, like clouds passing by in the sky. This can help individuals with anxiety to detach from their thoughts and emotions and view them more objectively.
3. Non-judgmentally – This skill involves accepting our thoughts and emotions without judging them as good or bad. This can help individuals with anxiety reduce feelings of self-criticism and increase self-compassion.
4. Participating – This skill involves fully engaging in the present moment and participating in activities that bring us joy and fulfillment. This can help individuals with anxiety increase positive emotions and reduce distress.

Emotion Regulation Skills

Description of emotion regulation

Emotion regulation skills are DBT skills that help individuals identify and manage their emotions healthily. These skills can be particularly helpful for individuals with anxiety, as anxiety can often cause intense and overwhelming emotions.

Examples of emotion regulation skills

1. Check the Facts – This skill involves checking the facts of a situation and challenging any distorted thoughts or beliefs. This can help individuals with anxiety reduce feelings of fear and uncertainty.
2. Opposite Action – This skill involves acting oppositely to our emotions to change our feelings. This can help individuals with anxiety reduce feelings of distress and increase positive emotions.
3. Problem-Solving – This skill involves identifying the root causes of our anxiety and developing a plan to address them. This can help individuals with anxiety to feel more in control and reduce feelings of helplessness.
4. Build Positive Experiences – This skill involves intentionally seeking out positive experiences and emotions, such as spending time with loved ones, engaging in hobbies, or practicing gratitude. This can help individuals with anxiety increase positive emotions and reduce distress.

Interpersonal Effectiveness Skills

Description of interpersonal effectiveness

Interpersonal effectiveness skills are DBT skills that help individuals communicate effectively with others and build healthy relationships. These skills can be particularly helpful for individuals with anxiety, as anxiety can often cause difficulties in social situations.

Examples of interpersonal effectiveness skills

1. DEAR MAN – This skill involves using specific steps to communicate our needs and wants effectively. This can help individuals with anxiety to feel more confident and assertive in social situations.
2. GIVE – This skill involves using specific steps to maintain healthy relationships with others, even in the face of conflict or disagreement. This can help individuals with anxiety to reduce feelings of stress and improve their interpersonal relationships.
3. FAST – This skill involves using specific steps to maintain healthy boundaries and self-respect in social situations. This can help individuals with anxiety to feel more in control and reduce feelings of anxiety or guilt.
4. Self-Respect Effectiveness – This skill involves taking care of ourselves and setting healthy boundaries in our relationships with others. This can help individuals with anxiety to reduce feelings of overwhelm and increase feelings of self-respect.

Conclusion

DBT offers a variety of practical skills that can help individuals with anxiety manage their symptoms and improve their overall quality of life. From distress tolerance and mindfulness to emotion regulation and interpersonal effectiveness, these skills can be powerful tools for reducing anxiety and building resilience.

It’s important to note that learning these skills is best done through DBT therapy and DBT peer group participation. While practicing these skills alone can be helpful, working with a trained therapist and participating in a supportive peer group can provide additional guidance, support, and accountability. If you’re struggling with anxiety, consider seeking out a qualified DBT therapist or group to help you learn these skills and apply them to your daily life.