DBT Skills for a New Season

Dialectical behavior therapy (or DBT) skills are a cornerstone component of clinical programming at Carolina House. We teach DBT skills at each level of care, and clients, staff, family, and friends all practice them. Many DBT techniques incorporate easy-to-remember acronyms.

The Carolina House clinical team compiled a list of DBT refreshers as we move away from summer into fall. Fall is a time of transition: changes in routine, work, school, and extracurricular activities. Take some time to review the following DBT skill list, and put them in your toolbox as we navigate this season of change.

TIP Skills
TIP skills change body chemistry in a crisis to reduce extreme emotions. “T” stands for temperature: Hold an ice pack or something cold. “I” stands for intensity: Being scared, crying, screaming, or punching a pillow are all appropriate forms of intensity. “P” stands for paced breathing: Breathe slowly and steadily. It can also stand for paired muscle relaxation. While breathing in, tense your muscles, and as you breathe out, relax.

Conscious Breathing
With conscious breathing, the main focus is awareness of the breath. There are lots of ways to do this: Breathe deeply, count to four as you breathe in and count to four as you breathe out, breathe in and out on a mantra, etc. Breathing is one of the most powerful ways we can help regulate our nervous system and decrease stress and anxiety.

“What” Skills
“What” skills help clients find grounding. In this skill, you observe, describe, and participate in what is currently happening. Try to do this without judgment. This is particularly hard when your experience is difficult, sad, or painful.

To practice observing, try putting one hand on a cool surface and the other on a warm surface. Notice the sensation on each hand for three breaths. Pay attention to how the sensation and temperature changes.

“How” Skills
“How” skills are the manner in which we hope to operate our “what” skills: nonjudgmentally, single-mindedly, and effectively. When practicing mindfulness, let go of judgments. Stick to the facts when describing something. Focus on the who, what, when, and where.

Nonjudgmental Stance
Taking a nonjudgmental stance is often harder to do in the moment than we expect. When you’re frustrated or angry, it’s difficult not to judge. But it can also be quite helpful. For example:

  • DON’T say: “It’s too hot today.”
  • DO say: “I better remember to grab my water bottle before heading out in this heat.”

You can also use this stance to describe relationships.

  • DON’T: “My partner is an inconsiderate jerk.”
  • DO: “I’ve had a crazy week, and it’s very frustrating to me that my partner is not helping out more.”

By taking a nonjudgmental stance, you take power away from emotions like anger, and you work toward problem-solving.

Willing Hands
Use “willing hands” when you feel angry. Place your hands on your lap or your thighs. With your hands unclenched, turn them outward with your palms up and fingers relaxed. This body language sends a message to your brain that signals you to be less angry. Remember, your face communicates to your brain and your body connects to your mind. A tip: Practice doing willing hands while imagining someone you are angry with. Observe how it felt to imagine being angry at someone with your hands open.