Mindfulness and DBT: “What” Skills

As promised yesterday, I am writing today more about the specifics about the use of mindfulness in trauma treatment. If you think about it, mindfulness is really the antithesis of dissociation, with its focus on being present in this moment and “training your mind to pay attention to what you choose to pay attention to instead of letting your mind hijack you.” (Cindy Sanderson, Ph.D., Mindfulness for Clients, their Friends, and Family Members). Although dissociation was a life-saver for you as a child living amidst trauma, we’ve talked before about understanding how it may be getting in your way as an adult.

In Dialectical Behavioral Therapy (DBT), mindfulness is broken down into six specific types of skills. The first three are referred to as “what” skills in Marsha Linehan’s Skills Training Manual for Treating Borderline Personality Disorder (1993). So you want to practice mindfulness, what exactly do you do?

1.  Observe

  • Just notice the experience. Notice without getting caught in the experience. Experience without reacting to your experience.
  • Have a “Teflon Mind” letting experiences, feelings, and thoughts come into your mind and slip right out.
  • Control your attention, but not what you see. Push away nothing. Cling to nothing.
  • Be like a guard at the palace gate, Alert to every thought, feeling, and actions that comes through the gate of your mind.
  • Step inside yourself and observe. Watch your thoughts coming and going, like clouds in the sky. Notice each feeling rising and falling, like waves in the ocean. Notice exactly what you are doing.
  • Notice what comes through your Senses: your eyes, ears, nose, skin, tongue. See others’ actions and expressions.
    “Smell the roses.”

Can you see how learning to observe could be useful for trauma survivors? How could you apply this as part of phase I, the stabilization phase, of trauma therapy? I think focusing on sensory input is an especially powerful grounding technique, one I often use to help survivors come back from a dissociated state. I see learning to observe whatever emotion you are experiencing in the moment as a way to begin to develop emotion regulation abilities.

2. Describe

  • Put words on the experience. When a feeling or thought arises, or you do something, acknowledge it. For example, say in your mind, “Sadness has just enveloped me.”… or… “My stomach muscles are tightening.”… or… “A thought ‘I can’t do this’ has come into my mind”… or… “walking, step, step, step…”
  • Put experiences into words. Describe to yourself what is happening.
    Put a name on your feelings. Call a thought just a thought, a feeling just a feeling. Don’t get caught in content.

What about these describing skills? Putting words to experiences and emotions can be a way of gaining a sense of control or mastery over them. Often complex trauma survivors have not developed the ability to differentiate and name different affective states. This can lead to them feeling all that much more overwhelming. Knowing that you are sad or lonely can give you more options. If you are lonely, maybe you need to reach out to a safe support person, Whereas if it is sadness you are experiencing maybe you need time alone to cry. Also, naming a thought and a feeling as just that can help you separate it from a fact. So “I feel worthless” is different from you actually being worthless!

3. Participate

  • Enter into your experience. Let yourself get involved in the moment, letting go of ruminating. Become one with your experience, completely forgetting yourself.
  • Act intuitively from Wise Mind. Do just what is needed in each situation, like a skillful dancer on the dance floor, be one with the music and your partner, neither willful nor sitting on your hands.
  • Actively Practice your skills as you learn them until they become a part of you, so that you use them without self-consciousness. Practice: changing harmful situations, changing your harmful reactions to situations and accepting yourself and the situation as they are.

I love that participate is include among the components of mindfulness. I think this helps to stress that these are new skills that take active engagement with in order to master. I often talk with trauma survivors about practicing mindfulness (or any self-care skills) consistently over time, like you would riding a bike or lifting weights, in order to develop new self-soothing “muscles” or capabilities.

As always, I’d love to hear your experiences with mindfulness. What works for you and what does not. Does this list of “what” skills make sense or raise more questions? Feel free to chime in!

Kathleen Young Psy.D.

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11 Responses to Mindfulness and DBT: “What” Skills

  1. Pingback: Tweets that mention Mindfulness and DBT: “What” Skills | Dr. Kathleen Young: Treating Trauma in Chicago -- Topsy.com

  2. Pingback: How to Practice Mindfulness | Dr. Kathleen Young: Treating Trauma in Chicago

  3. Thank you sharing DBT’s “What” skills of mindfulness. I enjoy writing about mindfulness and other DBT skills on my blog: http://LauraSchenck.com

    I am currently working on a post about DBT’s “What” skills of mindfulness as well and found your post helpful and inspiring.

  4. Healing says:

    Do you find that DBT works well with DID clients or does DBT need to be used with caution like EMDR does with DID clients?

    • I think it depends on the client and the aspects of DBT used. I think the program in its entirety could be challenging or even unproductive for folks with DID who are not co-conscious and if the therapists are not skilled at treating DID.
      I think teaching skills like those described here can benefit many, though I have learned from prior posts on this topic that some are very turned off by anything related to mindfulness.

  5. Thank you so much. I am currently starting a journey into DBT (the NHS won’t provide it so I am learning myself). This article was really helpful to me. x

  6. Pingback: Core Mindfulness – Part two (‘What’ skills) | Living with BPD

  7. Nicole says:

    I have found your posts on mindfulness very helpful. I have been in treatment for a couple of years for chronic ptsd and having recently changed to a new therapist who specialises in trauma, I have been introduced to Mindfulness for the first time. The level of relaxation and moments of being completely stress free that I experience when either learning this in session, or practising on my own, is a feeling I havent had for many years. It helps me realise that it is still possible for me to have that calmness in my life and I can see that this is possibly a way through the anxiety that has in the past prevented me being able to talk about my trauma. I highly recommend those that need this either seek out a therapist who uses mindfulness in their treatment, or look for ways to self learn these techniques. I would certainly appreciate any recommendations on books for learning Mindfulness techniques.

  8. melissa says:

    I need to find some relatively cheaper DBT training for myself. Is there anywhere in Chicago that offers low cost training for clinical social workers in DBT? Thank you!

  9. Sheraz A says:

    Your website is so cool. I am impressed by the info that you have on this site. It reveals how nicely you understand this subject.

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