DBT Coping Skills
The coping skills on this page all come from a treatment called dialectical behaviour therapy. DBT was developed for people with borderline personality disorder, but anyone who self-harms may find it useful. The skills are divided into four areas: mindfulness, getting through a crisis, managing your mood and relationship skills.
If you're interested in learning these skills, I highly recommend two websites which explain them far better than I ever could. The first is the free online DBT Class run by BPD from the Inside Out which takes you through one skill each week with a short homework assignment. The other is DBT Self-Help which provides lots of information on all the DBT skills. You can also find a selection of DBT self-help books in our Bookstore.
This page provides a summary of the main DBT skills with links to further help and information. If you're already familiar with DBT, you can use it as a reminder. If you're new to DBT, you'll need to click on the links to find out more.
Mindfulness is the art of paying attention to your thoughts, actions and experiences in the present moment without judging. I've found that mindfulness is grounding, reduces my stress levels and makes it easier to cope with any problems in life, so that I'm less likely to want to self-harm.
What to do (summary)
How to do it (summary)
DBT also teaches that there are three states of mind: reasonable mind, which is rational and logical; emotional mind, when emotions control or influence our thoughts and behaviour; and wise mind, which is a healthy balance of the two.
Distress tolerance skills are skills for coping with distressing emotions, events and crises. Once learned, these skills can be used in the heat of the moment as an alternative to self-harm.
Distraction techniques can be remembered with the acronym ACCEPTS:
- Contributing (helping others)
- Comparisons (with other people)
- opposite Emotions (e.g. watching a film or listening to music that will trigger a different emotion)
- Pushing away (mentally blocking the situation)
Self-soothing techniques focus on the five senses and have to do with nurturing, comforting and being kind to yourself.
IMPROVE the moment is an acronym for a set of skills:
- Imagery (e.g. create an imaginary "safe place")
- find Meaning in the crisis
- One thing at a time
- Vacation (take some time out)
- Encouragement (talk to yourself in an encouraging way)
Pros & cons involves weighing up the advantages and disadvantages of different courses of action.
Radical acceptance involves accepting reality as it truly is. That doesn't mean you have to like or approve of the situation, but it means you stop fighting reality. Radical acceptance can be a way to avoid unnecessary suffering.
Emotion regulation skills help you to understand the way you feel and manage your emotions. DBT teaches that emotions are not right or wrong - they just are. It is very important to validate the way you feel, but you can also learn ways of preventing or reducing negative emotions, and increasing positive ones. I find these skills work best when used together with CBT ones.
PLEASE Master is an acronym for a set of skills that can make you less vulnerable to negative emotions:
- treat Physical iLlness
- Eat healthily
- Avoid mood-altering drugs
- Sleep well (suggestions here)
- Mastery - do something every day that gives you a sense of competence or achievement
Being mindful of your current emotion is a way to reduce unnecessary suffering when you are feeling bad.
Acting opposite is a way of changing unpleasant emotions by doing the opposite of the way you feel - for example, doing something that scares you, or finding compassion for someone you are angry with.
In DBT, relationship skills are known as "interpersonal effectiveness" skills. This basically means being able to meet your goals in your relationships with other people. DBT teaches that there are three types of goals in relationships:
- objectives (getting what you want or saying no to what you don't want)
- relationship goals (keeping or improving the relationship)
- self-respect goals (feeling good about your behaviour and respecting your own values and beliefs)
DEAR MAN is an acronym of the skills needed for objectives:
- Describe the facts
- Express your feelings or opinions
- Assert your wishes
- Reinforce the positives (how the other person will benefit if they comply with your request)
- stay Mindful
- Appear confident
GIVE is for keeping or improving the relationship:
- be Gentle
- act Interested
- use an Easy manner
FAST is for self-respect:
- be Fair
- no Apologies
- Stick to values
- be Truthful
Obviously, you can use more than one set of skills at a time if you have more than one type of goal. However, it can be helpful to prioritise what is most important to you in a given situation - getting what you want, the relationship, or your self-respect.
The following links may also be useful:
- When to use interpersonal effectiveness
- Factors reducing interpersonal effectiveness
- Myths about interpersonal effectiveness
- Cheerleading statements
- Intensity options (how firm do you want you be?)
- Suggestions for practice
Behaviour chain analysis
You can do this exercise after you've self-harmed to help you understand all the factors that led up to it, and to look at what you could have done differently or can do differently in future. It can also be used for any problem behaviour - using drugs or alcohol, binge-eating, fighting with your partner, and so on.
Pocket reference card
A quick reminder of all the main DBT skills that you can carry in your wallet or pocket.